As fentanyl has become a leading cause of drug deaths in Oregon in the last 2 ½ years, state health officials are requesting a greater supply of medicine to reverse overdoses.

According to a recent analysis by the Oregon Health Authority, drug overdose deaths have more than doubled between 2019 and 2021, with officials attributing the increase to fentanyl, a synthetic opioid estimated to be 50 to 100 times stronger than morphine.

Preliminary data indicate that trend has continued in 2022, the state agency said in a statement.

The analysis by the agency follows a spate of increases in fatal drug overdoses in individual counties, said John McIlveen, Oregon’s state opioid treatment authority. The analysis found that nearly a third of Oregon’s counties saw more people die from fentanyl overdoses than overdose from any other drug in 2021.

“It literally is everywhere in the state,” McIlveen said. “Fentanyl is available in all communities in Oregon and that creates a danger and the need for awareness about the lethality of these drugs, about how they’re packaged.”

The health authority found that unintentional or undetermined fentanyl overdose deaths increased from 71 in 2019 to 509 in 2021, about 617%.

In the same period, unintentional or undetermined overdose deaths from all drugs more than doubled, increasing from 496 in 2019 to 1,072 in 2021. The agency said the numbers for 2021 can change as toxicology reports are still being analyzed.

The analysis shows that deaths involving fentanyl made up about 47.5% of total overdose deaths in 2021, compared to about 14% in 2019 and 32% in 2020.

The harrowing rise in drug overdose and fentanyl-related deaths has prompted health officials to make urgent requests for supplies of naloxone, a drug that can reverse an opioid overdose. The medicine can restore normal breathing if administered in time.

“We are seeing a critical need for naloxone as many communities experience dramatic increases in overdoses due to fentanyl misuse,” Dean Sidelinger, health officer and state epidemiologist, said in a statement.

Fentanyl has replaced black tar heroin and other traditional illicit opioids on the West Coast, McIlveen said.

He said the 617% increase is “corroborating evidence” that fentanyl has taken over the drug supply – it’s often used to make phony prescription pills and sold to unsuspecting users. The Oregon-Idaho High Intensity Drug Trafficking Area said in an April 2022 bulletin that 40% of all counterfeit prescription pills in circulation contain fatal amounts of fentanyl.

McIlveen said the state’s harm reduction supply clearinghouse has been effective in getting doses of naloxone to those who need it. Organizations that purchase supplies through the clearinghouse have ordered nearly 130,000 doses of naloxone, the health authority said in a statement.

But the vast majority of people who died from suspected opioid or fentanyl overdoses weren’t given naloxone, he said.

Many pharmacies don’t carry it and many people face barriers in going to a pharmacy to obtain it, he said.

State health officials are working with hospitals, emergency departments and local communities to develop availability and better access to naloxone and combating negative attitudes toward people who frequently use drugs, he said.

McIlveen recommended that people who struggle with substance or opioid use and their families should have naloxone on hand as well as law enforcement agencies, schools and places where people gather.

The accidental overdoses of two Portland high school students in March spurred Portland Public Schools to start distributing naloxone to its middle schools and high schools. Portland police have also said they’re working to give it to patrol officers citywide.

McIlveen said he’s also seen people carrying it on public transit. Oregon law allows people to carry and use naloxone.

“By carrying naloxone, you can really make a difference,” he said.

The Oregon Health Authority offers a list of resources for people struggling with substance use disorders.

The Oregon-based nonprofit Lines for Life and the health authority have a 24-7 helpline at 1-800-923-4357 that offers emotional support and resource referral to those who need it.

—Zaeem Shaikh; mshaikh@oregonian.com; 503-221-8111; @zaeemshake