Oregon is No. 2 in nation for addiction, last on access to treatment

Jan. 29—State falls to 50th place for addiction help

Oregon ranks second worst in the nation for addiction and has fallen to last place among states for access to treatment, according to the latest federal data.

The 2020 National Survey on Drug Use and Health shows Oregon is doing even worse than its poor showing in 2019, when it ranked fourth worst for addiction and was No. 47 for access to treatment.

In Oregon, 18.22% of residents 12 and older had an alcohol and/or drug use disorder in 2020, the national survey found.

Meanwhile, 18.08% of residents needed treatment at a facility for alcohol or drug addiction but didn't get the care they needed, the survey said.

Oregon ranks No. 1 for meth use, No. 1 for prescription drug misuse, No. 2 for marijuana use, No. 7 for cocaine use and No. 11 for heroin use, according to the survey.

Oregon has consistently failed to provide long-term, adequate funding for residential treatment beds. Instead, it throws money at short-term pilot projects in the community, said Sommer Wolcott, executive director of the OnTrack Rogue Valley addiction treatment organization.

"People at the highest risk of overdosing and dying need the highest level of care before they can be helped by supportive services in the community," Wolcott said.

She said residential programs across Oregon have been closing one after another. Reimbursement rates are so low that OnTrack's residential programs run at a deficit. They are essentially subsidized by outpatient programs, donations and grants.

Outpatient programs cost less to run per client, but some people need the intervention and high-intensity care of a residential program.

"Oregon has made strategic decisions for years that created barriers to high levels of care. That's great for people who thrive in outpatient settings, but it leaves others out. Then those people overuse hospitals or are on the street," Wolcott said.

Although Oregon doesn't prioritize funding for residential treatment, demand is high.

OnTrack has a wait list of 49 people who want treatment at its 24-bed Mom's Program for mothers struggling with addiction, Wolcott said.

The 10-bed Dad's Program has a wait list of 41 people, she said.

OnTrack's 16-bed Mountain View Recovery center for men and women has 96 people waiting for an open bed, she said.

Adding to the strain, OnTrack had to temporarily freeze admissions at the Mom's Program and the Mountain View Recovery Center after some people tested positive for COVID-19, Wolcott said.

OnTrack is struggling with a shortage of workers, especially for its residential programs. Low reimbursement rates from the state and federal government mean it can't pay enough to compete for workers during the ongoing labor shortage affecting all industries.

Wolcott said the Oregon Health Authority gave OnTrack money to provide $2,000 retention bonuses for current workers, but that doesn't address pay problems long-term or help it hire new workers.

"I can't increase salaries based on one-time funding," she said. "What would I do? Take part of their salary away next year?"

Although there aren't enough residential treatment beds, Wolcott said OnTrack has room in its outpatient programs and everyone is welcome to reach out for help.

"If somebody is struggling with substance use, we're here," she said.

Since the start of the COVID-19 pandemic, Oregon has lost 40% of its addiction treatment beds for adults and 60% of its beds for adolescents, said Mike Marshall, executive director of Oregon Recovers.

Oregon Recovers is a statewide coalition of people in recovery, plus their friends and families.

Marshall said it's disheartening to see Oregon is No. 2 among states for the worst addiction rates and No. 50 for access to treatment.

"We've fallen to last in access to treatment. We've known for years if you suffer from addiction in Oregon, there are huge hurdles to care," he said.

Only Montana has higher rates of alcohol and/or drug abuse, with 18.28% of its residents over age 12 struggling with addiction.

Marshall said the situation is especially frustrating because Oregon finished an addiction recovery strategic plan in 2020 that the state is not implementing. At the direction of the Oregon Legislature, a state commission consulted more than 150 stakeholders over two years to create the plan.

The plan relies on four proven strategies — prevention, intervention, treatment and post-treatment support, Marshall said.

Prevention includes making sure the public is aware about the potential harms of alcohol and drug use, he said.

Marshall said the state government makes money off alcohol taxes. But it doesn't have a statewide program to educate people that alcohol can be addictive, damage the liver and increase the risk of a variety of cancers, including breast cancer.

Oregon's total costs for excessive drinking were approximately $4.8 billion in lost labor productivity plus spending on crime, car crashes, health care and social services, according to a 2021 report by the economic analysis firm ECONorthwest.

That figure means each alcoholic drink sold in Oregon costs society $2.08, Oregon Recovers said.

The latest data available to ECONorthwest for its 2021 report was from 2019 — before people started drinking more during the pandemic.

In Oregon, 12.34% of people 12 and older had an alcohol use disorder in 2020. Oregon ranks No. 5 among states for the most alcohol addiction, according to the National Survey on Drug Use and Health.

Oregon ranks No. 1 in illicit drug use disorder, with 9.04% of people 12 and older struggling with drug addiction in 2020, the survey found.

Some people face both drug and alcohol addiction, so the partial overlap creates a drug and/or alcohol addiction total of 18.22% of Oregonians 12 and older. That is the figure that puts Oregon in the No. 2 spot for substance use disorder among states, according to the survey.

Many Oregonians lack knowledge of the mental and physical health risks of regular drinking, and compared to others in the nation, they don't think taking drugs is risky.

For example, Oregon ranked last on perceptions that trying heroin once or twice is risky, the national survey found.

Heroin is illegally trafficked with no consistent dosing, so users could overdose and die at any time.

Dealers have been adding potent, often-deadly fentanyl to heroin, meth, cocaine and counterfeit pain pills, fueling an overdose epidemic that killed a record 100,306 people in the U.S. for the 12-month period that ended in April 2021, according to federal Centers for Disease Control and Prevention.

As for the intervention and treatment prongs of Oregon's unused addiction recovery strategic plan, Measure 110 may further derail those efforts.

Passed by Oregon voters in 2020, Measure 110 essentially decriminalized the possession of small amounts of drugs such as heroin, meth and cocaine starting in 2021. People caught with user amounts get a $100 ticket and aren't arrested.

The criminal justice system no longer intervenes in drug use, Marshall said.

"The argument for Measure 110 was to move people out of the criminal justice system and into the health care system. That is absolutely the correct thing to do. Measure 110 gets people out of the criminal justice system, but not into the health care system," he said.

Measure 110 diverts hundreds of millions of dollars in Oregon marijuana tax revenue from schools and other needs into supportive services like housing and overdose antidote kits for people with addiction.

Those supportive services are critically needed, but so is addiction treatment, Marshall said.

Oregon isn't using the diverted marijuana tax revenue to fund addiction treatment counselors or doctors who could help people with addiction. Because marijuana is federally illegal, Oregon fears using marijuana money for treatment could cause the state to lose federal funding that helps cover addiction treatment and medical care.

The pro-Measure 110 campaign was backed by the New York-based Drug Policy Alliance, which has a goal to decriminalize a wide range of drugs. The group previously helped finance the measure that legalized recreational marijuana in Oregon.

"Measure 110 was a diversion," said Marshall, who opposed the measure. "Some people think it's solving this problem, but it was never designed to decrease addiction rates or increase access to treatment — although it was sold that way."

Marshall said Oregon should invest more money in training health care providers in doctor's offices and emergency rooms so they can deal with addiction.

"Currently, there's a huge stigma and an attitude of, 'That's not our problem. Go to a treatment provider. We don't do that in this doctor's office,'" he said.

Some health care providers, including the local La Clinica health care network and the Oasis Center of the Rogue Valley, integrate health care with substance use disorder treatment. Providers there know that drug and alcohol misuse can have major impacts on their patients' mental and physical health.

Medications are also available to help reduce opioid withdrawal symptoms like nausea, vomiting and diarrhea, while also curbing drug cravings.

The fourth prong of Oregon's unused addiction recovery strategic plan is post-treatment support to help people maintain their recovery, Marshall said.

"It's those first five years after treatment that are really important. If we invest in those first five years, the relapse rate goes down to 15%," he said.

With ongoing support, the outcome for addiction treatment is better than the outcome for many other chronic, costly health conditions, including diabetes, Marshall said.

Meanwhile, as Oregonians continue to struggle with addiction, the state's Chief Medical Examiner Sean Hurst testified this month to Oregon legislators that alcohol-related deaths in Oregon jumped 73% from 2019 to 2020. Drug overdoses were up 39%.

Preliminary data from the first six months of 2021 shows addiction-related deaths in the second year of the pandemic will outpace the first year, Hurst testified.

"Virtually all those deaths are preventable if we would invest in what works," Marshall said.

Reach Mail Tribune reporter Vickie Aldous at 541-776-4486 or valdous@rosebudmedia.com. Follow her on Twitter @VickieAldous.