PORTLAND, Ore. (KOIN) – The Multnomah County Health Department found a massive increase in synthetic drug overdose deaths — reaching over 500% between 2018 and 2022 — while the county has also seen BIPOC communities disproportionately impacted by the deaths, KOIN 6 News has learned.

During a late June briefing with the Multnomah County Board of Commissioners, the health department said from 2018 to 2022, there was a 533% increase in synthetic opioid deaths.

The department said this sharp upswing represents the “rapid and radical change in local drug supplies towards fentanyl and other potent synthetic opioids which began in 2019.”

OR drug crisis: Multnomah County reports over 500% increase in overdose deaths
According to Multnomah County Health Department, there was a 533% increase in synthetic opioid overdose deaths from 2018-2022 (Multnomah County Health Department).

According to the county, the briefing was requested by County Chair Jessica Vega Pederson and was the first time the department’s divisions met in a public forum to discuss the substance abuse crisis.

“We have the urgency. We sense the crisis and the gravity of the situation. We know that every day we don’t act, another life is lost,” Health Department Interim Director Valdez Bravo said.

Synthetic opioids, such as fentanyl, are more potent, addictive and deadly compared to other opioids, Multnomah County Interim Health Officer Dr. Teresa Everson explained. According to Everson, substance use interventions that have seen success in the past “do not have the same impact against substances at this level of potency and addiction.”

“These substances are not like anything we’ve seen in the last 40 years, including prior heroin epidemics, and are even harder to address with the buprenorphine-based medication-supported recovery services that have been expanding across the country,” Everson said.

Between 2019 and 2021, overdose rates per 100,000 people in the county rose across all demographics, Everson said, but these rates were the highest and increased the fastest among people over 30 years old.

Additionally, the health department says the BIPOC community across Oregon is experiencing overdose deaths at a disproportionate rate.

Statewide, American Indian and Alaska Native community members had the highest rate of overdose deaths with nearly 43 deaths per 100,000 people in 2020, according to the county – noting this rate is almost triple the statewide rate for non-Hispanic people.

Additionally, Black community members in Multnomah County experience overdose deaths at a 36% higher rate than white community members, the health department said.

OR drug crisis: Multnomah County reports over 500% increase in overdose deaths
Black community members experience overdose deaths at a 36% higher rate than white community members, according to Multnomah County Health Department (Multnomah County Health Department).

In addition to the presence of more potent and deadly drugs on the market, the county says another force behind the spike in overdose deaths is a growing number of people using both meth and opioids. Multnomah County noted that using more than one substance at a time dramatically increases the risk of an overdose and makes overdoes treatment more difficult.

“Many people often combine fentanyl with stimulants in an effort to balance the effects, hoping it will enable them to stay awake to accomplish tasks or stay safe,” said Kelsi Junge, a supervisor for the county’s Harm Reduction Program. “Mixing or alternating stimulants and downers is physically hard on the body and it increases the chance of overdose.”

According to the Multnomah County Medical Examiner’s Office, about 60% of overdose deaths in 2022 involved more than one substance – compared to 22% in 2020.

OR drug crisis: Multnomah County reports over 500% increase in overdose deaths
The Multnomah County Medical Examiner’s Office says a majority of overdoses in the county in 2022 involved more than one substance (Multnomah County Health Department).

“As long as our communities continue to grapple with the huge, systemic social challenges that drive dependence on illicit substances like trauma, economic insecurity and racism, people will continue to seek out methods to cope,” Junge said.

The Health Department stated that in order to address the fentanyl crisis in the community, the use of meth and other opioids must also be addressed.

“The hard truth is that the way we are currently set up, with the resources we have, the healthcare system and providers cannot compete with fentanyl,” said Ederlinda Ortiz, Corrections Health Transition Services program supervisor.


During the briefing, the health department highlighted its four programs to address substance use including primary prevention, harm reduction, treatment and recovery support. The county’s Behavioral Health Division has more than 90 contracts totaling over $13.6 million annually, as part of the county’s treatment and recovery efforts.

“When we first began to see routine use of synthetic fentanyl in 2018 and 2019, we started with the treatment approach that had historically worked for opioids and heroin,” said Anthony Jordan, addiction services manager for the Behavioral Health Division.

Jordan added, “it became clear the interventions were not effective for this substance. As a result, we’re in the midst of a pivot around the treatment and recovery services when it comes to addressing fentanyl.”