Peer mentors are key to Oregon’s Measure 110 success, but they are working in a broken system
By Emily Green
About 1,900 people in recovery have been hired to help those struggling with addiction find their way to sobriety, but with too few places to send people to safely detox or receive treatment there’s no clear path to success
On a sunny September evening in 2021, Nathaniel Sean Stringer joined family and colleagues for a recovery celebration at a park in the eastern Oregon town of Ontario. To enthusiastic applause, he received an award for his service to those struggling with addiction.
Just weeks later, Stringer overdosed on fentanyl and died inside a grocery store. He was 35.
His death shows how fragile recovery from addiction can be — and his story highlights a major pressure point in Oregon’s expanding addiction care system at a pivotal time.
Before he died, Stringer exemplified a growing statewide trend. He worked for the Malheur County Health Department as a peer mentor. “Peers” are people in recovery from addiction who engage with people who use drugs, offering mentorship and resources while demonstrating by example that recovery is possible. There are nearly 1,900 peers who specialize in addiction in Oregon, typically earning about $18 to $24 an hour.
The peer model is an evidence-based approach that is increasingly used around the country.
Now, using money generated through Oregon’s 2020 drug decriminalization law, Measure 110, a state-appointed council is pouring money into hiring many more peers as part of a shift toward treating addiction as a health care issue. Increasingly, peers across Oregon are connecting with people in need through street outreach and working in addiction care, mental health or homeless services, hospitals and jails.
But without adequate funding for detox facilities for withdrawal management, residential treatment and recovery housing, people inside the system say the state’s burgeoning peer workforce amounts to a pipeline that often leads nowhere.
A recent analysis from Oregon Health & Science University showed that Oregon’s addiction care system is half the size it should be to meet demand.
Stringer was hired before Measure 110 was implemented and those close to him believe factors outside his job drove his relapse. What’s clear, however, is that while people in the peer mentor role are tasked with motivating people to seek treatment, they — like Stringer did — frequently grasp for resources that don’t exist when their clients are ready to quit using. The situation puts tremendous stress on the very people on which the system’s current expansion relies.
“I absolutely believe in peers, I believe that they are the best people to engage people who are using drugs into treatment,” said Sarah Poe, director of the Malheur County Health Department, where Stringer worked. But peers don’t themselves provide treatment and without more services to connect people to, she said, “It’s really hard work for peers to show up and keep trying to push this boulder up a hill — when the hill keeps getting more steep.”