Substance Use and Overdose Prevention

Clackamas County, like many communities across Oregon and the nation, is facing a substance-use and overdose crisis. This crisis is driven largely by fentanyl, alcohol, methamphetamine, benzodiazepines, and the emerging presence of xylazine.

Clackamas County Public Health works with community partners to address this crisis through prevention, treatment, recovery, and harm reduction. We know lasting solutions require collaboration across health care, public safety, and community systems.

Our focus areas

• Timely access to behavioral and mental health care
• Safe prescribing and alternative pain management
• Access to medications for opioid use disorder (MOUD)
• Harm reduction strategies
• Education and prevention of substance misuse
• Innovative approaches for justice-involved populations

Help is here

If you or someone you know is struggling with substance use, support is available:

Overdose prevention

Signs of an overdose

• Unresponsive or won’t wake up
• Slow, weak, or no breathing
• Gurgling or snoring sounds
• Blue or gray lips or skin
• Cold or clammy skin
• Pinpoint pupils

What to do

1. Call 911 and say the person is not breathing and may be overdosing.
2. Give naloxone (Narcan) if available. Oregon’s Good Samaritan Law protects people who help.
3. Give rescue breaths.
4. Place the person on their side if you must leave briefly.
5. Stay until help arrives.

Drug safety and overdose prevention 

• Never use alone. Have someone with you and don’t use at the same time in case someone becomes unconscious. That person can call for help.
• Don’t trust your drug tolerance. Drug content and potency is not predictable, even within the same batch. Even people who have a high tolerance for opioids face an increased risk of death because of the inconsistency in the drug supply. Always go slow and do a test amount.
• Don’t mix different types of drugs and/or alcohol. This increases the risk of overdose.
• Get rid of medicines you don’t need anymore. Sharing or saving medications is a bad idea. People most commonly report they got drugs from a friend or family member. Please remember to store your medications in a safe location and dispose of them when they expire, or you are finished with the prescription. Medications should not be flushed down the toilet or drain because they can contaminate the local water supply. We have several drug take-back sites in our county to use and mail-back envelopes are an excellent resource if you don’t live near a take-back site. Visit the Med Take Back Oregon website to learn more. You can also get free medication disposal pouches from locations across Clackamas County.
• Syringe exchange is a proven, effective way to reduce HIV and hepatitis C transmission. These services also distribute naloxone, sharps containers, safer sex supplies and offer risk reduction counseling and can refer you to services like medical mental health care, shelter services and alcohol and drug treatment.

Naloxone (Narcan)

Naloxone is a safe, lifesaving medication that reverses opioid overdoses, including fentanyl. Anyone can carry and use it.

How to use naloxone

Where to get naloxone:

• Pharmacies (often covered by insurance or OHP)
• Syringe exchange sites
• Over-the-counter Narcan (discounts available via GoodRx)
• Free vending machines at Clackamas County Sheriff’s Office locations
• Community organizations across the county
  • Outside In
    Clackamas Service Center
    503-771-7914
    8800 SE 80th Ave., Clackamas
    Tuesdays and Thursdays from 1 to 4 p.m.
  • AntFarm
    503-668-9955
    39140 Proctor Blvd, Sandy
    350 SW Zobrist St, Estacada
    354 SW 2nd Ave, Estacada
  • Youth Era
    541-214-6643
    11097 SE 21st Ave, Milwaukie
  • LoveOne Events 
    In Milwaukie, Molalla and Oregon City

If you are a organization that serves people at-risk of overdose in Clackamas County, please complete the Naloxone Kit Request Form to request kits. Clackamas County Public Health has limited resources and is working hard to ensure equitable access to naloxone in the community. Because naloxone is now available over-the-counter for those with the means to purchase, our priority is to ensure that kits go to those who are most at-risk and for who cost is a barrier. With that in mind, we ask that you try to use the following guidance when distributing kits:

• The person lives or works in Clackamas County and is at least 15 years old, and
• They or a loved one use opioids or other drugs and are at-risk of overdose, or
• They are frequently in situations where they’re likely to respond to an overdose

Opioid and fentanyl crisis

In the U.S., more than 100,000 people died from drug overdoses in 2021—75% involving opioids. Fentanyl is extremely potent and often mixed into other drugs without a person’s knowledge, including counterfeit pills sold online or through social media.

Black and American Indian/Alaska Native communities are disproportionately impacted. Clackamas County Public Health is committed to health equity and connecting communities to culturally responsive resources.

Learn more about the county's opioid settlement funding.

Prevention-Focused Organizations

Organizations that provide education and prevention programming around youth substance use, positive youth development, extracurricular activities and more.

• AntFarm (Sandy, Estacada and Molalla)
• Community Living Above (West Linn and Lake Oswego)
• The Living Room/New Avenues for Youth (Gladstone)
• Northwest Family Services and Vibrant Future Coalition (Clackamas, Milwaukie and Happy Valley)
• Oregon City Together (Oregon City)
• Todos Juntos (Canby, Estacada, Molalla and Sandy)
• Youth ERA (Milwaukie)

Contact

Substance Use Prevention Program
substancesafety@clackamas.us