Nearly 21 years ago, Portland native Danny Phillips broke his knee in a skateboarding accident. His left kneecap was all but shattered. The doctors prescribed him Percocet, which is the brand name for the pain-relieving mix of oxycodone and Tylenol.
Phillips was 12 years old.
“I remember telling my mom I lost the bottle so I’d get another one,” Phillips says. “I got like, seven bottles from that one injury. They made me feel better. I didn’t know what I was doing.”
Phillips has struggled with opiate dependency ever since, unable to string together more than a year of sobriety at a time. He’s insured under Oregon’s Medicaid program, the Oregon Health Plan. But only certain drug treatment centers accept OHP, and they have only a limited number of beds.
So when Phillips, then homeless and hopeless, attempted to get treatment earlier this year, he was put on a waitlist. His bed would be available in three months — if he could survive that long.
“I couldn’t wait that long to be medically detoxed,” Phillips says. “I ended up going to the methadone treatment center. I don’t consider this recovery. I’m still taking opiates every day.”
The lack of resources available to Phillips is the result of what Gov. Kate Brown called a “public health crisis” after issuing an executive order on March 27, 2018, detailing Oregon’s need to address untreated alcoholism and substance abuse.
More than a year later, as resources for people experiencing addiction remain scarce, it was announced to the Alcohol and Drug Policy Commission that Brown plans on taking “no action” to end Oregon’s untreated addiction crisis until at least 2021.
The decision was made public a week before Brown issued a temporary ban on flavored vaping products in response to two recent deaths.
It also came only 10 days after a report submitted to the Oregon Legislature by the Criminal Justice Commission stated that “Oregon now ranks among the most-challenged states in the nation for substance abuse and mental health problems, while at the same time ranking among the worst states for access to care.”
Phillips tried to get treatment in Eugene last year at Serenity Lane, a nonprofit substance abuse center that offers both inpatient and outpatient services. He says that with his insurance, for inpatient treatment Serenity Lane required a down payment of $5,000 before he could be admitted.
Mike Marshall, executive director for Oregon Recovers, says that without action, Oregonians experiencing addiction and alcoholism will continue to die unnecessarily without access to affordable treatment.
“This is the single largest public health crisis in Oregon. Seven people a day die because our system can’t treat them,” Marshall says. “We’re looking for somebody to take responsibility for building a new continuum of care, and no one else can do that but the governor.”
While some treatment centers require large down payments, others aren’t accessible at all to people outside the legal system.
Ashlei Fraser works at Emergence as a treatment court counselor, dealing with people who chose treatment instead of a jail sentence after a run-in with police.
“I want people to get treatment before getting involved in the legal system,” Fraser says. “Having the court as your external motivator in the beginning is helpful. Then the idea is that they’re with us long enough that it turns to internal motivation by the end.”
Fraser says that access to poor long-term treatment is one of the biggest barriers to addressing the addiction crisis.
“We need to provide more money for health care providers so that they can do their jobs properly,” Fraser says. “This is a system-wide failure that deserves a system-wide response.”
Emergence patients sometimes wait two or three months for a residential treatment bed, Fraser says. Patients getting on the waitlist are often homeless and have no way of being contacted when their bed is made available.
When Phillips couldn’t get into treatment, he joined a methadone maintenance program in Portland to avoid the withdrawals that occur from habitual opiate abuse. While OHP won’t cover the cost of inpatient treatment, it will pay for detox and methadone maintenance.
Teri Morgan is the program coordinator for Springfield Treatment Center, one of the few methadone maintenance programs in Lane County. She says that a lot of the patients she sees either couldn’t afford or couldn’t wait for inpatient treatment.
“There are so many hoops to jump through in order to get qualified for treatment,” Morgan says. “When we first opened, there was such a huge influx of people trying to make an appointment that there was a four-week wait to see a doctor. Now we have about a week turnaround, which is really amazing.”
In the past few weeks, the Eugene City Council — as well as those of Bend, Medford and Portland and county commissions in Lane, Jackson and Multnomah counties — have supported Brown’s 2018 declaration that untreated addiction was a public health crisis.
Last year more than 1,000 people participated in separate Walk for Recovery fundraisers in Bend, Medford and Eugene.
Stemming from the 2018 declaration, the Alcohol and Drug Policy Commission was required to develop an official plan to address the crisis. It’s scheduled to be completed in December.
Phillips plans to remain on methadone until after he can have another surgery on his leg that never quite healed right. Afterwards he wants to get into a residential treatment center. He’s still searching for the type of peace that’s evaded him since he was 12.
Clarification: This story has been updated to reflect the governor’s office says, “While others outside her administration may have offered their own characterizations of her positions or words, it’s not accurate to quote the governor as saying the words ’no action.’l
The governor’s office responded with the following statement after the original story was published:
Drug and alcohol misuse, overdose, and addiction (i.e. Substance Use Disorder) remain persistent, costly, and devastating problems for Oregonians, with far-reaching impact on our children and families. Governor Brown has taken significant steps to address this crisis. During the legislative session, Governor Brown sponsored HB 2257, comprehensive legislation developed by the Opioid Epidemic Task Force which declared substance use disorder a chronic illness in Oregon, removed barriers to accessing treatment, expanded proven programs to treat pregnant women with substance use disorder and keep families together, and took an overall comprehensive approach to addressing the public health crisis of addiction in Oregon. HB 2257 passed with bipartisan support in the House and Senate.
Last year, Governor Brown declared that alcohol and substance abuse addiction is a public health crisis in Oregon that must be addressed through a commitment to addiction prevention, treatment, and recovery (see Executive Order 18-01). Her policy agenda on the topic further outlines her strategy to address substance use disorder in Oregon.
It remains one of her top priorities to ensure that state agencies are taking the steps necessary to connect each of the thousands of Oregonians who struggle with addiction every day with the services they need. Based on her executive order, which remains in effect, the Oregon Health Authority, the Department of Human Services, and other state agencies will continue to work with the Alcohol and Drug Policy Commission to implement their strategic plan to address addiction in Oregon. Oregon has made great strides in reducing both overdose deaths and prescription rates of dangerous opioid medications. However, much work remains to be done. The Governor’s 2019-2021 budget included several key investments (page 27), and in the 2019 session, she secured $2.5 million for addiction and recovery services for pregnant people suffering from Substance Use Disorder through the Project Nurture program.
In addition to these steps to provide direct support to those struggling with substance use disorder, Governor Brown has also focused on the root causes that can contribute to it, including mental health and homelessness. In the 2019 legislative session, the Governor secured $50 million to a behavioral health investment package to develop a stronger system of care through suicide prevention and substance abuse programs, foster care behavioral health services, and capacity for behavioral health homes. Governor Brown also integrated health care funding for behavioral health both via the Oregon Health Plan and under the Student Success Act.
Additionally, the Governor secured $50 million for Permanent Supportive Housing, which is directly targeted to those struggling with chronic homelessness. The chronically homeless includes populations facing barriers to stable housing such as seniors, those being released from prison and jail, individuals with intellectual and developmental disabilities, transition-age youth, people with substance use disorders, and those with serious and persistent mental illness. PSH combines non-time- limited affordable housing with wrap-around supportive services for people experiencing homelessness who also have disabilities.