Overdose fatalities expected to climb in 2025 figures  

Published 9:40 am Wednesday, December 24, 2025

Clatsop County officials try to combat drug epidemic

By MATHIAS LEHMAN-WINTERS

The Astorian

Since 2020, Clatsop County has seen a steady rise in drug overdose fatalities. In 2020, seven people died of drug overdoses; by 2024, the number had risen to 17 people. County officials say 2025 is on track to see an even higher number of fatalities. But the numbers have yet to come in.

“We do not yet have official overdose death rates for 2025 since the state lab often takes months to return the results,” said Elizabeth DeVisser, Clatsop County’s chief medicolegal death investigator, in an email to The Astorian. “I will say that our expected fatality rates for the county for 2025 are higher than 2024.”

Both DeVisser and Lisa Schuyler, health promotion supervisor with the Clatsop County Department of Public Health, say non-fatal overdoses in the county are likely undercounted. From Nov. 1, 2024, to Oct. 31, 2025, there were between 20 and 57 opioid overdose visits to emergency departments and urgent care centers countywide. This number puts Clatsop County on about equal footing for overdoses per capita with Multnomah County. But not everyone who overdoses seeks medical attention or is in a position to call for help.

“Some non-fatal overdoses that are successfully reversed without the person going to the emergency room or even calling 911 are unreported,” said Schuyler in an email. “So there is definitely some missing data there.”

Fatal overdoses may also be undercounted if a resident of Clatsop County passes away in another county. This could happen if they were transported outside of the county for treatment or were visiting a friend outside of the county at the time of their death.

Schuyler said the county is putting in effort to combat the drug crisis. They have a Regional Overdose Surveillance and Response Plan to standardize overdose tracking and partner with groups like Clatsop Behavioral Healthcare for deflection programs and to provide treatment to people struggling with addiction in jail.

However, the very nature of the drug epidemic in Oregon makes it difficult to combat.

“The drug landscape … it changes really quickly, and there’s not very many barriers for it to change,” said Schuyler. “They’re constantly making new types of drugs. We’re always behind the ball … we don’t know that there’s a new drug that’s really deadly until it’s already killing people.”

Clatsop County Sheriff Matthew Phillips said the issue is exacerbated by the manner in which drug cartels are transporting illicit drugs, like fentanyl, into the region.

“They’re coming across the border … . You have couriers that are employed by the cartel,” said Phillips. “They’re recruiting drivers on Snapchat and other social media platforms.”

Phillips said the amount of the drugs transported to the North Coast is difficult to measure, but fentanyl is “orders of magnitude more powerful” than other opioids, like heroin — which is also very dangerous.

The strength of and purity of the fentanyl being moved into the county is wreaking havoc on people’s minds and mental health, said Phillips. This only serves to exacerbate existing mental health issues.

“It is really tragic,” he said.

Phillips said the county’s partnership with CBH to provide medication-assisted treatment in jail represents a step in the right direction toward combatting the problem.

“Clatsop Behavioral Health is embedded in the jail already providing the treatment, so there’s continuity of care on release,” he said. “My philosophy is that the ultimate goal of law enforcement is to change behavior. So I want to use all the tools that are available to help people change their behavior, change their lives and improve (their situation).”

According to CBH, between July and September, 64 people received treatment while in jail.

Shyra Merila, executive director of CBH, said a large part of what their organization does is not only providing treatment in the jail but also helping them upon release.

“We try to get them connected to services upon release and help them get their insurance turned back on,” said Merila. “(Also to) make sure that they stay connected to service providers after they are out.”

Merila said people often assume those addicted to substances end up homeless because “they can’t keep it together.” But the issue is more complicated than that.

“The overall cost of living is the primary reason that people end up on the streets,” said Merila. Then, once on the streets, people start using drugs to manage different elements of survival —  “one being pain management, it’s uncomfortable to live outside. The other being safety. I know there’s a population of folks that started using uppers like methamphetamine to stay awake at night, to avoid being assaulted or robbed.”

On the street, Merila said people’s mental health can deteriorate even without drug use, contributing to a persistent problem of mental illness.

“If you’re living on the streets, you probably have some experience of anxiety or depression or trauma,” said Merila. “Because I would say it’s probably impossible to live outside and not have some kind of mental health need.”

Even with the work being done by CBH, Merila said there are big issues in the treatment system, “it has gaping holes throughout it,” said Merila. Sometimes, CBH helps someone through the painful process of detoxing, only to put them back out on the street because there are not enough residential beds to house them.

“(When) they get discharged back to the streets … their likelihood of overdosing is 10 times higher than it was before they went into detox,” said Merila. “They just endured this really painful experience, only to end up in the same place. So a lot of these individuals don’t trust the system because they’ve tried it before and it’s failed them … the system has culpability there, and I think it’s really important to acknowledge that.”

Fentanyl and methamphetamine are the two drugs most common in fatal overdoses, according to DeVisser and Schuyler.

Schuyler said if someone is having an overdose, it is important to give them naloxone, also known as Narcan, regardless of what you think they took. Narcan works by attaching to opioid receptors in the brain and blocking opioids from activating them. While it is not effective on non-opioid-based drugs, like methamphetamine, it is still recommended to give it as a precautionary measure that could save a life. 

People can obtain naloxone for free at CBH or at the county’s health department at 820 Exchange St., Suite 100, Astoria.