Molly Harbarger
The Oregonian, Portland, Ore.
MULTNOMAH COUNTY, Ore. — Multnomah County has found that people are 15 times more likely to die of an opioid overdose in the first seven days they are released from the jail than normally, so on Saturday, the sheriff’s office will begin to offer a medication to keep them alive as people leave.
While in jail, people who are addicted to opioids and other drugs start withdrawal and their tolerance lowers. If they then return to using the same amount of drugs as before they were in jail, they could overdose.
So the Multnomah County Jail will offer the opioid overdose-reversal medication naloxone to all people upon release from the jail.
It’s a first step to having the drug on hand at the front desk for anyone.
An average of 24 people die of an opioid overdose every year in Multnomah County. Last year, that number was significantly higher, with 31 at the time of the county’s data analysis.
Sgt. Brandon White said that all inmates will be able to pick up naxolone, commonly called by the brand name Narcan, at the front desk on their way out of jail.
In the future, though, Sheriff Mike Reese wants the front desk to have it on hand in a large enough supply that anyone can come in off the street to request it.
Public health officials and advocates have called for the sheriff’s office to distribute naloxone for years. Currently, the county’s needle exchange program is the Portland area’s largest provider of the overdose-reversal drug. More than 4,000 overdoses were reversed with naloxone in the region since the program’s launch in 2013.
Of those, 680 occurred shortly after the person who overdosed was released from jail.
Reese committed to stocking the jail with naloxone after a 2018 study by the Multnomah County Public Health and Corrections Health divisions.
An analyst found that between 2007 and 2019, 212 people died of an opioid overdose within a year of being released from jail. The numbers were taken from the county medical examiner’s investigations of all accidental deaths, which includes overdoses. The risk of overdose was 15 times greater in the first seven days after release -- the period when someone’s tolerance is likely lowest from being sober in jail -- than three months to a year later.
“It’s really stark,” Analyst Tyler Swift said. “We know that period is essential, and we don’t have time to refer people to go get naloxone. They need it immediately.”
This number includes people who were booked and released in the same day and likely weren’t in the jail long enough to start serious withdrawal. Swift said that indicates that future cuts of the data could show that number as higher when targeted at people who stayed longer in the jail.
The program is part of a broader initiative to reduce recidivism among people with mental health and substance abuse disorders. The sheriff’s office is also trying to expand drug treatment services within the jail and start peer support programs.
“Not everyone needs to get incarcerated to change their life, but you meet people where they are,” Reese said. “We want to leverage that moment of sobriety that jail offers to give that person a different choice. To let them know, ‘We want to help. You’re sober today. Do you want to change your life?’”
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©2019 The Oregonian (Portland, Ore.)