A Portland nonprofit organization has been rapidly using its supplies of Narcan to treat locals suffering from drug overdoses lately, and needs more access to the drug. Some relief could be on the way through state legislative proposals, as well as a recent ruling from the US Food and Drug Administration (FDA).
Blanchet House has been providing free meals and shelter to those in need in Portland’s Old Town neighborhood for 71 years. But Executive Director Scott Kerman said a lot has changed there in the past few years as dangerous street drugs have impacted the community.
“Methamphetamine was a game-changer in terms of the level of addiction it has, and the struggles people are having with it,” Kerman said. “P2P meth is resulting in greater levels of psychosis in users. And meth is often laced with fentanyl. We’ve been dealing with opioid/fentanyl overdoses for quite some time. We’ve been deploying Narcan for over a year.”
Narcan can rapidly reverse the effects of an opioid overdose. In a seven-day period, from March 25th through Saturday, there were seven opioid overdoses near Blanchet House, and staff there revived five of those individuals with Narcan, Kerman said.
Blanchet House is not alone in witnessing an increase in drug overdoses in the city. Downtown Portland police officers responded to 11 calls for service related to overdose emergencies on Friday, leading to at least three deaths and multiple applications of Narcan or other forms of naloxone to counteract the effects of opiates. And drug or alcohol toxicity either caused or contributed to nearly 60% of the city’s record 193 homeless deaths in 2021.
“The concern with fentanyl is, you can be using something and not realize it’s laced with it,” Kerman said. “And you can’t know the strength of it, and it’s accessible. And because of the potency, it’s taking three to four doses of Narcan to treat someone. We have enough on hand for seven overdoses. We can use that in a week.”
Blanchet House staff are often called on to help individuals who are experiencing an overdose while they are serving meals during the day.
“The way it often happens is, folks will bang on our door or window and say, ‘We need help outside,’ and someone is out there overdosing,” Kerman said. “All of our staff has been trained. And we have Narcan strategically stocked in different locations so we don’t have to spend time running around looking for it.”
It is not easy for a nonprofit to acquire Narcan, however, and Blanchet House cannot obtain a prescription for it, Kerman said.
“We have a nurse clinic on site, and that’s where we get it,” he said. “They can apply through the county, but sometimes resupply is delayed. I got in touch with Oregon Health Authority (OHA), and was told they can only supply us with free Narcan if we give it to the people we serve.
We serve hundreds of people per day. We would have to have a large supply. It would be much more efficient if they could supply us, but they can’t currently do that. Other nonprofits have a [connection], but everyone is paying a different price. And Blanchet House doesn’t receive public funding, so how do we get our hands on it? There’s got to be a better way.”
Access could improve with the FDA’s decision to approve Narcan nasal spray for over-the-counter use. The FDA announced that Narcan will be the first naloxone product approved for use without a prescription on Wednesday. It will be sold directly to consumers in drug stores, convenience stores, grocery stores, gas stations, and online by late summer.
“Greater accessibility is better,” Kerman said. “I think it helps destigmatize it. We have a lot of volunteers who would be happy to carry Narcan. There are a lot of people in our community who would take advantage of greater access. What we don’t know is what it will mean for pricing. Sometimes over-the-counter items can be more expensive than getting it with a prescription. And sometimes availability is an issue. I have no idea how it might impact Blanchet House or other agencies like mine, but it’s good news as far as destigmatizing it.”
There is also legislation in the works that could help address the issue. Rep. Maxine Dexter’s (D-Portland) House Bill 2395 would decriminalize the distribution of fentanyl test strips, remove barriers to naloxone availability in publicly accessible buildings, and allow OHA to issue standing prescriptions for short-acting opioid antagonists.
“It’s going to create greater access for first responders,” Kerman said. “For our purposes, I’m excited about it breaking barriers to access. But there’s a lot to this bill to be excited about. And there’s real bipartisan support for it. Dexter is a medical doctor, and we’re fortunate to have legislators that are doctors here. They bring that clinician point of view to their legislative work.”
HB 2395 passed the House on March 6th, and it is scheduled for a public hearing in the Senate on April 12th. Kerman will be watching the bill’s proceedings closely.
“We try to provide a compassionate, safe place to enjoy meals, giving people a reason to hope and think they could change their lives,” he said. “Right now, we literally have to save lives so we can change them.”