Lawmaker proposes legislation to address opioid overdoses

Oregon lawmakers will consider legislation this session aimed at preventing opioid overdoses that kill hundreds of Oregonians each year and account for a growing part of the state’s addiction epidemic. 

Opioid overdoses killed 280 Oregonians in 2019, a figure that more than doubled in 2021 with 745 deaths, according to Oregon Health Authority data. National studies show that Oregon has the second-highest overall drug addiction rate in the nation and the state ranks last in access to treatment. 

Rep. Maxine Dexter, D-Portland, is advancing changes aimed at making naloxone kits – which reverse overdoses – more available throughout Oregon, including schools, public buildings and for emergency personnel to give to people for future use. Now, mostly emergency personnel and health care workers have them for immediate use.

A critical care physician at Kaiser Permanente, Dexter said the state needs to address the epidemic head-on and provide the public with tools to reduce the risks and treat overdoses.

“These are lives that could have been saved with some pretty simple public health interventions for at least a good portion of them,” Dexter said in an interview with the Capital Chronicle. “We don’t have control over the drug supply and we’re not going to control the influx of illicitly manufactured fentanyl. … We need to do all that we can to make sure that the public’s aware of the risk, has tools to mitigate the risk, and has access to treatment.”

Pharmacists in Oregon can prescribe naloxone, often sold under the brand name Narcan. It only works against opioids.

Opioids come in different forms, including synthetic heroin, prescription painkillers and illegally manufactured fentanyl that has entered Oregon’s illicit drug market and is often mixed with other drugs. It is up to 100 times more potent than morphine.

Besides making naloxone more available, Dexter’s legislation would address the fentanyl threat:

• House Bill 2880 would remove pipes and fentanyl test strips from the state’s drug paraphernalia law, which currently criminalizes them except for providers. By making fentanyl test strips more available, the idea is that people could use them to test other substances, including street drugs, to ensure they don’t have fentanyl. Pipes would decrease the risk of overdose and other health risks from injecting drugs, HIV and hepatitis C.
• House Bill 2885 helps the owners of publicly accessible buildings – like stores, bars and other facilities – to obtain naloxone kits through the Oregon Health Authority. The authority would issue a standing order, which eliminates the need for business owners to get naloxone kits through prescriptions.
• House Bill 2887 would allow police, firefighters and other emergency responders to distribute naloxone kits to people for future use. First responders already administer naloxone to people suffering an opioid overdose.
• House Bill 2883 would shield public school staff from lawsuits and criminal charges if they administer naloxone to a minor student suffering an overdose without a parent’s permission. The law presently is unclear on this point. 
• Another proposal would allow minors under 15 to get access to addiction treatment without parental consent if the provider believes disclosure would put the youth at risk of harm. This is intended to address cases when addiction affects parents and children.

‘Harm reduction’ approach

Dexter said that the fentanyl test strips and pipe initiative is aimed at reducing the impact of opioids, or preventing more harm, though they currently are classified as drug paraphernalia.  She said she expects to hear lots of questions about it.

“That’s probably one that people are going to have questions about: ‘What are you trying? You’re trying to increase the use of drugs?’” Dexter said. “The answer is absolutely not. What we’re trying to do is acknowledge that people have drug addiction, that they need help. And when you have tools that are available to them to keep them safe, people want to be safe. They don’t want to die.”

The legislation doesn’t predict how many lives would be saved. But Dexter says the changes would equip Oregonians with tools to save lives. Her proposal also would require a public health campaign in the state.

Measure 110, which voters passed in 2020, decriminalized low-level drug possession and dedicated about $100 million a year towards addiction services. But drug paraphernalia is still banned in Oregon law.

Advocates for people with addiction say the state needs to provide life-saving tools and reduce the stigma of addiction, which is medically recognized as a disease. 

Haven Wheelock is the harm reduction manager for Outside In, a Portland center that helps people with addiction treatment, housing, food, health care and other needs.  The center serves about 4,000 clients a year with drug addictions. 

Wheelock said a range of proposals are needed to increase the public’s access to prevention and treatment tools in businesses, schools and other places. Wheelock, who has worked 20 years in the field, said the opioid crisis is worse than any drug crisis she’s seen.

“The heartbreaking numbers of losses and the grief in the community that we are experiencing today is nothing like I’ve ever experienced,” Wheelock said. “The level of just heartbreak and loss is more than I have seen in other points in my career.”

Tera Hurst, executive director of Health Justice Recovery Alliance, a statewide advocacy group, said it’s key for Oregonians to have tools they need.

“With fentanyl on the street, I think it’s really important that we have the testing strips,” Hurst said. Test strips can help people who are taking a drug know it’s not something completely different – like fentanyl – that is lethal, Hurst said. 

“You can’t get somebody the support and help they need if they die,” Hurst said.