Joshua Geer has overdosed before. Three times, in fact.

Every time he used heroin, a small voice inside his head would ask: Was this drug pure? How much fentanyl was mixed in? Should he use it all at once or just try it out?

Did he have naloxone, an overdose antidote, in case he overdosed?

Each time he used, he risked overdosing. The last overdoses were in July and August 2020 when the number of COVID-19 cases were soaring, and Geer risked becoming part of a trend of a record number of deaths by overdose.

Blame it on the pandemic, fentanyl, or lack of access to the services during the pandemic, but mixed together the United States has experienced the largest number of drug-related overdoses in a single year, according to the Drug Enforcement Administration.

“I started using hard when I was 16,” Geer said. “I was in a car accident, and I was hurt pretty bad. They prescribed me pain meds and Xanax.

“I got hooked right away. I instantly felt better, and I became attached to that feeling of being numb.”

A hospital stay for a bone and heart infection and a connection to Ideal Option, an outpatient drug rehabilitation program, has helped Geer, 30, stay clean for the first time since he started using.

Geer now has a job. He has a home in Bend.

And he’s not at risk of overdosing.

More people overdosed during the pandemic than ever before in Central Oregon and statewide. For the weeks of April 9 to 26, there were 28 hospital emergency department visits for opioid overdoses, according to the most recent data available, compared to 14 in 2020 and 22 in 2019, said Lynn Vigil, Crook County regional crisis overdose response coordinator.

Oregon saw a nearly 70% increase in the number of overdose deaths during April and May 2020 compared to the same time in 2019.

More than 93,000 people died of a drug overdose in the United States last year — a record number that reflects a nearly 30% rise from 2019, according to new data released by the Centers for Disease Control and Prevention.

The numbers could be far higher as overdoses are often under-reported because many don’t land in an emergency room either due to a lack of care or a stigma related to overdoses.

In Central Oregon, U.S. Highway 97 is a major drug trafficking route linking multiple states, said John McIlveen, who works with the state Opioid Treatment Authority.

“It’s a pretty big picture and it’s multi-faceted,” said McIlveen. “The pandemic had a role, but we can’t blame COVID-19. It exacerbated the conditions in society by disrupting the drug supplies.

“There were other stressors and anxiety too from the isolation and the state of flux that caused all that.”

Community efforts

Around Central Oregon, a team of private and public health workers is trying multi-pronged approaches to reduce deaths from overdoses. They’re going into the community and collecting used needles. They’re passing out naloxone nasal spray. They’re bringing health care to communities with transportation access issues.

They’re educating anyone who will listen about the effects of fentanyl, a synthetic opioid, and how it’s being added to illicit drugs.

“I think society has the perspective that substance use/misuse is a problem that is more prevalent in low socio-economic communities,” said Vigil. “Overdoses can hit the wealthy too. We’re working on reducing the stigma.”

Opioids include heroin, fentanyl, codeine, morphine and oxycodone, according to the CDC. They act on the brain, causing relaxation and eliminating pain, causing euphoria. The tendency for over-use or abuse is high.

Naloxone is a medicine that can reverse an opioid overdose by attaching to the opioid receptors in the brain, reversing and blocking the effects of the opioids. Most overdose deaths occur when the opioid causes the person to stop breathing or respiration slows way down.

Fentanyl, a synthetic illegal opioid, is being laced in the illicit opioid drug supply and is 50 to 100 times stronger than the average opioid, McIlveen said. Illicit drug makers are creating blue-colored fentanyl pills that look like the prescription drug, but are more potent than any prescription, fentanyl, Vigil said.

Fentanyl is also responsible for 92% of overdoses, she said. According to the CDC, data show a 159% increase in synthetic opioid overdose deaths in Oregon from November 2019 to November 2020.

“Illicit fentanyl contributed to overdose deaths in Oregon and nationwide,” said Dan Goulette, senior director of provider operations at Ideal Option in Oregon. “Most of the fentanyl is coming from Mexico. It’s cheaper and approximately 50 times more potent than heroin.

“Part of what has caused the spike in deaths is the unwitting ingestion of fentanyl, which can readily suppress the respiratory drive, leading to overdose.”

At the state level, funds are being released to counties to pay for needle exchange programs or the naloxone dispensing program, but the reality is it’s a supply issue.

“The whole goal is to get people off the drugs,” Vigil said. “We’re all trying to get out there and reduce the use of opioids. People are dependent upon drugs for a reason. We need to connect with them and get them some help.”

Naloxone is a lifesaver, Vigil said. Crook County received a grant to train and dispense the overdose antidote to first responders, homeless shelters, bus drivers and bartenders, police and the sheriff’s department.

Eric’s story

There’s a lot on the line right now for Eric Pancoast, 28. His sons need a parent who isn’t on drugs. He needs to be drug-free, and meet the court for weekly check-ins, group meetings and individual counseling.

“I’ve gotten to this point many times, but I wasn’t really ready until I lost everything,” Pancoast said. “I’ve lost friends to overdoses. I’ve been to jail. And I have two baby boys.

“That’s what has enabled me to quit.”

And his wife, who is a drug user, is still using. Pancoast said he worries that she’ll get a dose of street drugs laced with fentanyl and die.

“For a long time, I was OK with letting the drugs ruin my life, but now I’m seeing it ruin her life and it’s something else,” said Pancoast, a Bend resident.

After 11 years as a drug user, Pancoast is learning to rebuild his life away from drugs with the help of Ideal Option, which has five Oregon clinics and is located in nine other states. He is on a medication-assisted treatment program that includes counseling.

Pancoast said he volunteered for this program because he had been in prison and learned of a program that enables addicts to seek treatment rather than serving time.

“I volunteered because I didn’t want to go back to a life that was just wasting it,” he said. “I knew that I could be headed for an overdose.

“I have a lot of remorse and regret about the decisions I’ve made. I never understood the pain and  the hurt I caused."

Going forward

The rise in overdoses is a reflection of the potency of the substances circulating in Central Oregon, said Ashley Jones, Deschutes County Health Services Overdose Response coordinator.

To combat that, resources are needed to create touchpoints between the drug users and the health workers. These are opportunities for people to realize that there is help, Goulette said. So health workers are passing out more naloxone in the community and exchanging needles and did so throughout the pandemic, while wearing personal protective equipment, said Laurie Hubbard, Deschutes County Health Services Communicable Disease Prevention coordinator.

“The overdoses are COVID-19 pandemic related. It was alarming and sad,” Hubbard said. “During the shutdown, there were few services available. The loss of community was huge for these people.”

In the days since, Hubbard and others have worked to create relationships of intention, bringing services to where the people are living, in a homeless camps or on the streets. These are often the same people who overdose but don’t call 911, she said.

“Those overdoses count, and they need to count,” Hubbard said. “They represent a human life whether they call 911 or not. They’re not doing (drugs) on purpose. Drug use is not a moral failure.”

Geer said the program at Ideal Option has helped him stay clean. He goes to group sessions and is working on himself, he said with pride.

“They’re like my friends,” Geer said. “They’re helping me stay clean. I’ve seen so many people overdose. I always carry (naloxone). It’s super scary. One time, you can use, and it’s OK, but it’s not the next. “

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(4) comments


Who could have ever predicted that there would be a massive uptick in drug use and overdoses after the citizen of Oregon legalized drugs? We are in big trouble. Personally, I love Oregon but it's getting too crazy here for me. I hate to do it, but I am uprooting my family, selling the house and moving to a more family friendly, conservative state. Good luck Oregon!


Who’s going to tell PottsMandy that drug overdoses are much higher in more conservative states?

Thomas Who

Besides complaining about the problem, what solutions does the Bend Bulletin propose to REDUCE self inflicted drug overdoses?


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