Report Details Fentanyl Deaths

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The synthetic opioid crisis has been building for many years as cheap and widely available illegal fentanyl has created deadly cycles of addiction and overdoses across the United States. In Multnomah County, fentanyl-related overdose deaths have been increasing since the COVID-19 pandemic as illegal fentanyl became more available on the West Coast.

The Multnomah County Health Department has released a report that shows the dramatic rise in fentanyl overdose deaths in Multnomah County from 2018 to 2023.

  • In 2018 and 2019, there were two fentanyl overdoses deaths a month.
  • By 2022, that number jumped to 22 deaths a month.
  • In 2023, provisional data looks like overdose deaths will even be higher — nearly 36 deaths a month.
  • Since 2018 and with partial data from 2023, the report describes a total of 868 people who died from fentanyl overdoses.

“While reporting on data is a vital part of addressing any health crisis, no data report can fully describe the people who were lost to their family and friends,” said Multnomah County Health Department Director Rachael Banks. “Each death counted in this report represents a real person, the grief and heartbreak of those close to them, and the trauma felt throughout our community as a result of their loss.”

Fentanyl overdose deaths occurred across the County. However in 2023, the majority of fentanyl overdoses happened in downtown Portland, particularly in the Old Town and Pearl District neighborhoods. The report shows how often a fentanyl overdose death occurs when fentanyl is used with other drugs, most often methamphetamine. In 2018, 27% of fentanyl overdose deaths involved both fentanyl and another drug. In 2023, it rose to 63% of fentanyl overdose deaths.

The report also looked at the age, race, ethnicity and gender of the people who died. This helps provide insight into who is most affected in our community.

  • The majority of fentanyl overdose deaths were White men aged 35 to 44. 
  • Among communities of color, the Black community had the highest number of deaths.
  • Taking into account population sizes, fentanyl overdose death rates are much higher in American Indian/Alaska Native and Black/African American communities compared to other communities. 
  • Although the rates of fentanyl overdose death were lower among people with reported Hispanic ethnicity, the rate more than doubled between 2021 and 2022.
  • More men than women died of a fentanyl overdose and the data suggest this gap has widened over time.
  • In 2022, 20% of fentanyl overdose deaths occurred in persons likely houseless and provisionally in 2023, that proportion rose to 25%. This isn't always accurately recorded on death certificates, so the true numbers might be higher.
  • Fentanyl overdoses increased in every age group in 2021 and 2022, with the highest numbers in people aged 35 to 54.

“Highlighting racial and ethnic inequities can cause its own harms for communities that know all too well the unfair burden they experience” said Banks. “The information in this report needs to be considered in the context of the social influences that contribute to the inequitable outcomes, including racism, colonialism, intergenerational trauma and poverty.”

The County is taking culturally specific efforts to combat the identified health inequities occurring with fentanyl overdose deaths. Some of these include: 

  • County Health Native communities liaisons are working with the Future Generations Collaborative to create a Native-specific opioid overdose training for Native community health workers, host opioid crisis community conversations throughout May, and distribute naloxone and wound care supplies to Indigenous community members and tribal health clinics.
  • The Chronic Disease Prevention and Health Promotion Unit, the ACHIEVE (Action Communities for Health, Innovation and Environmental Change) Coalition and the REACH (Racial and Ethnic Approaches to Community Health) program are jointly organizing upcoming community forums in collaboration with the Oregon Health Authority to shed light on the impact of the fentanyl and polysubstance use on the Black and African communities.The forums seek to create a platform for discussing both immediate and long-term strategies to address the opioid and polysubstance use crisis. It aims to utilize community strengths and priorities and meet community needs within the Black immigrants and African American communities. 
  • County Health Latinx community liaisons have shared information on the 90-day fentanyl emergency with Spanish-speaking Community Health Workers and other community members.
  • Health Department leadership and staff have participated in recent Latino Providers meetings on communications regarding fentanyl awareness and overdose deaths in the Latinx community.

Reports such as these allow data to be shared with the community, Multnomah County leadership, partner organizations, and others, in a clear, concise way. The Health Department shared initial information with the equity officer for the 90-day fentanyl state of emergency to ensure that early analysis revealing health disparities was part of the response planning. 

As the Health Department continues to implement its Overdose Response Plan, the data will help focus funding and programs for prevention and treatment services across the County for the geographic areas and communities most impacted.

Multnomah County also continues to track overdose data with several partner organizations. Up-to-date information and a map showing fentanyl overdose locations can be viewed on the County’s overdose dashboard.

Source: Multnomah County Health Department

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