I was somewhat shocked when I tuned into the Portland mayoral debate last Tuesday and heard Press Herald executive editor Steve Greenlee cite the issues as “homelessness, affordable housing, rent control and asylum seekers.” These issues are great topics for debate. But what shocked me was the omission of substance abuse. I guess the city’s current hands-off approach means not only that our police officers cannot enforce basic laws, but also that we can’t stigmatize the homeless and suggest substance abuse is widespread in the encampments.

The reality is that many neighbors and abutting businesses of the encampments have spoken out about the used needles, witnessing open drug use, witnessing drug deals and dealing with people in crisis. In fact, in the Fore River Parkway cleanup report, the city of Portland recently reported collecting 22,000 needles in two months. Yet meetings and workshops often focus on other barriers to getting people out of encampments and into the homeless shelters: couples being separated, separation from pets, curfews and misinformation.

How about talking about addiction, substance abuse, substance use disorder or whatever you want to call it? Maine experienced over 700 overdose deaths last year! Do we have to approach that number again this winter to bring this issue back to the front page?

Long before many Portlanders used the terms “encampment” or “substance use disorder,” I was a registered nurse at Maine Medical Center and treated many IV drug users who lived in the woods or on the streets. They usually came to the hospital with a serious skin or bone infection or maybe an abscess in their arm, neck or spine. They were sometimes combative or suspicious, refused help, often left against medical advice and then often would return to the hospital in the next one to three days, only to repeat the same behaviors. Addiction is a brain disease, and if that individual has experienced an overdose (much more common today, because of fentanyl), then they most likely have a brain injury as well.

Portland needs to acknowledge the substance abuse and subsequent behaviors that are occurring all around us. The refusal of many to accept a bed offered by the city was no surprise to me. People need to understand that you cannot expect someone in the grips of addiction is going to want to go to the shelter. City officials have to reach out beyond local community partners and engage the state, partner with MaineHealth, invite Sens. Susan Collins or Angus King to spend an afternoon at one of the encampments. More treatment centers, recovery facilities and transitional housing need to be established.

Fortunately, substance abuse was acknowledged and discussed by the candidates for mayor last week. Now, can we elect one who will address it?

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