Portland officials say increased shelter use led to decline in fatal overdoses

The city’s decision to open a low-barrier shelter for chronically homeless people has “played a huge role” in the decline in fatal overdoses in Portland, city officials say, noting increases in shelter use and naloxone administration and a corresponding decrease in fatal overdoses.

Shaza Stevenson, the city’s new interim health and human services director, noted the correlation between overdose deaths and naloxone administrations when talking about findings of the city’s annual report on homeless services, which was released Friday.

Overdose deaths in Portland dropped significantly in 2023 as the number of naloxone administrations at the city’s homeless services center increased, finishing off the year at 38 doses, the report found. Usage increased as the center’s population grew with more beds being added.

January marked the first month in 2 ½ years that city police reported no overdose deaths, the report said.

“That’s no coincidence, no correlation, that’s cause and effect,” Stevenson said. “We are saving the lives of people who would have died at the encampment because shelter staff know how to identify someone who is overdosing and have the means to help them.”

The use of naloxone, the medication that reverses opioid overdoses, has increased so much that shelter staff added a new section to their overnight reports in January to record doses administered, Stevenson said.

The city had a team of people who distributed fentanyl strips, clean needles and naloxone packages at the encampments, but someone who overdoses inside their tent is not immediately visible to others who could have used the naloxone spray to try to revive them.

It has been a big year for the city’s health and human services department, which operates a range of crucial services for the city, including General Assistance, the needle exchange, the Barron Center for long-term nursing care for the needy, and the distribution of disability and Social Security benefits.

A homeless encampment at Harbor View Park in December. Ben McCanna/Staff Photographer

But it has been the city’s efforts to serve its increasing population of homeless people, including those who are chronically homeless and asylum seekers who arrive here without housing, that has been the biggest challenge for the department over the last year.

City Manager Danielle West said she was proud of what the staff has done with the resources that are available.

“Our HHS staff opened Maine’s two largest low-barrier shelters, increased the capacity by 50 beds at one of those shelters, and considerably minimized the number of people living in tents through a community-based effort to get people inside,” West said.

While opening new shelters and adding beds might be an easy sell to asylum seekers, or people who find themselves temporarily homeless, Stevenson said it had been proving difficult to persuade the 24% of people considered chronically homeless to trade an encampment for a shelter.

The federal government defines chronic homelessness as living in a place not meant for habitation or a shelter for 12 months total or at least four separate instances over the last three years. In 2023, 304, or roughly 13%, of Portland’s 2,252 shelter guests met that definition, the report said.

Stevenson attributed the increased use of the shelter to her staff’s work to dispel certain myths that encampment residents had about the shelter – for example, that they couldn’t store their things there – and the relaxation of rules that discouraged use, like pushing back a 6 p.m. curfew to 11 p.m.

Once people got to the shelter, they tended to stay, the data show. In 2023, the average length of stay for all residents was 64 nights. The 645 shelter residents who had moved from the Harbor View encampment had an average stay of 29 nights, as of mid-February.

The report outlined two new city programs that Stevenson hopes will close remaining service gaps: a pilot program to help 45 former encampment households find stable housing in 2024 and the creation of a homeless outreach team to track and get to know the city’s population of homeless people.