Not long before we left the state there was an OD in the parking lot of the building my office was in. Not sure if he died.
Portland was once perpetually in the top five most livable cities. Now it's a schidthole.
Yearly fentanyl overdose deaths in Oregon grew by an estimated 1,500% since before the pandemic, by far the largest increase in the United States, federal data show.
There were 77 known fentanyl overdose deaths in the state during the 12 months ending September 2019. Oregon deaths from the cheap, super-powerful opioid, mostly produced in China and Mexico and smuggled into the United States, ballooned to an estimated 1,268 during the 12 months ending September 2023, according to a federal analysis of the most recent available overdose-death data.
“That is a staggering statistic,” said Multnomah County Commissioner Sharon Meieran, who is also an emergency room doctor. “I knew it was bad, but I honestly did not know it was that bad.”
While the dramatic increase is at least in part due to Oregon recording so few deaths in 2019, the trend has been consistent: Oregon also recorded the highest percentage increase in fentanyl deaths from 2022 to 2023.
The precipitous rise means Oregon has shifted from a state with one of the lowest fentanyl death rates in America to one that’s now near the middle of the pack nationally — with no indication deaths will subside anytime soon. Oregon had the nation’s 17th-highest death rate last year, with 30 fentanyl overdose fatalities for every 100,000 people, up from ranking 36th out of the 39 states, including Washington, D.C., that reported fentanyl overdose deaths in 2019.
Illicit fentanyl has swept the country over the past decade, hitting East Coast locales earlier than Oregon but leaving few communities unaffected. It takes a very small dose of the chemical to get a person high, and a relatively small dose to kill. Some drug users seek out fentanyl deliberately, while others encounter it unknowingly mixed in with heroin or non-opioid substances like methamphetamine.
Fentanyl now accounts for the largest portion of overdose deaths from any drug in Oregon.
The carnage fentanyl has wrought in Oregon has prompted hand-wringing and political promises to take measures to tackle the crisis. Local and state officials came together last month to declare a 90-day fentanyl emergency in central Portland, intended to help cut through bureaucratic barriers to get people the help they need.
U.S. Centers for Disease Control and Prevention data shows exactly what they and other Oregon officials are up against.
Washington, D.C., and each of the 38 states that reported fentanyl deaths both in 2019 and last year saw such deaths climb, including 29 states where they doubled or more. The CDC calculated “predicted” death numbers to accommodate a lag in data reporting in some states, including in Oregon.
Oklahoma followed Oregon for the largest percentage increase from 2019 to 2023, with an estimated 717 deaths last year compared to 67 five years ago. Washington state was fourth, with deaths climbing nearly nine-fold in five years, to an estimated 2,653. On the other end of the spectrum, East Coast states, where the crisis started in the United States, had some of the lowest increases. New Jersey’s increase was the lowest, with fentanyl overdose deaths climbing 8% last year, to an estimated 2,377.
Oregon’s increase of about 1,530% tops the charts going away.
“Such a dramatic increase demonstrates that we are in crisis,” said Mike Marshall, director of Oregon Recovers, an advocacy group. “And a crisis requires a response.”
But while Oregon’s fentanyl death increase has been dramatic, state health officials point out that Oregon’s overall rate remains relatively in line compared to much of the country.
While the 10 states with the highest increases were all west of the Mississippi River, all but one of the 10 states with the highest death rates last year were east of it. Washington state, with 34 fentanyl overdose deaths per 100,000 people, was the exception. Washington, D.C., and West Virginia placed first and second both in 2019 and last year, now with 70 or more deaths for every 100,000 people.
Dr. Tom Jeanne, an Oregon Health Authority epidemiologist, said fentanyl hit eastern states several years earlier than western states because fentanyl, which usually comes in powder form, was easier to mix with the powder heroin common in the eastern United States. The heroin available on the West Coast, “black tar,” was harder to mix with fentanyl and far less potent, Jeanne said.
The “sudden and late” arrival of fentanyl in Oregon was exacerbated by the COVID-19 pandemic, he said, which increased isolation and dramatically reduced access to treatment.
Measure 110, the law intended to improve access to treatment at least in part by decriminalizing drug possession, has been widely criticized as a failure. But treatment options are available for people who want to quit fentanyl.
It’s unclear when or if fentanyl overdose deaths will level out in Oregon, Jeanne said.
“The increase is likely to keep going,” Jeanne said. “I can’t predict how soon it’ll start to slow down.”
