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CHAT includes specialized Overdose Response Teams (ORTs) and a Medication for Opioid Use Disorder (MOUD) program. These services support recovery through an innovative, trauma-informed approach that provides immediate access to life-saving withdrawal medications following a nonfatal opioid overdose.
Since January 2024, the Community Health Assess & Treat (CHAT) program has operated two programs to combat the opioid crisis. The first program includes the Overdose Response Teams (ORTs), who respond to overdose calls in the most impacted areas of the City. The second program, Medication for Opioid Use Disorder (MOUD), facilitates recovery through an innovative, trauma-informed approach by providing immediate access to Buprenorphine (Bupe) after a non-fatal opioid overdose. Bupe is a safe and effective medication for opioid use disorder and managing withdrawal dangerous symptoms. Together, these two programs work to reduce the rising number of opioid-related deaths in Portland.
Overdose Response Teams (ORTs)
The ORTs are specialized CHAT response units, each staffed by a Paramedic and an EMT and based at PF&R stations across the City. Their primary role is to respond to overdose calls from Monday to Thursday, between 8:00am and 5:30pm.
The ORTs support CHAT's broader mission: respond to low-acuity calls, divert unnecessary emergency department (ED) transports, and reduce the overall call load on fire responders. ORTs work in conjunction with the MOUD program, providing Narcan intervention and buprenorphine, while also ensuring follow-up and wraparound services.
ORTs are strategically stationed and dispatched from fire locations across the City. The Bureau of Emergency Communications (BOEC) dispatches these teams directly to all overdose calls, as well as other CHAT-related call types. If CHAT is unavailable, the nearest fire unit and AMR unit are dispatched instead. This added responder density, particularly in the downtown corridor, helps ensure that additional support or a transporting unit can arrive quickly when needed.
Medication for Opioid Use Disorder
Opioid overdose deaths in Portland have increased sharply in recent years, largely driven by the growing prevalence of fentanyl (OHA, 2022). In response, in spring 2023, Multnomah County EMS, Care Oregon, the Oregon Poison Center, Central City Concern, and Portland Fire & Rescue's CHAT team collaborated to develop a multidisciplinary approach to addressing the opioid crisis.
CareOregon supported the partnership by providing $389,577 to the City of Portland to fund the MOUD pilot program. The initial contract lasted through June 2025 and has been extended after successful proof of concept. The metrics used to determine success of the program include: the number of times CHAT administers medication for opioid use disorder; the number of unique patients served; the number of times CHAT dispenses naloxone; the number of patients referred to a treatment clinic, as well as the number who establish care at the clinic; and the number of patients remaining in the program after 30 days, 60 days and 90 days.
After receiving unanimous support from the Portland City Council, CHAT teams launched the MOUD pilot on February 5, 2024. The program aims to provide patients treated for an opioid overdose with immediate access to medication for opioid use disorder, along with follow-up recovery services, initiating the road to recovery immediately upon arrive to a 911 overdose call.
“Being able to provide life-saving medications for opioid use disorder at the time the paramedics respond versus waiting for patients to arrive in the emergency room or following up at a clinic is a promising method to reduce overdose deaths and pave the way for lasting recovery for community members,” said Multnomah County Health Officer Dr. Richard Bruno.
CHAT offers patients the option to enroll in the MOUD program during the initial 9-1-1 response encounter, as an alternative to using critical resources for transport to an emergency room. Providing medication for opioid use disorder at the time of an overdose response is an innovative approach that helps connect community members to vital recovery services and supports ongoing engagement in substance use disorder treatment. The program operates during standard CHAT operating hours, Monday through Thursday, from 8:00am to 5:30pm.
CHAT will offer to connect the patient directly to a treatment center that offers wraparound services for substance use disorder, including drug counseling, patient navigation, and aftercare services. If the patient declines to connect with a treatment center’s services, CHAT's follow-up teams will re-engage with the client to offer services and resources they need based on an assessment.
“We know that when people are connected with supports to get on the path to recovery, they are more likely to stay engaged in services,” said Stacie Andoniadis, CareOregon substance use disorder program manager. “It’s why we’re working so closely with partners to make access to medication for opioid use disorder (MOUD) available at every possible touchpoint that someone might have with the healthcare system, from their primary care provider to local emergency departments. This pilot project will help us close a critical gap and support even more Oregonians on their path to health.”
CHAT would like to give a huge thank you to CareOregon for their generous support, and to the collaboration of Portland Fire & Rescue and Multnomah County EMS. Together, we're taking a necessary step to address this crisis with the urgency it demands.
For more information on Medication for Opioid Use Disorder follow the links below:
https://www.oregon.gov/oha/PH/PREVENTIONWELLNESS/SUBSTANCEUSE/OPIOIDS/Documents/MOUD-factsheet.pdf