Drugs significantly contributed to record number of homeless deaths in Portland


Shane Ersland


A record number of homeless people died in Oregon’s Multnomah County, home to Portland, in 2021 according to the county’s annual Domicile Unknown report, which was released on Wednesday.


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At least 193 homeless people died in 2021, which was a 53% increase from the county’s 126 homeless deaths in 2020. Drug or alcohol toxicity either caused or contributed to nearly 60% of the 193 deaths. The 2011 report, in its initial year, recorded 47 homeless deaths in the county. 

The report’s data relies on the findings of state medical examiners who investigate deaths caused by suspicious or unknown circumstances, like homicides, suicides, accidents, injuries, contagious diseases, deaths occurring in jails or prisons, and unlawful use of controlled substances or the use of chemical or toxic substances.

“Yet the cause and manner of death only tells part of the story of why people die,” the report states. “And forces outside the person’s control, including the social, economic, and environmental factors that person experiences must also be considered by the public, elected officials, and social service providers as they identify resources and policies that can save lives.”

Methamphetamine contributed to 93 homeless deaths, which represented 82% of all deaths involving substances. Fentanyl was a primary or contributing factor in 36 deaths, which was a dramatic increase from the four fentanyl-related deaths last year. 

The state legislature is currently considering several bills that would boost Oregon’s efforts to battle fentanyl, including House Bill 2395, which would greatly expand access to naloxone, a medication used to treat fentanyl overdoses.

The report found that 76% of the individuals who died were male (147), with an average age at death of 48. The 46 females who died had an average age of 46. The majority of the decedents were white (76%), while 10% were Black, and 5% were American Indian/Alaska Native.

Two deaths in the report occurred as a result of complications from COVID-19, while a third death due to complications from chronic alcohol abuse also included a positive test for COVID-19 at the time of death.

More than half of all deaths (55%) occurred in outdoor public spaces like parks, sidewalks, and homeless encampments, while 22% occurred in hospitals.

Next year’s report could prove to be even bleaker, as the Oregon Health Authority recently released a dashboard that showed at least 207 homeless people died statewide in the first half of 2022. 

“Deaths that meet criteria for medical examiner investigation are often premature by definition,” the report states. “That said, looking at homeless deaths in aggregate over the course of a year paints a picture of potentially preventable deaths on our streets.”