What State Has the Highest Drug Use?

Sadly, Oregon distinguishes itself as the No. 1 state for illicit drug use, and as No. 50 in access to treatment for addiction.

Last month a young teenage girl in Oregon had a full-blown mental health crisis and desperately needed care. But no beds were available anywhere in the state, so she was held for days in a hospital emergency room and then transferred to a facility in another state, far from her family.

I was drawn into that case, and I’ve mentioned it to several health care professional over the last couple of weeks. They were unsurprised, for they had seen other cases of children kept for a week or more in E.R.s while undergoing crises. “It gets even worse than that,” one told me.

He had once cared for a 13-year-old Oregon boy in a similar mental health crisis who had been restrained in emergency rooms for two months — forced to use diapers — and finally was shipped out to a care center in New Jersey.

Can you imagine any more traumatizing and degrading experience for a troubled 13-year-old?

Any parent who handcuffed a mentally ill child in diapers for two months would be arrested for child abuse. Yet this is somehow tolerable because it’s the state, and in that sense, it’s all of us. This is our shame.

The backdrop is a crisis of mental health and addiction across America but particularly here in Oregon. An important new federal study finds that Oregon has the very highest rate of illicit drug use in the entire United States, and also the highest rate of misuse of meth and opioids.

Overall, including alcohol and drugs together, Oregon has the second highest rate of addiction, after Montana. This figure is wrenching: 18 percent of Oregonians aged 12 and over are dependent on alcohol or drugs.

These are among the issues that keep me up at night and impelled me to run for governor of Oregon. I had no longtime ambition to go into politics, and I loved my previous job. But I’m a problem-solver, and I’ve mourned too many friends, including two who died on the streets of McMinnville while homeless there.

Because these are hard problems, the tendency has been for politicians to avoid them and kick the can down the road. But that’s the worst way to respond, and my wife and I saw the problems getting steadily worse. Since the pandemic began, more Oregonians have died of drugs and alcohol than from Covid-19.

Oregon now seems at an inflection point, on issues from homelessness to addiction to public safety. We simply have to tackle these problems and get the state back on track.

I was asked at a campaign event recently why Oregon has such a high rate of drug and alcohol abuse. It’s a good question. I think the reasons are complicated and reflect broader challenges.

We have the second highest rate of unsheltered homelessness in the country, with 22,000 homeless children – and those kids are set up to struggle and self-medicate. We have the third lowest high school graduation rate in the country, and when kids don’t have a high school diploma, we are setting them up for failure in ways that will lead some to soothe themselves with drugs.

Perhaps most fundamentally, we’re creating escalating cycles of abuse. Oregon ranked 50th in access to treatment for substance use disorder, so parents get high and their children are traumatized — and end up self-medicating themselves, and the cycle repeats.

Just last year, even as the addiction crisis worsened, Oregon lost about 150 beds for adults and children for residential treatment for substance use disorder.

There’s no one solution to this problem, but there a thousand solutions. We need better mental health services, better addiction treatment options, more early childhood programs, better focus on getting third-graders on track to read so that they can succeed in school. We need to make sure that kids graduate from high school, and we also need better vocational education, more apprenticeships and more well-paying jobs that support a family.

When kids need mental health support, we need to offer it — not confine them to an E.R. and then ship them out of state. And we also need to be alert to child abuse. Oregon’s child abuse hotline is understaffed so that 20 percent to 30 percent of calls go unanswered, a recent article suggested.

“But fixing all that is expensive,” skeptics warn. To some extent, they’re right. But anybody who thinks that these programs are unaffordable doesn’t understand the costs of untreated mental illness and addiction.

I think of one of my school friends, who was raised in a dysfunctional family and abused by his alcoholic father. That friend got no help and drifted into his own dysfunction and, apparently as part of a drug deal gone wrong, set a man on fire. I struggle to reconcile my memory of this friend (he has died, along with more than a quarter of the kids on my old school bus) with this kind of brutality, but it fits into a pattern: I had good friends who both suffered greatly and who inflicted great suffering on others.

I keep coming back to that staggering figure: Almost one in five Oregonians is wrestling with an addiction. That doesn’t even begin to capture the torment in tens of thousands of households as desperate Oregonians struggle in vain to help loved ones with a substance use disorder. Their anguish should weigh on all of us.

We keep kicking the can down the road. Please, folks, it’s time to have straight talk about the toll of addiction in our communities. It’s time to tackle these issues head on. Yes, these are hard problems, but we can do better.

(I’m using these Substack newsletters to touch on broader issues I care about, not to press my campaign for governor. So I’m not going to hit you up for donations here. But if you want to visit my campaign website, check out NickforOregon.com.)