Meth has changed, and it’s sabotaging Oregon’s mental health system
Two Part story from the Lund Report, posted August 4 and August 5, 2022
In the state with the highest rate of meth use in the nation, the drug is driving severe mental illness among criminal defendants at the state psychiatric hospital, and other patients are paying the price
Editor’s note: This is Part 1 of a two-part series about how — despite a windfall of new funding — the state has no plan to address the “new meth” that is overwhelming behavioral health providers and inflaming ongoing crises across the state. On Friday: The Lund Report will take a look at how the state’s siloed approach to behavioral health is undermining its response to the increasing problem of meth.
Every time Anthony Ware got out of prison, he noticed the meth in Portland tasted more like chemicals.
“My daily routine was like, wake up, eat a piece, let that kick in, and then smoke to keep my high,” he said of that time in his life.
It was the “good stuff,” cooked by local bikers, that got Ware hooked on meth nearly two decades ago, he said. Then the drug cartels started making it. By 2018, the drug reminded him of “paint fumes.”
The changes Ware witnessed were at the heart of an article published in The Atlantic magazine this past October. In it, journalist Sam Quinones contended that cartels’ new formula for making meth is driving people into the throes of psychosis and homelessness at a much higher rate. With this “new meth,” he wrote, “traffickers forged a new population of mentally ill Americans.”
The observation holds particular relevance for Oregon, which has the highest reported rate of meth use in the nation. And more than two dozen interviews by The Lund Report with those involved in Oregon’s behavioral health system reveal that at every level, it’s well known that meth has changed — and that it’s inflaming Oregon’s already blistering addiction, mental health and homelessness crises like never before.
At the state’s largest psychiatric facility, the Oregon State Hospital, the overcrowding that has dominated headlines for years is, employees say, driven by a flood of patients whose mental illness is intertwined with meth. This, in turn, is closing out other acutely ill patients who instead are warehoused at other Oregon hospitals, increasing costs and taxing staff.
But despite widespread awareness among insiders, there’s been little public recognition of the outsized role meth is playing in problems plaguing Oregon’s mental health system. There’s also no coordinated approach to address it.
Experts, advocates and local officials say that needs to change.
“We’re up against formidable challenges right now in Oregon,” said Dr. Todd Korthuis, the head of addiction medicine at Oregon Health & Science University. “Not only do we have increases in methamphetamine use, but we have rapidly spiking increases in the number of fentanyl overdoses. And it’s going to require an all-hands-on-deck approach to really tackle all of these issues at once — with multiple different approaches.”
The surge of patients facing criminal charges means there are not enough beds in the state facility for patients who aren’t. In December 2019, Oregon State Hospital management let hospitals know it would no longer accept civilly committed patients.
A rise in meth use and related mental illness
In 2004, a sheriff’s deputy in Multnomah County came up with a public awareness campaign called Faces of Meth to highlight the drug’s corrosive impact.
Two years later, focus on the drug and its connection to psychotic behavior prompted Oregon lawmakers to adopt the country’s first ban on over-the-counter sales of ephedrine, the plant-based main ingredient for the small-scale local manufacturing then dominating the market. Congress soon followed suit.
Mexican cartels, however, promptly flooded the Oregon market, and began using a different method to make the drug, known as phenyl-2-propanone, or P2P. It was synthetic, cheaper and more potent.
It’s this P2P meth that Quinones, in The Atlantic, contended more frequently leads to mental illness. The link between meth and psychosis isn’t new, though studies validating the connection primarily focused on older iterations of the drug.
With symptoms like paranoia, delusions and hallucinations, it’s difficult for practitioners to differentiate between mental illnesses like schizophrenia and those that are meth induced. A common characteristic is for the afflicted person to believe someone or something is after them. At its worst, this can result in aggressive and even violent behavior.
Despite Oregon’s early attempts to combat meth, its reach has only worsened:
In 2020, Oregon jumped from having the ninth highest rate of meth use in the country to the highest, according to the most recent National Survey on Drug Use and Health data.
The volume of meth confiscated on Oregon highways saw a 75% increase between 2016 and 2020, according to drug trafficking reports.
Meth-related emergency department visits in Oregon climbed about 20% in both urban and rural areas between 2018 and 2021, and last year, urban hospitals alone saw more than 16,000 meth-related emergency department visits, according to Oregon Association of Hospitals and Health Systems data.
The number of those patients spending more than 24 hours in an emergency department bed doubled during that time.
The price of meth has dropped to as little as $5 for a three-day high, while the potency has increased. Anecdotal reports suggest meth overtook heroin as the drug of choice among Portlanders experiencing homeless as early as 2007.
In 2019, Portland’s only sobering center closed, with its operator, Central City Concern, citing an inability to safely sober the increasing number of people coming in who were behaving violently and erratically while under the influence of meth and similar drugs.
Methamphetamine contributed to more deaths in Oregon than fentanyl and heroin in 2019, 2020 and 2021.
Michelle Guyton and fellow forensic psychologist Alexander Millkey of Northwest Forensic Institute, LLC in Portland evaluate criminal defendants’ ability to stand trial for courts around the state. And they’ve been busy — over the last decade, the number of people deemed unfit to proceed with their criminal defense in Oregon has nearly tripled, according to state data.
Guyton and Millkey told The Lund Report that nearly everyone they evaluate uses meth.
“Frankly,” Millkey said, “if you have somebody who’s not using meth, it’s a very refreshing palate cleanser.”
In recent years, they said they’ve seen an increase in the number of defendants experiencing meth-induced psychosis. It usually resolves within a couple of weeks, but for some, it can take months or even years — if it’s resolved at all — Millkey said.
Guyton said the line between meth-induced psychosis and traditional mental health disorders has become “increasingly grayer.”
“I agree with the Atlantic article that new meth is a different bird,” Millkey said. “I don’t know if I’m seeing meth induced psychosis that lasts longer. But I do know that I am seeing more meth induced psychosis.”
A recipe for severe illness
Most experts interviewed for this story emphasized the high rate of homelessness among the most acutely psychotic people who use meth.
Annual Point in Time surveys, which take a one-day snapshot of homelessness each January, show that between 2015 and 2022, homelessness counts more than tripled in central Oregon and went up by nearly 40% in Multnomah County.
For many unhoused people, living outside evokes a hypervigilant state marked by trauma and sleeplessness. Often, self-care doesn’t happen. When these factors combine with meth use, experts say, it can be a recipe for longer lasting and more severe psychotic events. This can be especially true for people who are genetically prone to developing mental health disorders.
But homelessness and meth use don’t result in psychosis for everyone.
Quinones’ article in The Atlantic featured Rachel Solotaroff, then the executive director of Central City Concern, Portland’s largest homeless services provider. He quoted her saying that the “degree of mental-health disturbance; the wave of psychosis; the profound, profound disorganization” among her patients who use meth was something she had “never seen before.” She also told Quinones, “If they’re not raging and agitated, they can be completely noncommunicative … I’ve never experienced something like this — where there’s no way in to that person.”
Earlier this year, Solotaroff told The Lund Report she was talking about the behavioral effects of meth use at their most extreme during that interview.
Many of her patients “use meth regularly, or use meth intermittently, and do not present with that kind of symptomology,” she said. “I never meant to convey that there is a population of folks for whom there is no hope or there is no opportunity for connection.”
Ware, who noticed changes in meth over 15 years of use, never became psychotic, though he did struggle with mental health issues.
He’s mixed race and felt neither his Black nor his white peers accepted him. He eventually found comradery in gang life, committed robberies and stole cars. Childhood abuse, three stabbings and a car accident left him with anxiety and post-traumatic stress disorder, he said.
Now 35, Ware has been drug-free for more than a year on the Oregon Coast, and he’s looking to the future. He believes meth didn’t cause him to become delusional because he kept himself fed, rested and hydrated. When he acted out of character, he said his “homeboys” would tell him to “get his ass to sleep.”
And, he was housed.
He has friends who were not as lucky. He said a few have lost their minds to meth. “It’s like talking to a brick wall,” he said.
Meth strains state psychiatric hospital
The mental health impacts of meth and homelessness are apparent at Oregon State Hospital, which has 546 psychiatric beds between its hospitals in Salem and Junction City.
Last year, the per-patient daily cost of care there was $1,447, with Oregon taxpayers footing most of the bill. The state health authority director, Pat Allen, has called it the “world’s most expensive homeless shelter.”
It’s where people facing criminal charges who are found mentally unfit are often recommended for admission. Staff at the hospital say the growing number of these patients who are homeless and use meth are taking longer to treat due to increasingly severe illness.
“Folks are coming through the door more acutely, psychiatrically ill, more psychotic — a little bit harder to stabilize,” said Sara Walker, the psychiatric hospital’s chief medical officer, adding that it’s hard to tell how much of the trend is meth, and how much of it is societal problems such as homelessness.
Walker said that patients being restored for prosecution are typically at the hospital for about 90 days, which is not long enough to make a definitive mental health diagnosis for someone who has been using meth. It’s unclear if or when their symptoms will resolve, or “clear.”
“There are plenty of folks who do not become psychotic until they graduate to methamphetamine use … And sometimes they clear, and sometimes they don’t,” Walker said. “You’re typically not going to know just how clear somebody’s going to get unless they are sober for a solid two years — which is not an easy thing to accomplish.”
A couple of years ago, an intern at the Oregon Health Authority researched drug use among the patients sent to Oregon State Hospital because they were mentally unfit for prosecution. From the start of 2017 to the end of 2018, the intern found that 96% had a history of substance abuse, with nearly 70% having used meth.
Walker doesn’t think those percentages have changed. What has changed is the number of these patients admitted to the hospital. Fifteen years ago, people being treated for court competency comprised about 15% of the daily population. Today they comprise about 60%, according to Walker.
But while their stays at the hospital tend to be shorter, their share of admissions is even greater. Last year they accounted for 94% of all patients admitted to Oregon State Hospital, according to hospital spokesperson Amber Shoebridge.
Hospitals trapped in ‘really bad cycle’
The surge of patients facing criminal charges means there are not enough beds in the state facility for patients who aren’t.
In December 2019, Oregon State Hospital management let hospitals know it would no longer accept civilly committed patients. These are people who are found to be a danger to themselves or others due to acute mental illness.
This forced other hospitals to board patients they would typically transfer to the state for long-term care. And the state’s largest hospital system has become backed up with psychiatric patients it has nowhere to send, according to Robin Henderson, Providence Oregon’s chief of behavioral health.
“We recently had an individual with us for 694 days,” Henderson said, adding that hospitals can’t offer the long-term therapies these patients need. “We don’t have an outside area for somebody to be able to go to — so this individual’s feet didn’t touch grass.”
Patients occupying beds long-term means the hospital must turn other people away.
“It’s a simple math problem,” Henderson said. “It really just kind of backs up the whole system.”
For Henderson, meth’s role in crowding at the Oregon State Hospital — and the “unintended consequences” for hospitals — is clear. “It’s a really bad cycle we’re in right now,” she said.
The problem has gotten so bad that hospitals and the Unity Center for Behavioral Health have begun going to court to force the state to take these patients off their hands.
Boarding psychiatric patients is adding to the strain on hospitals’ finances — which in turn affects their ability to fill staffing gaps. At the Unity Center in Portland, boarding civilly committed patients is hampering its ability to serve its purpose: to serve as a space for people suffering acute mental health crises.
Meanwhile, hospitals are also overtaxed with the influx of shorter-term emergency room visits related to meth. There were nearly 7,500 such visits to Portland area emergency departments last year, eclipsing the number of alcohol-related visits. At their worst, these meth-involved visits can include patients acting violently and erratically, resulting in injuries to the patient and staff.
Untreated addiction feeds a revolving door
Despite widespread substance use among patients facing criminal charges at Oregon State Hospital, addiction treatment is typically not an option.
Patients’ condition must be somewhat stabilized before they can fully engage in substance use treatment. But to keep patients in the hospital longer than it takes to restore their competency to stand trial would infringe on their civil rights, said Julia Howe, Oregon State Hospital’s chief of psychology.
In March 2020, an Oregon State Hospital work group began to develop recommendations for improving substance use treatment for patients. But, a spokesperson said, the pandemic put that work on pause.
In June, an outside expert recommended the expansion of substance use disorder treatment at the hospital, suggesting criminally involved patients would be less likely to reoffend.
The lack of treatment feeds a revolving door in which patients are restored to face trial, get released, go back to meth and homelessness, and then end up at the state hospital again, only this time more acutely psychotic and challenging to treat, according to state hospital staff.
Workers at other hospitals around the state see the same thing — people returning again and again due to meth use. And it takes an emotional toll.
“Every time you see the person again, they’re worse than they were the last time you saw them. And they’re less the person that they were,” Henderson said. “It’s very sad, and it’s a very helpless feeling. And I think helplessness is probably the hardest thing that emergency department staff deal with.”
Oregon’s meth problem: More money than leadership
Despite a windfall of new funding that could combat Oregon’s meth-fueled behavioral health crisis, leaders have no plan and risk leaving promising approaches on the shelf.
Editor’s note: This is Part 2 of a two-part series about how — despite a windfall of new funding — the state has no plan to address the “new meth” that is overwhelming behavioral health providers and inflaming ongoing crises across the state. Read the first story, about the way meth has changed to be more toxic to users.
In November 2020, when voters decriminalized small amounts of meth and other hard drugs with Measure 110, the rate of meth use in Oregon had already climbed higher than any other state.
Meanwhile, many in Oregon say the meth problem has changed. The drug has become more potent, harmful and ubiquitous. And while not everyone using the drug experiences psychosis, many people who do struggle with more severe and longer lasting mental illness, often punctuated by homelessness.
In approving Measure 110, voters may have thought they were addressing Oregon’s long-standing abysmal rankings in addiction rates and access to treatment. That’s because the new law unleashed a windfall of spending — $300 million every two years — that proponents said would pay for “drug treatment and recovery services.”
But despite widespread awareness among behavioral health providers and policy makers, there’s been little public recognition of the outsized role meth is playing in problems plaguing Oregon’s hospitals, jails, mental health system and homeless communities. And early indications from spending under Measure 110 suggest that addressing the cascading effects of meth won’t be a focus. As a result, important potential responses to the problem won’t get the support they deserve.
Top state officials interviewed for this article conceded that meth and its effects on the behavioral health system have not received enough attention, despite lawmakers’ approval of significant new spending.
“We’ve been fortunate in having a billion dollars in new investments in the behavioral health system, but that’s a lot to implement,” said the state’s behavioral health director, Steve Allen. “So some of the pieces — like a focus on methamphetamine — have had to take a bit of a backseat.”
This blind spot illustrates how the state has failed to map out a plan to ensure the unprecedented spending underway will actually address Oregon’s most pressing needs.
Local officials and experts say that needs to change.
“There is no plan at all, there is no coordination,” said Multnomah County Commissioner Sharon Meieran, an emergency room doctor who has long called for behavioral health reforms. “We are watching more and more people dying, we’re watching the impact on mental health increase. We need to be addressing all of it in a comprehensive way.”
Without a comprehensive plan for combating the effects of Oregon’s growing meth problem, or leadership to drive it, promising interventions fail to be prioritized or are left entirely on the shelf, The Lund Report has found.
A new approach
Measure 110 was intended to reverse the harmful effects of the war on drugs, which disproportionately impacted people of color, by putting people from communities most harmed in charge of spending hundreds of millions of tax dollars to expand addiction and recovery services.
But the law isn’t playing out as expected in a variety of ways — just ask Billy Nunemann.
When voters passed Measure 110, they put in place a hotline for people to call if given a ticket for drug possession. By agreeing to a substance use screening, ticketed people could get their $100 fine waived and be referred to treatment services if they wanted.
Nunemann is the Addictions Recovery Program supervisor at Lines for Life, which oversees the hotline. The problem? He doesn’t get a lot of requests for help, and when he does, he may not have the right kind of help to offer.
Police aren’t writing many tickets for drug possession, and as of April, more than a year after the law went into effect, only about 100 people had called the hotline. Fewer than half asked for resources. When they do ask for residential treatment or detox, they are waitlisted, said Nunemann.
Those services are not prioritized for funding under Measure 110 the way that peer services, harm reduction, housing and low-barrier out-patient treatment are.
Nunemann, who is himself in addiction recovery, said what people recovering from meth really need is their own specialized treatment program — like people with opioid use disorder have. Right now, the system doesn’t offer the long-term recovery that people in recovery from meth use need to clear their “ravaged” brains, he said. “It’s just not how our system is set up.”
Years ago, with available funding targeted to opioid treatment, “we did forget about meth,” said Reginald Richardson, director of the state’s Alcohol and Drug Policy Commission.
The system is the problem
While officials often talk about mental health and addiction services in one breath, calling them “behavioral health care,” the reality is that they are largely two separate systems in Oregon.
This is a problem because about half of the people who have a mental health disorder also struggle with addiction, according to the National Institute of Mental Health. Experts say those patients need integrated care. That includes the growing population of people experiencing meth-involved mental illness in Oregon.
But the separation between addiction treatment and mental health services has been baked into funding, training, staff credentialing, licensing certification and “the hearts and minds” of service providers over many years, Allen, the state’s director of behavioral health, said. Dismantling those barriers will take time, “and that process has only just begun — there’s years in the making to really have people rethink how we do that.”
In 2012, 2016 and 2019, highly touted efforts to integrate the different arms of Oregon’s systems either did not solve the problem or were simply dropped.
Lawmakers tried again in 2021 to tackle the fragmented situation with House Bill 2086, which directed the health authority to take steps toward a more integrated system. But Richardson said the issue is “the speed in which the health authority can implement its provisions.”
Confronted with the absence of a coordinated strategy to address the new meth and the complex needs of its users, officials at the Oregon Health Authority and at the office of Gov. Kate Brown said the state is fixing the system holistically to help all who struggle with addiction and mental health disorders. They pointed to recent investments in “behavioral health care” and largely, to Measure 110.
But much of the infrastructure funded with the Legislature’s billion-dollar investment in the “behavioral health care” system is actually going to mental health services that don’t include addiction treatment.
And when questioned about the state’s approach to combating meth addiction, a spokesperson for a coalition of the law’s proponents said that’s not Measure 110′s job.
“Our interest as a coalition is not necessarily to reduce SUD (substance use disorder) in Oregon,” said Tera Hurst, of the Health Justice Recovery Alliance, “but to stop the ongoing harms of the war on drugs, end fatal overdoses, reduce stigma and make sure that people have access to whatever services they need to stay safe and alive.”
“We have never said that (Measure 110) is the only thing that our state should be doing to address this issue,” Hurst added. “We’ve always said this is a piece of the pie, but it’s not the full pie.”
The council set up to oversee Measure 110 spending is composed of people with lived experience in addiction and who represent various disciplines around substance use and reform. Administering a grant program and designing a system of treatment services is new territory for the council’s members. Despite this, they receive little guidance in spending the river of money voters gave them to fix the addiction services system.
Instead, the council has an agenda that does not prioritize some of the interventions experts say would help people struggling with meth use, mental illness and homelessness: residential treatment beds, secured facilities and programs that treat mental health and addiction simultaneously.
Critics say the state’s new approach doesn’t do enough to get people to enter actual treatment.
Promising solution denied
As reported by The Lund Report earlier this week, meth is increasingly driving costly overcrowding at the state’s psychiatric facility, the Oregon State Hospital. The ripple effects are felt system wide, with other hospitals forced to warehouse patients who can’t get in. The problem affects communities across the state and can have catastrophic effects for the people that don’t get the help they need.
Judge Nan Waller presides over Multnomah County’s mental health court, and a significant portion of her docket is filled with people battling meth use, homelessness and mental illness simultaneously. She said many need to be stabilized in a secure setting, and “there is no access to that in the community right now.”
So she has helped plan a proposed meth stabilization center intended for Portland to divert meth users away from hospitals and jails and into a stabilization center instead, where they could be connected to resources instead of criminally prosecuted or discharged back to homelessness. The idea has been a focus for local officials and providers. Waller said while the initial focus will be on meth, the facility would also “provide triage, assessment, warm handoff to services — a much more comprehensive vision than simply stabilization.”
Organizers in Multnomah County recently asked the Measure 110 oversight council to help fund the effort, only to be turned down, sparking a backlash from supporters.
Such a facility would have helped one Portland-area woman, who told The Lund Report about her experiences on condition of anonymity due to the stigma around mental illness and meth use.
She has bipolar disorder with schizophrenic side effects, she said. Her only diagnosis when she began using meth was depression. The hallucinations and “grandiose thoughts” — like thinking the U.S. president was going to buy her a car — came with drug use, though they persist without it. She’s not sure if meth caused her disorders; her family has a history of mental illness.
In 2014, the woman was high on meth for three days when she began to believe that a house down the street from where she lived in Beaverton had been built especially for her. Her delusions led her onto the property, and her acute psychosis elevated the situation when she was asked to leave. Eventually police removed her from the property where she believed she was supposed to be living. She was taken directly to the jail in Hillsboro, where she waited for admittance to Oregon State Hospital to be restored to competency to face charges. She said staff at the jail gave her little information about her situation.
“I felt scared. I felt alone. I felt like I was locked up for no reason,” she said. “I started seeing things, like vampires.”
Opportunities missed
Part of the problem is a lack of focus and leadership, many say. In 2019, the state’s Alcohol and Drug Policy Commission created a strategic plan for strengthening Oregon’s treatment and recovery system. The state is two-and-a-half years into the five-year plan, but many of its ambitious goals haven’t moved far off paper. Richardson, the commission’s director, cites a lack of funding and administrative support. “I’ve got myself and two staff. There’s a lot of things we have to do, but it gets down to a bandwidth issue,” he said.
Creators of the plan coordinated with the Governor’s Opioid Epidemic Task Force, but there was little strategizing around meth, which Richardson said is a bigger problem in Oregon than opioids. There was more focus on opioids because that’s where the federal funding was, he said. “We don’t have good treatment options” for meth use like there are for opioid use, Richardson said. “I’ve got no answer for meth.”
But experts say there are promising and emerging approaches to address meth use, and they suggest that treatment that tackles addiction and mental health disorders in tandem would be the best approach for many people struggling with the drug.
One promising method of treatment is known as “contingency management,” referring to programs that reward meth users with money or gift cards for drug-free urine samples or successful engagement in treatment. A large body of evidence shows it’s highly effective, but while Measure 110 has funded some rewards-based programs that tackle meth, it hasn’t done so in a methodical way.
There are also medications shown to reduce methamphetamine cravings or use in some patients. Though two providers in Portland have recently established programs offering these prescriptions, their enrollment is strikingly low. Some providers around the state who offer medications to ease opioid addiction told The Lund Report they were unaware of medications that could help methamphetamine addiction.
The addiction treatment advocacy group Oregon Recovers has recommended the addition of 500 detox beds to Oregon’s system, a 500% increase in residential treatment beds, as well as the creation of 7-day respite centers that would have beds for people who need to transition between detox and treatment —which advocates say would be especially beneficial to meth users.
But there has been “no progress” on any of these initiatives, said Mike Marshall, the group’s co-founder and director. He said state officials “are simply not taking responsibility for building the infrastructure needed to end the crisis. They are simply focused on distributing money.”
The Oregon Health Authority is working on plans for crisis stabilization centers that would “provide specialized short-term care in a residential setting for individuals experiencing behavioral health crises and are meant to serve as an alternative to placements in emergency departments and jail,” said Rusha Grinstead, Behavioral Health Crisis System and 988 Lead for the Oregon Health Authority.
Crucially, it’s not yet known whether they will house people for up to five days, which experts say is what people coming down off meth need to stabilize.
The state has not given meth enough focus, the state’s behavioral health director, Allen, said.
“We haven’t been able to elevate it to the level that it really deserves,” he added. “This is a big problem. And it’s likely to get worse.”
Need for leadership
Marshall, of Oregon Recovers, used meth for 10 years before entering recovery 14 years ago. He said he’s “always assumed that our mental health problems are largely being driven by meth.”
He said state leadership, at the governor’s office and health authority, have failed to prioritize the state’s existing strategic plan for building a system of care in the first place.
“There’s no behavioral health system relative to SUD (substance use disorder)” Marshall said, “it’s fractured and incomplete.”
He said the health authority has focused on administering legislative directives, but has failed to lead and innovate to address problems it’s responsible for addressing — such as the state’s addiction crisis.
A plan for meth should not overshadow the many other areas that need attention, many Oregon experts said. But meth is causing high-impact, high-cost problems that deserve focused attention.
In 2004, when the state was also in the midst of a meth surge. Then-Gov. Ted Kulongoski convened an interdisciplinary task force that brought together experts in prevention, treatment and law enforcement. Allen told The Lund Report he suggested convening a similar task force to Gov. Kate Brown, one aimed at synthetic drugs, including fentanyl. He said he brought it up this past fall, and then again in the spring, but there’s been no follow-up.
Charles Boyle, spokesperson for the governor, said Allen’s suggestion came as the state was dealing with the omicron surge.
“Rather than standing up a new task force in the midst of that surge, we instead prioritized actions that could be taken immediately to address synthetic drugs,” he said, and then listed actions taken to address synthetic opioids, though not meth.
“While Oregon has made historic investments to address substance use disorder and behavioral health,” Boyle said. “This implementation work will continue into the next administration.”
Leadership at the state’s health authority also urged patience.
“Oregon’s underfunded and fragmented behavioral health system hasn’t worked well for many decades …but that’s changing,” said Pat Allen, the director of the state’s health authority. “This transformation is fully underway, but it can’t happen overnight.”
But others stress the need to come up with an integrated approach now — while the state has unprecedented resources for behavioral health at its disposal.
Meieran, the Multnomah County commissioner, said the state should appoint a “meth czar” with accomplished staff to tackle the “inextricably linked” issues around meth holistically, in close coordination with the justice system and agencies tackling homelessness.
“We need to have been addressing this yesterday. And watching it unfold is like watching the slow-moving train coming towards you and not being able to stop it,” she said.
“We need to be the ones on the cutting edge looking for the answers, implementing innovative approaches that other jurisdictions are looking at — rather than just waiting for the train to hit.”
This story about the Oregon government’s response to the meth problem was produced by The Lund Report, an independent nonprofit health news organization based in Oregon. The Lund Report is tracking addiction issues as part of a reporting fellowship sponsored by the Association of Health Care Journalists and The Commonwealth Fund. Emily Green can be reached at emily@thelundreport.org.