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The Multnomah County Health Department will begin distributing tinfoil and straws this month to fentanyl smokers at sites across Portland, WW has learned.
The “smoking supplies,” which also include glass pipes for smoking meth and crack as well as “snorting kits,” are part of a national effort to minimize the health consequences of drug use. Smoking is considered by many health experts a safer way of consuming hard drugs than injection, and government officials are now seeking to encourage users who haven’t already switched to do so—and to make it safer for those who already have.
The Oregon Legislature just passed a bill decriminalizing the distribution of “drug paraphernalia” for harm reduction purposes, although it awaits Gov. Tina Kotek’s signature. There are similar programs in other states, including Washington and California. New York City recently installed a vending machine with smoking kits, including bubble pipes.
Yet the decision to distribute smoking supplies arrives as many officials and Portland residents are exhausted by open drug use on city streets. Fentanyl, which is most commonly smoked, is now the drug of choice, and it’s difficult to walk downtown without passing someone in a stoop with a torch and a piece of tinfoil.
The policy is brand new. Multnomah County confirmed it Thursday afternoon after WW inquired. Spokeswoman Sarah Dean noted that the rise of fentanyl, which is commonly smoked and not injected, has decreased demand for the county’s “harm reduction” services. Visits to clinics have dropped by more than 60% since 2019.
Heroin, the opioid of choice on Portland’s streets only a few years ago, is typically injected. For years, harm reduction advocates focused on creating syringe exchange programs to minimize the health consequences. But now, with the rise of fentanyl, those programs aren’t as popular. “It’s difficult to engage folks who don’t come in,” Dean says.
So the county is offering what drug users want: tinfoil, which, thanks to the explosion in fentanyl use, already dots downtown Portland’s streets.
The smoking supplies serve two purposes, Dean says. They encourage people to stop injecting, a vector for disease. And they encourage people who are already smoking to come into clinics, where the county can offer fentanyl test strips, Narcan, a fast-acting overdose reversal drug, and other services. “Several decades of research have also shown that providing supplies for safer drug use does not increase illegal drug use,” she adds.
Officials announced they were distributing smoking supplies in a PowerPoint presentation at a briefing of the Multnomah County Board of Commissioners last week. The health department confirmed to WW yesterday what those supplies entailed and that they would be distributed “beginning in July 2023.”
“Multnomah County has been an innovator and a leader in harm reduction practices for many years, which I’m very proud of,” county public health director Jessica Guernsey said at the meeting last week. “Harm reduction is often a topic that is sensationalized or misrepresented in public and media discourse. But make no mistake, the work is not only lifesaving, but also a critical way to form trusting, safe relationships with community members who have been otherwise marginalized.”
Guernsey says the county’s harm reduction efforts decrease emergency room visits and help connect people to treatment services.
Despite the county’s efforts, however, overdose deaths have continued to climb. They’ve doubled in Multnomah County between 2018 and 2021, thanks to the rise of fentanyl. (Data for 2022 is still trickling in.)
Mayor Ted Wheeler, meanwhile, has taken a different tack. He recently announced, but later withdrew, a proposal to ban the smoking of fentanyl in Portland’s public spaces.
After initially declining to comment, the mayor’s office releasing a scathing statement.
“I adamantly oppose distributing paraphernalia to encourage using a drug that is the leading cause of death for Americans under 50 and responsible for 190 fatal overdoses a day in the U.S.,” Wheeler said. “This misguided approach also results in greater risk to public safety for those who simply want to enjoy our city without walking through a cloud of toxic smoke.” (County health officials say that fentanyl smoke puts passersby “at very low risk of health effects.”)
“Our community would benefit more from the county using its funding to urgently increase treatment and sobering facilities rather than actively enabling this deadly epidemic,” he added.