The approach over the 90-day declared emergency – EMT responders helping provide overdosers with Suboxone, the common street currency for illicit opioids – had predictably consistently failed with lethal outcomes in other locations. 

by Clark Miller

Published  May 17, 2024

Political and institutional damage control is activated, with the positive spin that,

“The biggest achievement to come out of the 90-day emergency was increased collaboration between bureaus.”


If “the data shows the deadly crisis does not appear to be slowing down” turns out to be an understatement, as it appears, that was predictable. 

From the news report

Since Monday, Portland first responders have been called to 195 opioid overdoses, according to data from Portland Fire & Rescue Community Health. It’s unclear how many were fatal, but the data shows 53 were non-fatal.

Last month, they were called to just over 1,000 opioid overdoses across the city — more than 200 each week. The data shows they are often happening in and around Old Town  . . .

The crisis continues just one week after Portland’s 90-day fentanyl state of emergency ended. 

“There’s more work to be done and we all know that, and I want you to know that the state will continue to be a key partner in the work here in Portland,” said Gov. Tina Kotek at a press event on May 3.

The biggest achievement to come out of the 90-day emergency was increased collaboration between bureaus.

Let’s do the math, acknowledging that a confident extrapolation or prediction is not yet warranted. 

Over 5 days sometime between May 1 and May 10, there were 195 overdoses responded to. Using 30 days in a month, that would become 1,170 for May if the incidence remains constant, higher than the “just over 1,000 opioid overdoses” the month prior. 

That apparent increase or lack of moderation comes at the end of Portland’s declared 90-day emergency response to steadily increasing deaths, most involving fentanyl. 

Those results were predictable, based on the main thrust of efforts over that period formulated by Oregon’s public health and medical experts, and funded by the Oregon Health Plan (OHP) Coordinated Care Organization (CCO), Care Oregon. 

That’s described in this recent post. From that post – 

As Portland declares a state of emergency due to skyrocketing opioid overdose deaths – those deaths predicted and predictable due to lack of any available treatments in Oregon for compulsive substance use –  Oregon’s healthcare experts and  Medicaid administrators (Care Oregon coordinated care organization, CCO) have a plan. First responders will attempt to supply high-risk opioid users, post-overdose, with free supplies of the failed doctor-dispensed  substitute opioid Suboxone established as lacking beneficial treatment effect; as fueling and worsening the lethal epidemic; and as functioning as street currency for fentanyl and other illicit opioids (descriptions here, and here, and here scroll down to “The bupe economy”).

The OPB report neglects to mention that the  buprenorphine, ‘bupe”, users will be hooked up with is among the most common drugs traded on the street, currency for fentanyl and other high-risk drugs, plentiful and cheap. But even better when that currency for “real dope” is free.  

In the similar program in New Jersey, it was “not what researchers expected” for the free, doctor-dispensed opioid to have no positive treatment outcomes.

It is exactly what was expected by any adult mind paying attention to American Medicine’s increasingly lethal opioid crisis.

As were the results, explained here, in Escambia County, Florida, where similarly EMS staff successfully inducted overdosers into MAT programming, with a supply of free “bupe”, and with a 19 percent increase in opioid overdose EMS calls the following year. 

Expected as well in North Carolina, where beginning in 2018 EMT responders began transporting opioid overdose subjects to “rehab” over a period when buprenorphine MAT services were rapidly expanding for Medicaid and uninsured persons.  

Predictably, with increased dispensing of the street currency for illicit opioids of abuse, opioid overdose visits to EDs mounted over the ensuing years. 

And as predictable in Houston, Texas, where beginning in 2017 paramedics, outreach workers, others worked post-overdose with high-risk opioid users to connect them to Suboxone provided through a MAT program. Over the years 2018 to 2023, lethal opioid overdoses per 100,000 persons in the area  approximately doubled. 

Four similar programs, in 

New Jersey

Escambia County, Florida

North Carolina

Houston, Texas

each with the predictably lethal outcomes. 

Back to our current post

It seems that Portland, Oregon will need to be added to that list. 

And that damage control will include assurances of regrouping of some collection of Oregon public health, medical and addictions experts whose failed approaches have taken Oregon to the bottom. 

“There’s more work to be done and we all know that, and I want you to know that the state will continue to be a key partner in the work here in Portland,” said Gov. Tina Kotek at a press event on May 3. . .

“No, we weren’t going to successfully eliminate fentanyl in the 90 days, but we were going to get a better plan,” said Graves on Friday. “Now, the communications are being made, plans are being discussed on how we can enact a better response to address the fentanyl crisis in our community.”

Is that what Oregonians voted for in passing decriminalization Measure 110

Why A Critical Discourse?

Because an uncontrolled epidemic of desperate and deadly use of pain-numbing opioid drugs is just the most visible of America’s lethal crises of drug misuse, suicide, depression, of obesity and sickness, of social illness. Because the matrix of health experts and institutions constructed and identified by mass media as trusted authorities – publicly funded and entrusted to protect public health – instead collude to fabricate false assurances like those that created an opioid crisis, while promising medical cures that never come and can never come, while epidemics worsen. Because the “journalists” responsible for protecting public well-being have failed to fight for truth, traded that duty away for their careers, their abdication and cowardice rewarded daily in corporate news offices, attempts to expose that failure and their fabrications punished.

Open, critical examination, exposure, and deconstruction of their lethal matrix of fabrications is a matter of survival, is cure for mass illness and crisis, demands of us a critical discourse.

Crisis is a necessary condition for a questioning of doxa, but is not in itself a sufficient condition for the production of a critical discourse.

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