A white van is parked near a busy intersection in Medford, Oregon, on a Saturday night in January. Its doors are open and Melissa Jones and her colleagues are handing out supplies from big plastic containers: kits that test for the powerful opioid fentanyl, the overdose medication naloxone, and hand warmers.
Jones named the vehicle the Stabbin’ Wagon in a nod to the clean syringes her team offers.
The idea behind her van, and the growing practice of harm reduction, is to make drug use less dangerous for those using. Clean needles can prevent the spread of disease like HIV. Pipes and foil are meant to discourage users from injecting which can be riskier than smoking.
It’s all free. And there’s no requirement for drug abstinence or treatment, although Jones says she provides information on that. She’s been to treatment herself and says she’s driven people to detox centers around the state.
“We don’t coerce anyone into anything. We just sort of offer the supplies. And what we found actually is when people have accessibility to make healthier choices, they 100% will,” Jones said.
Harm reduction is already controversial. Critics say it can enable drug use. But Stabbin’ Wagon, which got nearly $600,000 in Measure 110 funding, has been especially contentious.
Jones is a vocal critic of the Medford Police Department. And they’ve arrested her before — for trespassing in a Medford park while helping the homeless population and interfering with officers at a free HIV testing event.
Recently she filed a notice to sue the city of Medford for harassment and constitutional rights violations among other allegations. In that filing her attorney notes local officials pushed their lobbyist to fight a $1.5 million grant awarded to Stabbin’ Wagon from the Oregon Health Authority. That money is to start a peer respite center which is a short-term residential program. Critics worry the center will allow open drug use, although Jones denies that.
But for all the controversy, her work on this January evening seems pretty calm. Drug users, many also homeless, mill about and form lines at her van’s open doors.
Jones said Measure 110 funding helped her hire employees, provide trainings and afford more naloxone, which costs $45 for a two-dose box of the nasal spray.
Yolanda Garrett is one of those getting supplies tonight. She’s 56 and started using hard drugs about 10 years ago when her mother passed.
“I just gave up for a while. I blame myself and I blame God. But you know, we make our own choices,” Garrett said.
She’s homeless and camps in town. She said one night she came across her friend unconscious, turning blue, from a fentanyl overdose.
“My heart dropped. I thought that I lost another friend,” she said.
Garrett sprayed Narcan in his nose twice and he survived. But she doesn’t know for how long.
Jones says fentanyl is a game changer in the world of illicit drugs. It’s too addictive and too deadly.
“Fentanyl has just changed everything. And I wish people will just step into this century, to the modern age, and meet people where they’re at,” said Jones.
Syringes and naloxone aren’t enough to fight drug crisis, prof says
Oregon’s opioid deaths more than tripled from 2019 to 2022, reaching nearly 1,000. Last year’s numbers are still being counted but are on track to be worse.
Oregon’s Democratic lawmakers want to tweak Measure 110 in this month’s legislative session, making hard drug possession a misdemeanor. Those ticketed would need to enter treatment options to avoid fines or jail.
Studies show harm reduction efforts like giving out naloxone cut overdose deaths — at least for the short term.
But Keith Humphreys, a professor of psychiatry at Stanford University and an expert on addiction, thinks syringe exchanges and naloxone won’t solve the drug epidemic alone.
“I think that’s the challenge if we just move into a sort of a passive mode and just try to keep people alive until tomorrow, even though that is noble. As a policy of only doing that you get some pretty negative public health effects,” said Humphreys.
Measure 110 created a hotline for people ticketed for drugs. They can get out of a fine if they call and enter treatment options.
But in the last three years fewer than 600 people called, according to the Oregon Health Authority.
Humphreys said Oregon needs better ways to get people into recovery.
“I think rebuilding that — the diversion system, the drug court system — could reduce the harm of drugs, both to the people who use them and also to everybody else, while still keeping the spirit of Measure 110,” he said.
There can be a philosophical divide between those providing addiction services. Jones with the Stabbin’ Wagon said she tries to center autonomy and self-determination for drug users. And that often doesn’t have anything to do with recovery, she explained.
A 2022 study by Oregon Health & Science University shows the state had about half as much addiction services as needed.
Jones said it can be hard to get someone into detox or treatment centers in Medford. Even if those visiting her van tonight wanted to get sober, it’s unclear whether they would have somewhere to go after the Stabbin’ Wagon pulls away.
Garrett, who saved her friend with naloxone, quit heroin. That at least cuts her chances of overdosing. It’s a success in the world of harm reduction.
“I just want people out there that’s in the same situation to know that there is hope and not to give up. We’re all survivors. And we’ve got to continue surviving,” she said.