It was the sort of blue-sky afternoon in downtown Portland that draws people away from their desks, but the dreary scene along Southwest Fifth Avenue chased away the optimism of a spring day.
The patch of sidewalk in the shadow of Oregon’s largest office building represented the latest front in the city’s rolling battle against open-air fentanyl markets. Several dozen people milled about, hollowed out by the uniquely potent synthetic opiate, waiting for dealers to make their rounds.
A few weeks earlier, officers had swept the nearby Washington Center, a blighted block where doorways and alcoves had hardened into a hive of drug dens, greeting commuters as they motored into downtown.
Yet the effort did little more than scatter fentanyl users onto nearby blocks and corners.
Public health experts, doctors and police say a medley of public policy, social forces and basic economics play into the city’s plight: a downtown depleted by still-empty offices, scarce affordable housing and a cheap and plentiful fentanyl supply that has all but squeezed out heroin over the past four years.
Add to the mix Measure 110, the voter-approved law that police officers say has amplified the longstanding problem of illegal drug dealing downtown.
In Multnomah County, fatal opioid-related overdoses saw a fivefold increase between 2018 and 2022, according to public health data. A record-high 209 people in the county died from fentanyl overdoses last year.
Statewide, 567 people died after taking multiple drugs in 2021 and fentanyl was detected in more than half of those cases, according to the latest data available from the Oregon Medical Examiner’s Office.
Likewise, police seizures of fentanyl have skyrocketed, federal data shows. According to the Oregon-Idaho High Intensity Drug Trafficking Area program, nearly 1.5 million counterfeit fentanyl pills were seized in Portland last year, up from a half-million the year before.
“Open-air drug use is at an all-time high. Open-air drug dealing is at an all-time high,” said Portland police Sgt. Jerry Cioeta.
For a while earlier this year, those problems coalesced around Washington Center, just three blocks from the Morrison Bridge off-ramp.
“You come off the freeway,” Cioeta said, “it’s the first thing you see.”
TICKETS FOR FENTANYL
The crowd had already gathered by the time Portland police Officers Eli Arnold and Donny Mathew walked up to Southwest Fifth Avenue, between Oak and Harvey Milk Streets.
Some wandered, talking to no one in particular. One pushed a stroller full of junk, paying the cops little mind. A woman appeared on the corner, clutching a surprised starling and briefly tucking it into her oversized jacket before letting it go. A few drifted away, steering clear of the police.
A man prepares to use fentanyl on a park bench in downtown Portland.
Charred bits of foil and makeshift straws lay scattered about. People who use the drug heat crushed pills or powder on scraps of foil and inhale the fumes. Some melt the drug and inject it.
Oregon’s voter-approved Measure 110 removed criminal penalties for possessing small amounts of fentanyl and other street drugs including methamphetamine and heroin and infused the state’s anemic treatment system with hundreds of millions of dollars from cannabis tax revenues.
The law, passed in 2020, put minor drug possession on par with a traffic ticket.
Those cited for drug possession have the choice to call a statewide hotline to get screened for substance abuse treatment options or pay a $100 fine. Anyone needing help with substance abuse can call the hotline: 503-575-3769.
Advocates pitched Measure 110 as a fundamental transformation of Oregon’s approach to addiction. Instead of cycling people through jail, the law would steer them toward treatment and other help, like housing and peer counseling.
The Oregon Judicial Department’s data shows Portland police ranked below other agencies in handing out tickets, coming in behind Grants Pass and Medford, since the law took effect in February 2021.
Confronted with the proliferation of open drug use downtown, Portland police this spring decided to ramp up enforcement, issuing 36 tickets in the first eight days of May, doubling the number officers handed out in April, according to the latest data available. Since January, Portland officers issued 344 citations; last year, they gave out 236.
So far, the citations seem to have had little lasting effect. About 4,000 tickets have been issued statewide since February 2021; the vast majority of people have ignored the requirement to pay the $100 fine or have the citation dismissed by calling the hotline, state data shows.
The lack of follow-through doesn’t surprise Haven Wheelock, a harm reduction manager at Outside In, a Portland-based organization that provides health care and social services for marginalized people and youth experiencing homelessness.
People living with addiction tend to feel disregarded and don’t get much help finding housing and detox services, she said.
“You can only get kicked by a system so many times before you stop trusting that system, especially when we think about ticketing by law enforcement,” she said. “The message has been, ‘We are going to take you to jail’ so of course people are not going to trust law enforcement when they say, ‘Hey, call this number and get some help.’”
‘YOU’RE NOT GOING TO JAIL’
That warm afternoon on Southwest Fifth Avenue, Arnold, a bike cop who patrols downtown, approached a man on a bench.
The man was half-dressed, a scrap of foil in one hand. The bass blasting from a nearby speaker made it hard to hear. Arnold bent down to talk, handing the man a business card with a number to call to learn more about treatment options.
A man in downtown Portland holds fentanyl in one hand and a card offering hotline information for drug treatment in the other.
He wasn’t in trouble, Arnold reassured him as he began to scribble a citation.
Call the number, he explained, and the ticket goes away.
“It’s literally just an opportunity for you to get drug treatment,” he said. “You’re not going to jail.”
The man appeared disoriented and unable, or unwilling, to provide his name. Over the following 10 or so minutes, his hostility shifted to desperation as he tried to pull off his pants, screaming that bugs were devouring his legs.
To police, his sudden agitation suggested the fentanyl he’d used had been mixed with methamphetamine.
These small encounters between Portland police and fentanyl-addled people play out dozens of times a day along downtown sidewalks, in alcoves and doorways, as officers try to keep fentanyl users from taking over public spaces.
Measure 110, police said, drew the existing drug market into the open, fentanyl’s potency only compounding the crisis.
Amounts of the painkiller vary from pill to pill and it doesn’t take much to be lethal, especially for people whose tolerance is low. In pharmaceutical form, fentanyl is used as a short-acting drug to treat severe pain.
Arnold said he’s noticed that people who use the drug tend to fill up public spaces with impunity.
“We are seeing lots of just blatant open use,” he said. “It’s kind of changed the dynamic.”
‘HELP ME GET CLEAN’
Arnold and Mathew recognized some of the faces as they walked downtown blocks, like the man leaning against a boarded up wall of Washington Center whose face had developed a large swollen mass from what the officers guessed was an infected tooth.
Mathew at one point crossed the street to cite another man he’d seen around after watching him buy what the officer suspected was fentanyl. The man stared blankly at the citation, holding it upside down as the pair of cops walked away.
Police figure it’s the same 50 to 75 people they see each day.
Fentanyl confiscated by Portland bike police and posted to their Instagram page.
On this day, many gathered along Southwest Fifth, previously the site of what was Portland’s oldest food cart pod. Big Pink stood across the street.
Cioeta said foot traffic remains down, even as the pandemic recedes. About 600 people report to work each day at the 42-story U.S. Bancorp Tower, down from about 3,000 before the pandemic, according to a spokesperson for Unico Properties, owner and manager of the tower.
“That’s problematic,” Cioeta said. “You don’t have that positive activity, the commuter energy. And so this is what you see instead of that good, positive, thriving activity.”
Fentanyl confiscated by Portland bike police and posted to their Instagram page.
As Cioeta spoke, a man nearby leaned back on a wooden bench, a lighter in one hand and wrinkled foil in another. Roy Williford, 43, said he lives on the street and has used fentanyl for “a while.”
He stared at the hotline number on the card Mathew handed him. Sometimes he thinks of getting help, he said.
“It’s never been offered,” he said. “There ain’t enough facilities here for help.”
Around the corner, Matt Carmen, 22, said he survived a near overdose that morning thanks to the quick administration of naloxone, or Narcan, by a bystander. Narcan rapidly reverses an opioid overdose. Police said they knew of two other non-fatal overdoses on the block that week.
“It was scary,” Carmen said.
He said he tried to get into treatment but was told the program had a waiting list. He’s attempted to stay off fentanyl on his own, but it was no use. He said he lives on the street and first tried the drug about a month ago.
“I need someone to get me help to get clean,” he said.
‘FEEL LIKE YOU ARE DYING’
The next week, the scene on the sidewalk was gone. That section of Southwest Fifth was mostly clear, its benches removed. One large tent remained.
Over at Washington Center, the block police have tried to keep clear, about a dozen people had settled onto the corner of Southwest Fourth Avenue and Washington Street.
They came and went over an hour. Some wandered by looking for a fentanyl dealer. Several chatted with each other as they sat on the pavement, inhaling the drug. Trash had piled up along one wall.
Some said they’d gotten citations for open drug use; none had followed-up by calling the hotline for treatment resources.
Andrew Suchocki, the medical director of the Clackamas County Health Centers, said treating people who use fentanyl is exceptionally challenging. The trio of drugs -- naltrexone, buprenorphine and methadone -- used to help wean people off opiates is often outmatched by fentanyl’s potency, he said.
Withdrawal tends to be so severe that people abandon treatment, leading to high failure rates, Suchocki said.
“The experience is so triggering and so traumatic that they don’t want to do it again,” he said.
One of the men at Washington Center said he could not imagine ever again attempting to get clean. The man, in his 20s, declined to give his name.
“It’s so excruciating on your body,” he said. “It’s so debilitating you can’t even fathom. After you start, it’s a nightmare to think of stopping. It’s scary as hell. It just gets worse and worse and worse and you feel like you are literally dying.”
Another man, who gave his name only as Angel, paid $20 for a grimy bag that contained broken fentanyl pills. He slowly made his way up the block, pausing at a corner to use the drug.
He figured the dose would last him half the day.
“If I quit,” he said, “I die.”
A man who goes by Angel smokes fentanyl on the street in downtown Portland.
He nodded into unconsciousness, struggling to keep upright as afternoon commuters passed by in a blur.
Another man riding by on his scooter stopped a few feet away. He had just come from Washington Center to look for a dealer to feed his $80-a-day habit.
The man, who gave his name only as Kevin, said he got odd jobs to help his girlfriend pay off a citation for drug use last year. He said they didn’t realize she could have called the hotline to avoid paying the $100 fine.
He said he, too, has tried treatment only to return to the streets. He’s 30.
“I have a really big habit,” he said, leaning on the scooter. “It sucks.”
Yet he takes a dim view of decriminalizing drugs, acknowledging the irony given his predicament.
“I miss Portland the way it was before, before COVID, before the drugs,” he said. “I know I’m a drug addict, but I don’t want to be.”
-- Noelle Crombie; ncrombie@oregonian.com; 503-276-7184; @noellecrombie
Our journalism needs your support. Please become a subscriber today at OregonLive.com/subscribe