22/03/2026
During my Churchill Fellowship research, I spent time in Portland, Oregon, examining how a city grappling with a synthetic opioid crisis was implementing harm reduction initiatives.
When a person has the urge to change, it is a small window of opportunity that needs to be capitalised on. Four initiatives stood out that aim to make the most of these opportunities when they presented themselves.
𝗣𝗼𝗿𝘁𝗹𝗮𝗻𝗱 𝗦𝘁𝗿𝗲𝗲𝘁 𝗥𝗲𝘀𝗽𝗼𝗻𝘀𝗲
PSR is a trauma informed first responder that receives calls through the 911 emergency call service. Adding a layer of response, their focus is de-escalation and providing appropriate support for mental and behavioural health crises, as well as non-emergency situations involving vulnerable populations.
𝗗𝗲𝗳𝗹𝗲𝗰𝘁𝗶𝗼𝗻 𝗣𝗿𝗼𝗴𝗿𝗮𝗺𝘀
Recognising at in some cases, alternatives to law enforcement can provide opportunity for a greater impact, persons who were stopped by law enforcement with small amounts of illicit drugs, and fit a set criterion, would be offered to enter the deflection program. The person in question had to volunteer and if they declined, police would continue their original course of action.
𝗕𝗲𝗵𝗮𝘃𝗶𝗼𝘂𝗿𝗮𝗹 𝗛𝗲𝗮𝗹𝘁𝗵 𝗥𝗲𝗰𝗼𝘃𝗲𝗿𝘆 𝗖𝗲𝗻𝘁𝗿𝗲
BHRC is a low barrier resource centre which provides a range of support services, to meet the needs of Portland’s homeless community. It has four levels, each providing further resources to aid a person in their recovery. Their daily commitment to be out on amongst the community was second to none.
𝗥𝗲𝗰𝗼𝘃𝗲𝗿𝘆 𝗪𝗼𝗿𝗸𝘀 𝗡𝗪
Recovery Works Northwest. It has an inpatient detoxification centre where their staff of medical and health specialists as well as peers support people who attend with a desire to interrupt their substance dependency and start a pathway of recovery. Recovery Works NW not only is there to support Portland. It operates within its regional communities with clinics in outlying towns. These clinics provide access to health and social services. It is also a venue where various recovery medications can be dispensed by medical professionals to give a person the best chance of recovery.
Portland’s experience provides valuable lessons for communities around the world confronting the threat of synthetic opioids. Each initiative demonstrates an important principle I observed repeatedly during my entire Fellowship, meeting people where they are and building pathways toward recovery.
Recovery does not happen through one service or one agency alone. It is about how cities, health services, outreach teams and law enforcement must collaborate to respond to complex drug markets and protect vulnerable communities.
These observations form part of my Churchill Fellowship report exploring global responses to synthetic opioids and what lessons Australia can learn.
If you are interested in the full context behind these initiatives and the broader lessons from Portland and other cities, I encourage you to read the full report.
https://www.churchilltrust.com.au/fellow/warren-lysaght-nsw-2024/