As Portland firefighters report a surge in 911 calls for drug overdoses, and Oregon sees rising rates of substance use disorder, a new mobile addiction treatment program could provide hope. 

An overdose response team at Portland Fire & Rescue (PF&R) will soon start administering opioid withdrawal medication. A new pilot program, called the Mobile Medication for Opioid Use Disorder (MOUD) program, is set to kick off in early February. Once live, it will allow emergency medical technicians (EMTs) to administer buprenorphine, commonly known as Suboxone, and enroll patients in a detox program through Central City Concern. 

Suboxone, which helps ease opioid withdrawal symptoms, is commonly administered to patients in detox and rehabilitation programs. It’s widely considered a safe and effective way to treat opioid addiction.

The new pilot builds on an Overdose Response Program announced earlier this month by PF&R. The six-month program, which started this week, redirects part of the fire bureau's Community Health Assess and Treat (CHAT) unit to specifically to respond to ODs. A CHAT crew from Fire Station 1 in Old Town will focus on overdose response in the downtown core, where a majority of those calls originate. 

Portland firefighters say the volume of reported drug overdoses is overwhelming the system. The fire bureau responded to about 7,000 calls for ODs in 2023. The calls often tie up resources needed for more critical incidents. Bureau leaders hope the Overdose Response Program will help streamline the way firefighters and EMTs are dispatched to medical calls.

While fire and medical personnel already frequently administer the overdose reversal drug naloxone, commonly called Narcan, EMTs say they’re often treating the same patients over and over again. Naloxone can stop a fatal overdose, but it doesn’t prevent or treat addiction.

Soon, the CHAT team will take overdose prevention a step further with the new mobile opioid treatment program.

The new program is a partnership among PF&R, the Multnomah County Health Department, Oregon Poison Center, and CareOregon. CareOregon is kicking in roughly $390,000 to the city of Portland to fund the pilot program through June 2025. The pilot will operate 8 am to 6 pm, Monday through Thursday, during normal CHAT operating hours.

“Being able to provide life-saving medications for opioid use disorder at the time the paramedics respond versus waiting for patients to arrive in the emergency room or following up at a clinic is a promising method to reduce overdose deaths and pave the way for lasting recovery for community members,” Multnomah County Health Officer, Dr. Richard Bruno, stated.

Under the new program, the CHAT team will offer to connect patients directly to a treatment center. Those who decline will be put on a list for follow-up and reengagement by the CHAT team. 

The effort is the latest alternative response program to be included in the fire bureau. Another alternative program, Portland Street Response, focuses on behavioral health crisis calls. Portland Street Response won’t take part in the overdose pilot efforts (overdose calls are typically routed to fire and EMS personnel), but fire bureau leaders said that team will be “instrumental” in the program through outreach and follow-up with patients. 

The pilot also comes with measurable metrics for success, based on patient outcomes and other data, which was a key recommendation in a recent audit of PF&R's alternative response programs.

County health officials and fire bureau leaders say the mobile medication program’s goal is to give OD patients “immediate access” to opioid use disorder medication and follow-up recovery services. The new program could play a key role in getting people into detox and treatment programs, as Oregon sees a surge in fentanyl use.

“We believe from a public health model, that opioid use disorder, in particular, overdoses that are fatal, is one of the most pressing public health concerns that we have currently in our community,” Dr. Jon Jui, medical director of the county’s EMS system, said during a press conference Thursday. 

Dr. Jui said the new program is unique in its ability to effectively treat overdoses while simultaneously guiding people toward treatment, but it’s not unprecedented. Similar programs have reported success in Baltimore and California, where Contra Costa County launched the first EMS addiction treatment program.

“We’re meeting the individuals who have opiate use disorder, literally in the street where they’re actually living,” Dr. Jui noted, saying the hope is EMS staff “can convince some of them actually to go into recovery here.”