Governor's race gets more crowded as New York Times columnist jumps in

Nicholas Kristof in downtown Portland at the waterfront
With two old friends in Yamhill, Oregon, in 2015. Both were smart and talented, both abused drugs, and both are now dead.

They come up to me shyly and confide in a broken whisper: My son overdosed.

Or: My cousin is homeless because of alcohol and drugs.

Or, just a couple of days ago: My ex-husband is addicted.

When my wife and I go on the campaign trail in my new life as a candidate, we hear stories like that all the time. Since the pandemic began in March 2020, more people have died here in Oregon from substance abuse than from Covid-19.

Yet while we take far-reaching steps to reduce the coronavirus toll — with vaccines, masks and public health campaigns — we seem oddly relaxed about the devastation from substance abuse. A 15-year-old neighbor girl died recently from fentanyl, and it infuriates me that we don’t try as hard to save the lives of young people dying from drugs as we try to save the lives of adults dying from Covid-19.

“Oregon is gripped in the throes of a rapidly deteriorating substance use emergency,” a group of people in the field wrote Governor Kate Brown in September. They warned that a dozen substance abuse centers are closing down, with a particular crisis in programs for teenagers. “Our adolescent system is nearly decimated,” the letter cautioned.

One problem is that money, while available in the system, doesn’t reach the centers in time. Another is staff shortages. A third is a lack of urgency in finding remedies. These are the kinds of bureaucratic obstacles that America overcame when we faced Covid-19, and that can be solved in this space if we make the lives of kids and neighbors a top priority.

What does this failure mean in practical terms? It means that people die unnecessarily.

One old friend — smart, talented and funny — lost his job in the pandemic, and then self-medicated with heroin. He quarreled with his girlfriend, she went for a walk, and when she came back he was dead from an overdose. Perhaps it was suicide, but more likely he tried to console himself with heroin that was laced with more fentanyl than his body could handle.

I then tried to help his girlfriend, who also wrestled with addictions, get into a treatment program. But she has an anxiety disorder and is fearful of being around strangers, so she was herself ambivalent.

Her experience underscored to me again that helping people is hard, but that we have to do a better job of it. And that’s particularly true of services for mental health and substance abuse.

I’m asked all the time on the campaign trail about homelessness and about public safety issues: Oregon has the second worst rate of unsheltered homelessness in the country, and Portland just set a record for homicides. These are complicated problems that require a range of policies to address them. But part of the response has to be a much greater effort to treat people with mental health problems and with addictions — and it breaks my heart that instead, programs are shutting down just when they are most needed.

We Democrats have denounced Red states that have been cavalier about masking and vaccinations to deal with Covid-19. But we should look in the mirror: Here in Oregon, we have been too lackadaisical about providing treatment for people with urgent mental health and substance abuse needs. Especially when children are involved, this is unconscionable.

The Oregon Capital Chronicle has just run a terrific four-part series about the failing mental health system for children. It tells of a mom named Angela Weirich who tried desperately to get help for her 16-year-old daughter. The girl attacked family members, skipped school, ran away and repeatedly tried to commit suicide.

You’d think that with a life at stake, the system might respond. But it didn’t. The family couldn’t get a spot for the girl in a residential program. “Our daughter was going to die in Oregon,” Weirich told the Capital Chronicle.

So the family moved to Pennsylvania, where the girl was able to access the help she needed.

If anything, the problem is now getting worse. The behavioral health system for children is pretty much collapsing in Oregon, experts say, with long waits for care. Oregon children are often sent to out-of-state programs where they have no family member nearby, or no one to help if staff abuse them.

One national expert tells me that when he visited residential programs for troubled teenagers around the country, he was surprised to encounter Oregon children in state after state. He eventually realized that this was because Oregon didn’t have adequate treatment at home and sent its own children far away.

Maybe I’m framing this too much in policy terms. What all this means in the real world is shattered lives, devastated families and children languishing in foster care, on top of the 23,000 children who are homeless in Oregon. I think of my neighbors who lost their 15-year-old daughter and who can never be the same, and then I multiply that by thousands.

Some of my most emotionally wrenching reporting has been in hospital neonatal wards, watching newborns go through heroin withdrawal.

They fuss, they cry, they are inconsolable — and this continues day after day.

I have a longstanding belief that we as a society are worst at addressing problems that are taboos or hard to talk about — because they involve embarrassing topics, from sex to domestic violence, mental illness to addiction. That’s probably why we have bungled our response to substance abuse.

As a journalist, I found that my spotlight was often most effective in shining a light on taboo topics, because this forced the issues onto the agenda. I’m planning to do the same thing as a candidate. I hope to win, of course, but I also want to elevate these difficult issues so that we can come up with better policies to manage them.

And I do believe that while these challenges are difficult, they are not impossible to address. I have friends who are alive today because programs worked. One friend of mine overdosed 17 times during the pandemic but is now getting medication-assisted treatment. Only about one-fifth of Americans with substance abuse problems get treatment, yet treatment pays for itself many times over.

In Tulsa, Oklahoma, a treatment program called Women in Recovery has a 95 percent success rate over three years, partly because it lasts longer than other programs and because it includes a component that gets people into jobs and raises incomes and self-esteem. It has saved Oklahoma more than $80 million because while treatment is expensive, incarceration is even more so.

Nicholas Kristof in downtown Portland at the waterfront
With two old friends in Yamhill, Oregon, in 2015. Both were smart and talented, both abused drugs, and both are now dead.

In McMinnville, Oregon, I’ve admired a program called Provoking Hope that has worked with many of my friends to wean them from addictions. It started by simply offering people in trouble some soup, and a place to sit down. Later it offered group therapy and peer counseling, and it helped my friends start their lives over.

We need to increase access to these kinds of treatment programs, including medication-assisted treatment. (Medication-assisted treatment is not currently available for meth addictions, but research is promising and Oregon should pioneer that work.) We also need to understand that treatment takes time: It’s difficult to expect someone who has been addicted for a decade to overcome the dependency in a 30-day program.

I’ve been to too many funerals and seen too many children struggling in the shadow of their parents’ untreated addictions and mental health burdens. We need to do a much better job tackling the pandemic of despair, addiction and mental illness that afflicts our state and nation.

Nicholas Kristof with his wife Nick with his dog

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