PORTLAND, Ore. — Editor's note: On Monday, Multnomah County Chair Jessica Vega Pederson said she was suspending the program to distribute tin foil and straws for fentanyl users, pending further analysis. Read the update here.
Original story below:
Multnomah County on Friday confirmed reporting from Willamette Week that it will soon begin distributing clean tin foil and straws for street drug users, particularly those who smoke fentanyl.
In addition, the county Health Department said in a statement, it will be distributing "bubbles" and "stems" or glass pipes for people who smoke methamphetamine or crack, as well as "snorting kits" for those who inhale drugs.
The reason for this is fairly simple, MCHD laid out matter-of-factly — fewer people are looking for clean needles to use drugs intravenously, particularly as fentanyl becomes more prevalent than heroin.
"Changes in drugs and in drug use behaviors that began in 2022 have continued, resulting in less effective naloxone distribution and client engagement via the public health harm reduction program," the agency said. "It’s difficult to engage folks who don’t come in."
The county's harm reduction program has seen a 30% decrease in individuals seeking clean syringes; from a peak of 3,367 people in 2019 down to 2,359 in 2022. Overall visits went down almost 61% between 2019 and 2022, from 14,337 to 5,625.
Multnomah County's harm reduction program can and does distribute Narcan to users who come in for supplies, but people don't seem to be coming in for Narcan alone. So they're changing up what kind of supplies they offer.
"By bringing more people into our sites, this increases opportunity for health education, referrals to resources such as (substance use disorder) treatment, and more opportunities for HIV, STI and Hepatitis C testing," the agency said. "Building relationships with people actively using substances also gives our department more insight into emerging public health issues that impact this population. We are able to directly hear from our clients when there are concerning changes to the drug supply, increased wound issues, or other related issues that are of public health concern."
After the story broke Friday, Portland Mayor Ted Wheeler fired off a tweet in apparent opposition to the county's new harm reduction offerings, suggesting that it would "encourage" the use of fentanyl.
The Multnomah County Health Department declined to comment on Wheeler's statement directly. However, the agency made clear in its statement that it does not agree with that assessment and believes that it is making a positive public health decision — precisely because of the rise in overdoses.
"Several decades of research have also shown that providing supplies for safer drug use does not increase illegal drug use," MCHD said. "Research to date specific to smoking supplies is limited, but the logic model is the same as offering syringes — offering these supplies does not mean people will start using substances. Syringe access does not mean that people will start injecting, just as offering condoms does not encourage young people to start having sex."
Smoking supplies are catching on as a part of harm reduction programs globally, the county added.
MCHD acknowledged that these smoking supplies are currently considered drug paraphernalia under Oregon law, but said it already distributes supplies with that label, including fentanyl test strips. House Bill 2395, currently awaiting Gov. Tina Kotek's signature, would change those designations.
"The goals of updating the supplies offered at MCHD Harm Reduction sites are to 1) re-engage clients who switched fully to smoking, 2) newly engage clients who have only smoked/snorted drugs, and 3) support clients who are moving to decrease injecting frequency in favor of smoking or snorting when able," the county concluded. "While we all understand that abstinence from drug use is the safest, the people who are seeking out services are doing so because they are already using substances."
Dangerous as fentanyl is, many of Portland's street drug users already seem to be making the switch. The upside, the county reasoned, is that a reduction in intravenous drug use can decrease the risk of infection and spreading blood-borne diseases.
MCHD said that distribution of these new harm reduction supplies begins this month.
