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News / Health / Clark County Health

People are staying homeless for longer than ever before in Clark County — experts say fentanyl is a factor

Tin foil litter replaces used syringes as fentanyl, 50 times more powerful than heroin, takes over camps

By Alexis Weisend, Columbian staff reporter
Published: April 20, 2024, 6:14am
6 Photos
Members of the Vancouver Police Department respond to a call of a dead person suspected to have overdosed at a homeless encampment near Hazel Dell on April 4.  At top, Officer Cole Larson of the Vancouver Police Department confiscates a device for smoking fentanyl from a motorist while on patrol April 4.
Members of the Vancouver Police Department respond to a call of a dead person suspected to have overdosed at a homeless encampment near Hazel Dell on April 4. At top, Officer Cole Larson of the Vancouver Police Department confiscates a device for smoking fentanyl from a motorist while on patrol April 4. (Amanda Cowan/The Columbian) Photo Gallery

It was during cleanup of an encampment in east Vancouver two years ago that the city’s homeless response manager realized a dangerous shift had occurred.

People at the camp were acting strangely, refusing to cooperate with outreach staff as they normally would, Jamie Spinelli recalled. The mess was beyond the usual found at encampments — it was layer upon layer of mush and trash. Burned foil, a sign of fentanyl use, was everywhere.

“I thought, ‘Oh, this is a big problem. It’s not going away,’” Spinelli recalled. “Nearly everyone in that camp — it’s like they weren’t even aware of how bad the conditions were that they were living in. … Because of fentanyl, all of those basic needs have been replaced with acquiring and using.”

Fentanyl is 50 times more powerful than heroin and deadlier than any drug on the streets before it. The wickedly addictive opioid has ripped through encampments since the pandemic — often trapping people in homelessness or killing them. Drug dealers make regular deliveries to camps. But with limited funding for Clark County’s drug task force, law enforcement officers say there’s little they can do.

The number of overdoses involving fentanyl in Clark County has essentially doubled every two years since 2017, according to the county’s overdose dashboard. From 2020 to 2022, 163 people died from an overdose involving fentanyl.

Although the county did not track housing status in death records at that time, more than a third of the 45 deaths among homeless people last year were from overdoses, according to the homeless organizations keeping track. It’s what motivated the city of Vancouver to declare a civil emergency in November.

“I cannot stress enough that fentanyl has completely changed the landscape and changed the game,” Spinelli told the Vancouver City Council minutes before the city declared the emergency.

Dying to survive

Many people who have used fentanyl say they started using the drug to cope with their homelessness.

Amber Rodriguez, who lives in a downtown Vancouver encampment, said she started using fentanyl six months ago. She said she couldn’t sleep at night in the camp, where passing cars rev their engines and people cry out, until someone offered her the drug.

“I smoke a little bit, and I’m out for like five hours,” she said.

Rodriguez said she’s been revived by opioid reversal medication 13 times.

Fentanyl users say quitting can seem impossible. They must take the drug every hour or so to avoid vomiting, diarrhea, chills, muscle cramps and bone pain. They’re so focused on the next dose that many can’t contemplate going to a shelter, walking across the city for housing appointments or navigating the complexities of applying for housing, they say.

Aeryal Crayne, who camps in downtown Vancouver, has been sober for almost a year now but she became hooked on fentanyl after a miscarriage and the fatal overdose of a close friend.

Before a high was even over, Crayne would figure out how to get another dose. It felt like there was no time for anything else besides that next pill, she said.

“You want nothing but to feel not sick anymore,” she said.

She knows many in camps who are constantly fending off “the sick.” Some receive drug treatment and make it into housing. Some are stuck in limbo. Others have their bodies dragged out of tents and vehicles after overdosing.

Not all people experiencing homelessness use drugs, but isolation, trauma, stress and easy access to drugs are all factors that can lead to drug use, according to American Addiction Centers. That puts people experiencing homelessness more at risk.

Data show people are staying homeless for longer than ever before, and experts say fentanyl is a factor. In 2018, 60 people were homeless for more than a year, according to a Point in Time Count. In 2022, that number jumped to 223. At the same time people are falling into homelessness faster than ever.

Case of blues

On a recent warm afternoon, Rodriguez sat with her friend, who would only identify himself as BLK Rob, as he crushed pills bought for about $1 each.

The blue pills are stamped with “30” and meant to appear as oxycodone 30 milligram pills. But the “blues,” as they’re known, are often counterfeit and laced with fentanyl.

“Do you know how much that costs?” BLK Rob asked, pointing the tip of a knife toward a small pile of white powder next to the blues. “$25.”

Fetty, the nickname for powdered fentanyl, is the most powerful form of the drug people can buy from drug dealers. It’s more expensive — and more deadly.

BLK Rob scraped aside a crumb of fetty and explained that tiny bit could kill someone who has never used drugs before. He said he started using heroin at 17 before switching to fentanyl, so he can handle it.

BLK Rob crushed the pills with his knife and sprinkled some fetty on top. He and Rodriguez placed the drug dust on tin foil, held the flame of a small torch to the bottom of the foil, and then inhaled the smoke using a straw-like tool. Unlike the stench of marijuana or the chemically sweet odor of methamphetamine, fentanyl smoke is odorless, making the drug use undetectable from outside the tent.

By the next day, they had smoked BLK Rob’s entire supply of fentanyl.

Shift in drug market

Five years ago, people used to complain about finding needles used for heroin on the streets of Clark County. But when the pandemic started, tinfoil began to replace orange-tipped syringes.

“Spring of 2020 hit, and it’s like it flipped overnight,” Dr. Kevin Fischer said. He’s the chief medical officer at Columbia River Mental Health Services, where he tracks what drugs flow in and out of Clark County.

By the Numbers

  • More than a third of the 45 deaths among homeless people last year were from overdoses.
  • From 2020 to 2022, 163 people died from an overdose involving fentanyl.
  • Fentanyl is 50 times more powerful than heroin.

Heroin requires farming and large cargo trucks to transport the drug in bulk, according to the United Nations Office on Drugs and Crime. Fentanyl, on the other hand, can be manufactured in a small lab. It’s also potent, making it easier to transport high doses.

The pandemic caused stricter crossing restrictions at international borders, which resulted in fewer personal vehicles traveling into the United States, especially from Mexico, according to the U.S. Department of Transportation. Fentanyl is often made in foreign labs and smuggled into the U.S. through Mexico, according to the U.S. Food and Drug Administration.

With fewer vehicles to transport drugs, fentanyl became a profitable solution.

“A dishwasher size of heroin … is equal to about a Thermos of fentanyl,” Fischer said. “It’s a lot easier to transport and smuggle a Thermos than a dishwasher.”

One law drug markets will follow is the law of supply and demand. Before the pandemic, pills laced with fentanyl cost around $30, according to law enforcement. Now they can cost as little as $1 each, which drives the drug’s prevalence.


Many people know where to get fentanyl in Clark County, but few want to talk about it.

“Questions like that will get you killed,” one homeless person told The Columbian.

Others spoke in hushed voices about the men who slowly drive in vans or nice cars through the camps. They said people linger at the car windows with cash to buy drugs for themselves and others in the camp.

Spinelli said she sees these exchanges when she’s working in Vancouver’s homeless camps.

“That’s been occurring my whole career,” she said. “And then I’ve seen people in tents or structures that they’ve built who seemingly are running the show. And it’s not the people who live in those tents. There are people calling the shots that don’t actually live there.”

But there’s not much law enforcement can do about it, said Sgt. Erik Zimmerman of the Clark County Sheriff’s Office.

Clark County’s drug task force, which investigates drug trafficking, was shut down in 2023.

In January, the task force regained some funding but not much, Zimmerman said.

When the task force does have staffing to go after drug dealers, it needs evidence beyond slow moving cars in camps, Zimmerman said.

“We’ll have so many drug dealers identified, but we literally can’t take action behind just that information,” he said.

The way law enforcement most often takes down drug dealers is by flipping buyers and initiating “controlled buys” — a drug deal where the buyer is working with authorities to expose drug dealers.

“That’s how we start building that investigation to where we now can go in to their home to search for evidence of distribution,” Zimmerman said.

He said the state Supreme Court’s 2021 Blake decision, which ruled drug possession was no longer a felony under state law, further complicated matters. Officers could only charge someone possessing drugs with a misdemeanor — and only on the third offense after giving them treatment options the first two times. Officers noticed more open drug use after the Blake decision.

Things changed in July 2023. Senate Bill 5536 — often called the Blake Fix — set a maximum penalty of 180 days in jail and a $1,000 fine for the first two convictions. Beginning with the third conviction, someone can be sent to jail for up to 364 days. Knowingly possessing a controlled or counterfeit substance, including illicit fentanyl, is a gross misdemeanor.

Since the Blake Fix, 245 misdemeanor drug possession cases have been filed, according to Clark County District Court.


If you are struggling with substance use, call Columbia River Mental Health Services at 360-993-3000 to start a treatment plan or visit NorthStar Clinic from 7 a.m. to noon Mondays through Fridays at 7105 N.E. 40th St., Vancouver.

People who need housing and shelter assistance should call Council for the Homeless’ Housing Hotline at 360-695-9677, which operates 9 a.m. to 8 p.m. on weekdays and 11 a.m. to 5 p.m. on holidays and weekends.

If someone is overdosing on opioid drugs, administer naloxone and call 911. It may take several rounds of naloxone, such as Narcan, to stop an overdose from fentanyl.

If you or someone you know is struggling or in crisis, help is available. Call or text the suicide prevention hotline at 988 or chat at 988lifeline.org

While on the city’s Homeless Assistance and Resource Team, however, officers have not cited anyone for possession, said Vancouver Police Department spokesperson Kim Kapp said in an email. They focus on connecting homeless people with help, although they might issue citations for lower level offenses to get people into Community Court.

Clark County’s Community Court connects people with offenses relating to homelessness — such as unlawful camping or urinating in public — with services, including housing or addiction treatment.

The push and pull between legal consequences and drug treatment has captivated attention in the Vancouver-Portland area since both Washington and Oregon recriminalized drug possession. A criminal record could affect someone’s ability to receive housing or employment. But people may not seek treatment on their own.

The debate has sparked frustration from both sides.

Spinelli said “tough love” doesn’t motivate people who already feel disappointed with themselves and the system.

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Even before the rise of fentanyl in Clark County, it was already challenging to go from homeless to housed, Spinelli said. People often walk across the city for appointments just to miss them or have their phone’s battery die while on hold with the housing hotline.

“It becomes like, ‘What’s the point? There is no point. I can’t seem to get past these hurdles. It is not possible. I might as well just do this (drug), because at least then I’m not sick,’” Spinelli said.

It’s easy to feel hopeless about the fentanyl epidemic, but Spinelli said witnessing people getting into treatment and housing after years of homelessness keeps her going. Although these small successes can often get lost within the daunting statistics illustrating the fentanyl crisis, they show it is possible to recover — both as individuals and a community.

She encourages others not to lose hope, either.

“If it can happen for that person,” she said, “then it can also happen for the next.”

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This story was made possible by Community Funded Journalism, a project from The Columbian and the Local Media Foundation. Top donors include the Ed and Dollie Lynch Fund, Patricia, David and Jacob Nierenberg, Connie and Lee Kearney, Steve and Jan Oliva, The Cowlitz Tribal Foundation and the Mason E. Nolan Charitable Fund. The Columbian controls all content. For more information, visit columbian.com/cfj.