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Reducing Opioid Overdose and Misuse

Opioid Overdose and Misuse Resources


About Opioids

Opioids are a class of drugs that are used to relieve pain and that can produce a feeling of euphoria, which can lead to misuse, substance use disorder, and overdose. Opioids include prescription painkillers, illicit drugs such as heroin, and illicitly manufactured fentanyl.

Prescription opioids are intended to treat moderate to severe pain and are often prescribed after surgery, an injury, or for chronic pain caused by conditions like cancer. Common types include oxycodone (OxyContin), hydrocodone (Vicodin), morphine, and methadone. For more information on prescription opioids, visit OHA's Prescription Opioids webpage.

Illicit opioids include drugs like heroin and illicitly manufactured fentanyl (IMF), which is often found in powder or counterfeit pill form. Counterfeit pills containing fentanyl and other substances may look just like common prescription painkillers, and even pharmacists often cannot tell the difference. For more information about illicitly manufactured fentanyl visit OHA's Fentanyl webpage.
The consumption of too much opioid can have several consequences including overdose and death. Illicitly manufactured fentanyl is a highly potent synthetic opioid which is currently causing the majority of opioid overdoses across the country. When fentanyl is mixed with other types of drugs from non-regulated markets (counterfeit pills, cocaine, and stimulants) the risk of rapid unintentional overdose increases. Due to the potency of fentanyl, multiple doses of an opioid overdose reversal medication such as naloxone may be needed to save someone from a fatal overdose. More information can be found in CDC's publication on Understanding the Epidemic.


Oregon, like the rest of the U.S., is experiencing an opioid crisis involving misuse, overdoses, and deaths. The types of drugs that most commonly cause overdose in Oregon have changed significantly in recent years. While the state has made notable progress in reducing misuse and overdoses related to prescription opioids, there have been significant increases in overdoses from fentanyl and from non-opioid drugs such as methamphetamine, which are often mixed with opioids. 

More than half of overdose deaths in Oregon involve more than one drug and/or alcohol. For more information about fentanyl, stimulants, and mixing substances (polysubstance use), please reference the links below: 

Oregon’s overdose crisis has impacted every community, but some communities are affected more than others. Black/African American and American Indian/Alaska Native communities are experiencing the highest rates of fatal overdoses. Other populations at higher risk of overdose include males; people aged 34-44; LGBTQIA2S+ people; people with substance use, alcohol, or mental health disorders; people recently released from jail or prison; and people experiencing houselessness.  

 

Oregon’s overdose disparities are closely tied to systemic racism, generational trauma, and long-standing health inequities. There are large gaps in Oregon’s substance use disorder treatment services, where the demand and need for these services outweigh the availability of resources. Furthermore, there is limited access to culturally and linguistically appropriate services in Oregon. This further contributes to inequities among communities experiencing health disparities. 

 

  • Review OHA’s Overdose Death Disparities in Oregon fact sheet for more information. 
  • Review OHA’s Black and African American fact sheet for more information on the disproportionate impact of opioid related overdose among Black and African Americans in Oregon. 
  • Review OHA’s Latinx fact sheet (English) (Español.pdf) for more information on the disproportionate impact of opioid related overdose among Black and African Americans in Oregon. 

 

Substance use disorder is a chronic, treatable medical condition. It is not a choice or a character flaw. People who use drugs commonly face discrimination and stigma that impacts their wellbeing and discourages them from seeking help. This can increase the risk for overdose and other substance use-related harms.  

 

People who use drugs, people who are houseless, and people who have mental health disorders also experience negative stereotypes, many of which are false. Oregon is experiencing a co-occurring housing crisis and overdose crisis; however, most fatal overdoses in Oregon occur in a house or apartment, not in a public setting.   

 

There are several complex factors contributing to Oregon’s overdose crisis, including racism, stigma, affordable housing, healthcare access, economic opportunity, climate change, and other forms of individual- and community-level trauma. Addressing these issues will require partnerships and coordination across systems to promote improved quality of life and wellbeing among all Oregonians.  ​

​Oregon has continued its trajectory of notable progress over the last decade in reducing substance use and overdoses related to prescription opioids. However, significant and sustained increases in the supply of illicitly manufactured fentanyl (IMF) and non-opioid drugs such as methamphetamine, which are often used with opioids, are continuing to drive unprecedented increases in fatal and non-fatal overdoses, making Oregon's fentanyl overdose death rate one of the fastest growing in the country from 2019 to 2023. 

The Oregon Health Authority coordinates a broad array of programs and works with organizations across the state to reduce the burden of substance use disorder and overdose-related harms through the following key strategies:​

  • Improving access to overdose and substance use data (fatal and nonfatal) to increase public knowledge and inform state and local response.
  • Improving local capacity to prevent substance use disorder and overdose among priority populations through community-driven, culturally specific approaches.
  • Strengthening and expanding internal and external partnerships to improve cross-system coordination, collaboration, and information exchange across the substance use continuum.
  • Expanding public communications to increase awareness of overdose risk, harm reduction strategies/resources, treatment and recovery resources, and OHA's response to the overdose crisis
  • Increasing equitable access to harm reduction supplies such as naloxone kits, sterile syringes, and fentanyl test strips. Visit the Save Lives Oregon or Salvando Vidas Oregon website for more resources on safe drug use.

​Four Goals for Immediate Action

In November 2023, the Oregon Health Authority Overdose Response Team adopted four goals for immediate action to address the polysubstance and overdose crisis in Oregon:

  1. Engage communities for action
  2. Adjust naloxone distribution
  3. Enhance public awareness and education
  4. Increase outreach, harm reeducation, and access to treatment

 The Overdose Response Team held regional listening sessions in late 2023 in support of Goal #1. Providers, partners, and members of impacted communities shared insights about Oregon's overdose crisis and provided recommendations on how OHA can improve its response. From March through May 2024, OHA conducted five additional community-specific listening sessions. The feedback from these sessions is further refining OHA's response to ensure the statewide approach is meaningfully focused on eliminating health inequities associated with substance misuse and overdose.


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Quarterly Opioid Overdose Data Report

The Oregon Health Authority publishes a quarterly opioid overdose public health data update. This report compiles overdose information from two state-based data systems: the State Unintentional Drug Overdose Reporting System (SUDORS) and the Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE). To directly receive updates, subscribe to the listserv.


2023 Oregon Opioid Overdose Report

This 2023 report summarizes the burden of opiate and opioid overdose among Oregonians, as required by Oregon law (Oregon Revised Statute 432.141). This report summarizes Oregon overdose data from January-December 2022. It describes trends in deaths from unintentional overdoses (including those from fentanyl and methamphetamine) and demographics of decedents. It shows trends in opioid overdose emergency department and urgent care visits, hospitalizations, and opioid prescribing practice information from the Oregon Prescription Drug Monitoring Program. The report describes OHA's role in the many efforts underway to address the overdose crisis in Oregon.

​The 2024 version of the report will be structured differently, with several shorter reports published throughout the year.

​T​he Oregon Health Authority presents this information with the acknowledgement that the data within this report represents individuals whose loss of life has had an enormous impact of their families and communities. 

​If you use drugs (even just experimentally, occasionally, or recreationally), you are at risk of overdose. Learn how to prevent, recognize, and respond to a drug overdose with the following resources.​

Get the Facts Overdose Prevention.pdf

Get the Facts Overdose Prevention - Spanish.pdf

Get the Facts Polysubstance Use.pdf

Get the Facts Polysubstance Use - Spanish.pdf

Overdose Death Disparities in Oregon.pdf

​Since 2020, Oregon Health Authority has funded Local Public Health Authorities in 11 regions to support local overdose prevention work and expand programs and collaborations. This report summarizes the accomplishments of these regions from September 2022 - August 2023. 

​Annual Report: Oregon Overdose Prevention Coordination in Funded Regions (December 2023) 


​OHA developed this communications guidance for Local Mental Health Authorities, as required by 2023 House Bill 2395. The purpose of this guidance is to improve local notifications and information-sharing when a person 24 years of age or younger dies of a suspected drug overdose. 

Please be advised that this document contains information related to youth and young adult drug overdose deaths. Oregon's overdose crisis has impacted every community across the state, and the highly sensitive and tragic nature of these events may cause distress. 


​OHA is hosting a three-part virtual training series May-June 2024 for Oregon’s Local and Tribal public health leaders and staff to learn more about available data to support their local overdose response and prevention work. OHA will post the meeting recordings following each training. 


Part 1: Overview of Data Sources to Support Local Response and Prevention 

Part 2: Take a Deep Dive into Oregon Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE)  
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Part 3: Take a Deep Dive into the Overdose Detection Mapping Application Program (ODMAP) 

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If you or someone you care about is struggling with substance use, please reach out for help. Speak with a healthcare provider or visit the links below for support and treatment resources. You are not alone.

 
If you have additional questions about stimulants, please contact the Injury & Violence Prevention Program at IVPP.General@odhsoha.oregon.gov.​



Prescribing Guidelines

Oregon Health Authority convened experts from across the state from 2016-2019 to develop clinical guidelines on opioid prescribing. These guidelines focus on recommendations to improve patient safety and care.

In 2022, CDC released an updated Clinical Practice Guideline for Prescribing Opioids for Pain. This update has expanded guidance on acute and subacute pain, maximizing nonpharmacologic and nonopioid treatment, targets a broader clinical audience spanning from primary care to outpatient settings, and specific implementation considerations. OHA is currently reviewing and revising our prescribing guidelines to reflect updated guidance and best practices

Acute Opioid Prescribing Guidelines

Opioid Prescribing Guidelines

Pregnancy and Opioids

Opioid Tapering Guidelines