Multnomah County Reverses Plans to Distribute Foil to Fentanyl Smokers

WW first reported the new harm reduction strategy last week.

FOILED: Smoking a fentanyl "blue" off foil in downtown Portland. (Blake Benard)

Three days after WW reported that the Multnomah County Health Department planned to begin distributing “smoking supples,” including tinfoil and straws, to fentanyl smokers in Portland, the county is suspending the program.

“Our health department went forward with this proposal without proper implementation protocols,” says County Chair Jessica Vega Pederson. “And in that light, I am suspending the program pending further analysis.”

Multnomah County health officials have been telegraphing the plan, which is similar to other harm reduction efforts across the country, in briefings to the county board as early as May. But after WW reported the details of the new initiative, which included plans to distribute tinfoil, straws and pipes at county clinics, two county commissioners told WW it should be delayed.

“As it relates to distributing foil and straw to enable fentanyl use, there is no compelling evidence that it is comparable to safe needle exchanges or that the county currently has capacity to connect individuals to treatment who want it,” Commissioner Julia Brim-Edwards told WW this morning.

The county gave two rationales for the new program. First, the smoking supplies encourage people to stop injecting, a vector for disease, health department spokeswoman Sarah Dean says. 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. Visits to the county’s harm reduction clinics have dropped substantially in recent years as fentanyl, which unlike heroin is more commonly smoked than injected, gains popularity on the street.

Prior to the county chair’s statement, Dean told WW that the county would pay $82,835 for the smoking supplies “using cost savings from underspent syringe budget.” The county plans to spend a total of $3 million over the next fiscal year on harm reduction supplies.

“The county has considered this for several years, but in reviewing results of our 2022 harm reduction client survey it became increasingly clear that this was a needed change in our area,” Dean says. “The proposed change was reviewed and supported by a number of public health experts within clinical and administrative health department leadership before being presented to the board.”

Even as she hit the pause button on the program, Vega Pederson defended the county’s efforts to address rising overdoses on Portland’s streets.

“My focus has been on saving lives,” she said in a statement. “We’ve seen overdose deaths from fentanyl increase eightfold since 2019, from 26 deaths to 209 deaths in 2022. I’m interested in connecting people with lifesaving materials like naloxone because we’ve seen a significant decrease in the number of people utilizing our harm reduction resources as fentanyl use became more prevalent. We must connect people to services and continue communicating to those struggling with addiction that your life is worth saving.”

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