Eastern Oregon is no stranger to the opioid crisis, which reaches from Appalachia to Alaska. Union County is home to Oregon’s second-highest opioid prescribing rate. According to the Oregon Health Authority, the rate was more than 280 opioid prescription fills per 1,000 residents from April through June 2019. 

Short-term use of opioid medications for acute pain has proven beneficial through the years. However, use of opioids for longer durations for chronic pain or repeat acute injuries can lead to serious dependence issues even when patients follow their doctor’s best intentions. As a result, the Eastern Oregon Coordinated Care Organization’s Regional Opioid Prescribing Group (ROPG) meets quarterly in La Grande to discuss issues related to the manner in which medications are prescribed to patients in Eastern Oregon. The ROPG has been instrumental in directing proper prescribing habits by issuing opioid prescribing guidelines to regional providers in addition to opioid tapering protocols to help ease patients off of long-term opioid use.

Fortunately, Eastern Oregon, and much of the West Coast, has avoided the massive surge of deaths attributed to the opioid crisis that have been commonplace in areas such as West Virginia and Ohio, partially due to the delayed start of the crisis in the region and the increased availability of Naloxone as a lifesaving measure. This is not to say the crisis isn’t worsening. Union County has seen an increase in patients enrolled in medication-assisted treatment, which typically consists of the medication Suboxone, said to be the gold standard in safely assisting patients through their opioid dependence. Suboxone can be compared to the many nicotine replacement therapies that help tobacco users taper off their nicotine dependence with greater success than simply quitting cold turkey. With that said, the increase in Suboxone prescriptions suggests a greater number of patients struggling to kick opioid dependence.

According to the CDC, the opioid crisis occurs in three main waves. The first wave, which Union County has confronted, is the prescription wave. The second wave is the heroin wave, and the third is the synthetic opioid wave often associated with fentanyl. Regional law enforcement has encountered both heroin and fentanyl, including fentanyl pills made to look like the pharmaceutical variety. The potency of fentanyl is especially troubling, ranging from 50 to 100 times more powerful than morphine. 

Fentanyl’s potency is what has led to a drastic increase in opioid-related overdose deaths nationwide. In 2017 the CDC listed opioid-related deaths at 61,000, about 50,000 more deaths than were attributed to methamphetamine. According to the CDC, 12 percent of all opioid-related deaths had methamphetamine present, and from 2017 to 2018 the number of opioid overdoses co-occurring with methamphetamine increased nearly 15 percent. This trend will continue to require a multi-pronged approach.

After talking with community members, it is clear the opioid crisis goes much deeper. In May 2019, Northeast Oregon Network enlisted two OHSU nursing student interns to conduct 28 interviews with people from various settings in Eastern Oregon, including health care, mental health, social services, prevention, treatment, recovery, tribal and faith organizations. While these interviews indicated there are varying opinions on what caused the crisis, most agreed it is, indeed, a problem that affects us all in some way. 

Most of the interviewees felt the problem runs so deep that it may never be entirely solved, but that it is currently shifting toward improvement and can get better. One of the biggest factors in that improvement, especially for those in recovery, is our small, close-knit community and support systems that exist among scarce treatment resources. Connection to resources, people and support are key in prevention and recovery.

October is Red Ribbon Month in Union County. Raise prevention awareness by making some of those connections. Have conversations with kids about the dangers of drug abuse, support their healthy choices and celebrate being substance free.

National Prescription Drug Take Back Day will take place at the La Grande Safeway from 10 a.m. to

2 p.m. Oct. 26. Turn in your unused or expired medicines for safe disposal. This event is a collaborative effort of the La Grande Police Department, Safeway Stores, Elkhorn Media Group and Union County Safe Communities Coalition.

Holly M. Sorensen is the Outreach Programs Coordinator at Northeast Oregon Network. Mike Stensrud, MS is the Eastern Oregon Prescription Drug Overdose Prevention Coordinator for Baker, Malheur, Umatilla, and Union Counties. Both are members of the Union County Safe Communities Coalition.