Dr. Ben Schwartz used to be an emergency room physician. Now, he spends most of his time treating people who need addiction medicine and recovery.

The need for addiction treatment was so pressing, it changed the trajectory of his career. Now, with a stronger, more powerful opiate overtaking the illicit drug market, Schwartz’s job just got harder.

“Fentanyl is what got us here,” Dr. Schwartz said, noting many modern opioid withdrawal and overdose prevention medicines aren’t working on fentanyl addicts. “You used to be able to give people detox, almost on an outpatient basis.”

Schwartz co-founded Recovery Works NW. The organization operates a trio of outpatient drug treatment, detox, and diversion programs. Soon, it will add a medically managed detox center in Southeast Portland to its roster–the first in the region to be opened using funds from Oregon’s Measure 110. 

Recovery Works NW estimates about $1.5 million from Measure 110 funds were used to help purchase and establish the site, with another $236,000 from Clackamas County.

The new detox center is slated to open within the next two weeks, as soon as staff are trained and onboarded. 

The new Foster Road Detox Center will offer 16 beds, mostly to people who need to withdraw from fentanyl, and is expected to serve about 1,200 people a year. Medically-managed withdrawal takes about three to five days. It’s the first step in the longer road to recovery. The center won’t accept walk-ins. Prospective patients need to call for an appointment or have a referral.

“Detox gets you so you’re at least thinking right,” said Douglas Oglesby, a certified alcohol and drug counselor and behavioral health resource coordinator for Clackamas County. “Once someone gets clean from that, then you can see if they’re ready for residential treatment.”

Physicians say Measure 110 is finally paying off 

Measure 110 was approved by Oregon voters in November 2020 as a pathway to treating drug addiction as a public health problem, rather than a criminal problem. Under the measure, users are supposed to be offered drug treatment and rehabilitation as a way to avoid jail time and criminalization. The measure uses state funds from cannabis sales to pay for treatment services. To date, the state has allocated more than $264 million toward Behavioral Health Resource Networks (BHRNs), which can include addiction treatment services, across Oregon.

Recovery Works NW’s Foster Road Detox Center is a major milestone. Since implementation, Measure 110 has seen more public criticism and backlash over a perceived lack of results than it has celebrated wins. Elected leaders have criticized the state’s rollout of the measure, and drug recovery specialists report a patchwork of resources in Oregon that leaves people in need of treatment on a long waitlist. Now, physicians say service providers and taxpayers are finally starting to see services come online. 

Dr. Schwartz’s son, Dr. Bryan Schwartz, is CEO of Recovery Works NW. 

“We received our first round of funding in September and have already opened two new facilities and expanded services in all our clinics,” Dr. Bryan Schwartz said in an announcement of the new detox center, noting 2023 is “the year that we are seeing tangible, lifesaving changes in our community, thanks to Measure 110.”

Since the measure was passed in 2020, the landscape has been further complicated by a surge in fentanyl distribution and addiction. Addiction medicine specialists say heroin used to be the drug du jour. Now, fentanyl is more readily available and far more deadly. Fentanyl is a synthetic opioid that’s more potent than heroin, making it easier to overdose on and harder to treat. Because of its potency, it only takes a small amount to mix with other drugs, often making it less expensive than other opioids sold on the street.

The Recovery Works NW CEO said the organization has been providing behavioral health and addiction treatment services for a decade, but staff there “have never seen anything approaching the severity of the current emergency.”

Oregon Rep. Rob Nosse (D-42), whose legislative district includes Portland, chairs Oregon’s House Interim Committee on Behavioral Health and Health Care. Nosse calls himself a champion of Measure 110. 

“That measure is about shifting to a public health approach as opposed to a criminal justice approach,” Nosse told a crowd gathered at the Foster Road Detox Center for a ribbon cutting celebration. “We’ve had over 50 years of a War on Drugs and a criminal justice approach, and it’s time that one place in the United States try and give a different approach a chance. 

Nosse said Oregon is now diverting people from “a system that we know is not helping them, to one that actually provides treatment."

"Treatment. Not jail,” Nosse emphasized.

Nosse estimates Measure 110 has saved Oregon’s criminal justice system $40 million since it went into place.

Center will help fill gap in services

The new detox center, which previously served as an adult foster care facility, is slated to be the first drug withdrawal center in the Portland metro region that will focus on fentanyl addiction.

It’s also one of the few detox centers that will accept Oregon Health Plan patients.

After a stay at the detox center, patients are referred to services where they can be in longer outpatient treatment, or if space is available, move on to an inpatient rehab center. 

The new center is expected to fill a gap in addiction treatment services, but it’s a small part of the bigger push for treatment centers and access that’s needed to truly put a dent in Oregon’s addiction crisis. 

Oregon health care studies show the need for addiction treatment far surpasses the state’s available services.

“I think a lot of the biggest needs are around supporting access to treatment,” Eve Klein, a medical director at CODA Inc. treatment and recovery center, said. “It’s so complex. There are so many different needs. Measure 110, largely where it’s fallen short so far, is because of access.”