By Dr. Jonathan Robbins

By framing Portland's homelessness epidemic as a critical lack of affordable housing, I believe that Gov. Kate Brown and Rep. Knute Buehler have ignored the main driving factor behind the city's increasing homelessness epidemic. I believe that rampant, untreated addiction is the driving force for the city's ongoing struggle to effectively house its citizens.

I am a primary care physician who treats dozens of patients with opioid addiction. Addiction is a disease that hijacks a deep part of the brain that helps people assign meaning and value to life. When addiction goes untreated, the need to use substances and avoid withdrawal takes priority over every other aspect of existence, including finding shelter.

When addiction is active, people do things they would not otherwise do -- sometimes to the great detriment of their bodies, their families and community safety. Recent articles in the New York Times have highlighted rampant property crime, violence and squalor in the Tenderloin district of San Francisco and the Kensington neighborhood in Philadelphia, all due to untreated addiction. Portland could easily be a third case study.

It is naive and short-sighted to think that federal Section 8 housing and shelter beds alone will solve the homelessness crisis. Leaders in Salt Lake City, Utah, reduced chronic homelessness by more than 90 percent by pairing affordable housing with intensive addiction services and case management. Organizations like Portland's Central City Concern work to promote supportive housing and addiction services, to the great benefit of its clients and the city.

To effectively tackle homelessness in Portland, we must address addiction.

First, we need to increase funding and expand organizations such as Central City Concern throughout the Portland area.

Second, when homeless individuals interact with the criminal justice system, they should be offered addiction services, including evidence-based medications for addiction. By providing addiction treatment in jails and prisons, state officials in Rhode Island were able to reduced its overdose rate in 2017 by 18 percent over the previous year.

Third, affordable housing projects need to include case management and integrated addiction services for their clients. And fourth, the city should take a bold stand by opening safe injection facilities, which are known to reduce overdose rates and increase rates of addiction treatment.

In the future, I hope to see the gubernatorial candidates, particularly Dr. Buehler, acknowledge the role of addiction in Portland's homelessness crisis and propose concrete solutions.

-- Jonathan Robbins, M.D., is an assistant professor of medicine (general internal medicine and geriatrics) in the OHSU School of Medicine. This is a personal opinion and does not represent the opinion of OHSU.

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