Oregon is facing one of the most severe addiction crises in the nation, marked by high rates of substance use, limited access to treatment, and an under-resourced behavioral health system. According to the Oregon Health Authority, the state consistently ranks among the worst in the U.S. for access to addiction care, with an estimated one in ten residents struggling with substance use disorder.
Methamphetamine, fentanyl, heroin, and alcohol are the primary drivers of addiction and overdose deaths, and fentanyl-related fatalities have surged dramatically in recent years.
While urban centers like Portland, Eugene, and Salem have a concentration of detox facilities, MAT (medication-assisted treatment) providers, and outpatient clinics, long waitlists and staffing shortages limit availability even in these areas.
In rural Oregon—particularly in the eastern and southern parts of the state—access to care is even more limited, with entire counties lacking inpatient services or addiction-certified professionals. Oregon expanded Medicaid under the Affordable Care Act, and the Oregon Health Plan provides coverage for a wide range of addiction treatment services.
However, coverage alone has not translated into adequate infrastructure, and the state is struggling to meet the growing demand for both immediate care and long-term recovery support. In 2020, Oregon passed Measure 110, decriminalizing the possession of small amounts of drugs and redirecting funding toward treatment and harm reduction.
The rollout of this law has been mixed—while it represents a bold step toward a public health approach to addiction, critics argue that implementation has been slow and treatment pathways remain unclear for many.
Harm reduction services are widely supported in Oregon, with syringe exchange programs, naloxone distribution, and fentanyl test strips available through community organizations and local health departments. The state has also launched mobile outreach units and peer recovery networks to reach underserved populations, including unhoused individuals, LGBTQ+ youth, and communities of color.
Despite these efforts, stigma remains a barrier—especially in rural and politically conservative areas—discouraging many from seeking help. Faith-based and community-led recovery programs are active throughout the state and often fill critical service gaps, though they may lack clinical integration.
Youth substance use is an ongoing concern, particularly around vaping, marijuana, and alcohol, prompting increased focus on school-based prevention and behavioral health screening. Oregon’s diverse population, including significant Latino, Native American, and Southeast Asian communities, requires culturally responsive care—yet language access and provider diversity continue to lag.
To reverse its addiction crisis, Oregon must continue building a coordinated, well-funded system that emphasizes access, equity, and long-term support at every level of care..
![]() | A Better Today - Drug & Alcohol Rehab PortlandA Better Today - Drug & Alcohol Rehab, located at 1122 NE 122nd Ave, Ste A102, Portland, OR 97230, is dedicated to helping individuals overcome addiction through comprehensive rehabilitation services. Offering personalized treatment plans, counseling, and support, A Better Today focuses on addressing the root causes of substance use disorders while promoting sustainable recovery. With a team of experienced professionals, the facility provides a compassionate environment that empowers clients to reclaim their lives and achieve their goals. Explore the life-changing programs available at A Better Today and begin your journey to a healthier, addiction-free future. 1122 NE 122nd Ave a102, Portland, OR 97230 | Levels of Care:Detoxoutpatient Payment Options:Self-Pay Options Private insurance Financial Aid Military Insurance | ||
![]() | Acadia NWAcadia NW, located at 9570 SW Barbur Blvd Unit 100, Portland, OR 97219, is dedicated to providing comprehensive behavioral health services aimed at promoting mental wellness and recovery. Offering a range of programs including individual therapy, group counseling, and substance use treatment, Acadia NW focuses on personalized care tailored to the unique needs of each client. With a compassionate and experienced team, the center creates a supportive environment where individuals can address their challenges and build a path toward a healthier future. Explore the resources available at Acadia NW and take your first step towards improved mental health. 9570 SW Barbur Blvd Unit 100, Portland, OR 97219 | Levels of Care:outpatient Payment Options:Private Insurance Self-Pay Options Medicaid Medicare Military Insurance | ||
ACME CounselingACME Counseling | Payment Options:Medicaid | |||
ADAPTADAPT | Payment Options:Medicaid | |||
ADAPTADAPT | Payment Options:Medicaid | |||
ADAPT - CorrectionsADAPT - Corrections | Payment Options:Medicaid | |||
ADAPT - Crossroads Residential TreatmentADAPT - Crossroads Residential Treatment | Payment Options:Medicaid | |||
ADAPT - Deer Creek - Adolescent Treatment CenterADAPT - Deer Creek - Adolescent Treatment Center | Payment Options:Private insurance | |||
ADAPT North BendADAPT North Bend | Payment Options:Medicaid | |||
Addictions and Family CounselingAddictions and Family Counseling | Payment Options:Medicaid | |||
Addictions NorthwestAddictions Northwest | Payment Options:Private insurance | |||
Addictions Recovery Center - Genessee StreetAddictions Recovery Center - Genessee Street | Payment Options:Medicaid | |||
Addictions Recovery Center - West Main StreetAddictions Recovery Center - West Main Street | Payment Options:Medicaid | |||
![]() | Addictions Recovery Center, Inc. - Engagement & AssessmentsAddictions Recovery Center, Inc., located at 1025 E Main St, Medford, OR 97504, specializes in providing essential engagement and assessment services for individuals seeking help with substance use disorders. The center focuses on creating personalized treatment plans based on thorough assessments and understanding of each clients unique needs. With a compassionate team of professionals, Addictions Recovery Center aims to guide individuals on their recovery journey, offering the support and resources necessary for lasting change. Discover the pathways to recovery available at Addictions Recovery Center, Inc. and take the first step towards a healthier life. 1025 E Main St, Medford, OR 97504 | Levels of Care:DetoxInpatientoutpatient Payment Options:Medicaid Private insurance Self-Pay Options Financial Aid Medicare Military Insurance | ||
Advance Treatment CenterAdvance Treatment Center | Payment Options:Medicaid | |||
Alano Club909 Northwest 24Th Avenue, Portland OR, 97210 | ||||
Albertina Kerr Centers - Gresham CampusAlbertina Kerr Centers - Gresham Campus | Payment Options:Medicaid | |||
Alliance Counseling - The CenterAlliance Counseling - The Center | ||||
Allied Health ServicesAllied Health Services | Payment Options:Medicaid | |||
Allied Health ServicesAllied Health Services | Payment Options:Private insurance |
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