Formation | 1968 |
---|---|
Type | 501(c)(3) |
Registration no. | EIN 93-0567549 |
Headquarters | 1132 SW 13th Avenue |
Location |
|
Executive Director | Kiku Johnson [1] |
Budget (2018) | about $12 million [2] |
Staff | about 170 (2018) [2] |
Website | outsidein |
Outside In is a medical and youth service nonprofit organization in Portland, Oregon, United States that provides primary care and "wraparound services" for low income and homeless clients. [7] It also has several other programs such as needle exchange program for drug users, and eligibility restricted tattoo removal service. The needle exchange has been the cause of community objection as well as cancellation of insurance policy and donors declining to give. It has reported that in fiscal year 2015–2016, it has given out 988,399 needles which was 20,962 more needles than what was returned. [8] Founded in 1968 to serve youth, the organization has since continued to revise its services to meet the needs of its clients. [9] [10] Its services as described in October 2014 include medical care, mobile medical vans, tattoo removal, housing, education, counseling, and job training. [11]
Three founders, Dr. Charles Spray, Arnold Goldberg, and Mary Lu Zurcher founded Outside In in June 1968 and it was one of the earliest free clinics on the west coast. [9] [12] [13] The organization was founded to serve Portland's "alienated youth", some of whom were illegal drug users and most had mental health issues. [10] At its beginning, it operated out of a rented space at First Unitarian Church of Portland in downtown Portland. [10] Spray helped found the organization after learning that the Unitarian church's youth coffeehouse space, Charix, was in danger of being shut down by the city and a group that had successfully shut down the Crystal Ballroom music venue because of its association with the 1960s drug culture. [13] Outside In was told by its insurance carrier that all of the organization's policies would be cancelled if they were to start a needle exchange. It took the clinic a few years to find a replacement insurance carrier. [14] The needle exchange program started in July 1989 was the first authorized exchange in the United States. It was started as a pilot project involving 125 drug addicts. Bud Clark, the mayor at the time expressed concerns that it maybe seen by some as encouraging drug use. [15] In September 2002, Portland Business Journal reported some prospective donors refuse to donate to Outside In, because of its needle exchange program. [16]
Some of the group's early work involved staffing a 24-hour crisis hotline that was later spun off to form the Metro Crisis Intervention Service. [12]
In November 2017, two staff members were stabbed on the job; [17] as a result, in May 2018 the workers of Outside In voted to unionize, with Oregon AFSCME as their parent union. [2] [18]
Willamette Week reported in April 2019 that Outside In employees are members of AFSCME along with a handful of other private nonprofits heavily funded by government contracts. [19]
In April 2019, Outside In announced the plan to add a second location in Gresham intended to provide services to "unique populations that are not well-served in other health care settings,". The location opened in September 2020. [7] [20]
By 2023, the street on which the organization is located on has become the point of encampment congregation by homeless youth who rely on Outside In services. [21]
Outside In is a Federally Qualified Health Center (FQHC) and a licensed mental health agency,[ jargon ] [9] and also operates a needle exchange. [22] The syringe exchange, implemented in 1989, was the first one to be developed and the third to go into operation in the country. [23] The needle exchange program has been operating a fentanyl testing service on street drugs for about two years where subjects bring samples of their illegal drugs or drug residues from paraphernalia as told to Oregon Public Broadcasting . The article said drug possession remains strictly illegal. [24] They have also been handing out other supplies like glass pipes, tin foil and naloxone at its downtown Portland location. [6] In 2023, the organization self reported it served 969 youth with mental health care, drug and alcohol treatment, employment, education, job training, and housing. [25] Outside In's medical clinic provided primary care to 4,601 patients in 2023. [25] The same year, the group's syringe exchange furnished 1.14 million syringes to 3,157 clients. [25] The organization's harm reduction program has received over a million dollars from Measure 110 funding and an estimated 100 clients utilize it daily. Some of the funds are directed to the purchase of pipes, needles and other supplies. [26] After it started handing out smoking supplies in October 2022, its program manager reported this caused an 87% increase in monthly visit to the ham reduction services. [27]
The needle exchange program offered through Outside In and Multnomah County was the subject of a grievance by the adjacent neighborhood Goose Hollow Foothills League due to concerns that needles handed out by Outside In are littered in Goose Hollow by its drug addict clients. The neighborhood association sent a letter on the matter of needles and other supplies given out by Outside In to a Multnomah County Commissioner Sharon Meieran in February 2018. This letter was published in part in Portland Tribune
"We are drowning in the needles put out into the community by Multnomah County," said a letter complaining about the health department program that was sent to Commissioner Sharon Meieran by the Goose Hollow Foothills League last month. "Our residents are picking up hundreds of needles each week," the letter states. "Our neighborhood has experienced a shocking increase in unsafe and unsanitary levels of needles since MCHD started this program ... while keeping drug addicts safer, MCHD is risking the health of thousands more with this program. "Our neighborhood is also filled with bloody cotton balls and feces-covered wipes that were given out at Outside In," added the letter, which was signed by Tracy Prince, the league's vice chair. "It is humane and necessary to hand out these items, but MCHD should put a plan in place so that these items aren't disposed of in our neighborhoods." [28]
In May 2019, a Portland activist Brandon Farley who believes the needle exchange add to a city's addiction and homelessness problems dumped out syringe caps and dirty syringes on the sidewalk in front of the Outside In's needle exchange in what he calls as an "act of civil disobedience". [29] The harm reduction program's policy of prohibiting drug use within three blocks from facilities while handing out paraphernalia has drawn criticism from neighbors and businesses in October 2024. Critics have complained drug use is being pushed into neighborhoods. [30] Outside In did not comment what steps are taken to ensure the three block rule is being enforced. [31] The posted sign at the site asks clients to not use or deal drugs within three blocks of the site. The facility stops just short of allowing drug use on site. [26]
Some of the services offered are eligibility restricted to clients 16–24 years of age. [32]
"Bespoke" is bicycle-powered smoothie cart set up in Portland's O'Bryant Square that gives homeless youth on-the-job training. [33]
In 2005 the organization set up Virginia Woof, a non-profit dog daycare centre to provide training and employment for their clients. It operates in two locations. [34] [35]
In addition to the fixed location clinic, Outside In's medical clinic operates two medical outreach vans and a school-based health center at Milwaukie High School. [34] [36] [ better source needed ]
Harm reduction, or harm minimization, refers to a range of intentional practices and public health policies designed to lessen the negative social and/or physical consequences associated with various human behaviors, both legal and illegal. Harm reduction is used to decrease negative consequences of recreational drug use and sexual activity without requiring abstinence, recognizing that those unable or unwilling to stop can still make positive change to protect themselves and others.
A needle and syringe programme (NSP), also known as needle exchange program (NEP), is a social service that allows injection drug users (IDUs) to obtain clean and unused hypodermic needles and associated paraphernalia at little or no cost. It is based on the philosophy of harm reduction that attempts to reduce the risk factors for blood-borne diseases such as HIV/AIDS and hepatitis.
Needle sharing is the practice of intravenous drug-users by which a needle or syringe is shared by multiple individuals to administer intravenous drugs such as heroin, steroids, and hormones. This is a primary vector for blood-borne diseases which can be transmitted through blood. People who inject drugs (PWID) are at an increased risk for Hepatitis C (HCV) and HIV due to needle sharing practices. From 1933 to 1943, malaria was spread between users in the New York City area by this method. Afterwards, the use of quinine as a cutting agent in drug mixes became more common. Harm reduction efforts including safe disposal of needles, supervised injection sites, and public education may help bring awareness on safer needle sharing practices.
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Drug injection is a method of introducing a drug into the bloodstream via a hollow hypodermic needle, which is pierced through the skin into the body. Intravenous therapy, a form of drug injection, is universally practiced in modernized medical care. As of 2004, there were 13.2 million people worldwide who self-administered injection drugs outside of medical supervision, of which 22% are from developed countries.
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Low-threshold treatment programs are harm reduction-based health care centers targeted towards people who use substances. "Low-threshold" programs are programs that make minimal demands on the patient, offering services without attempting to control their intake of drugs, and providing counselling only if requested. Low-threshold programs may be contrasted with "high-threshold" programs, which require the user to accept a certain level of control and which demand that the patient accept counselling and cease all drug use as a precondition of support.
Youth Projects is an independent, not-for-profit organisation founded in Melbourne, Australia. Youth Projects provides a broad range of services designed tackling social disadvantage, homelessness and drug and alcohol issues including health and education programs, community outreach and training and employment services.
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In 2016, a report from the Department of Housing and Urban Development (HUD) revealed that the U.S. state of Oregon had an estimated homeless population of 13,238 with about 60.5% of these people still unsheltered. In 2017, these numbers were even higher. As of January 2017, Oregon has an estimated 13,953 individuals experiencing homelessness. Of this homeless population, 1,083 are family households, 1,251 are veterans, 1,462 are unaccompanied young adults, and 3,387 are individuals experiencing chronic homelessness. As of 2022, 17,959 people total experienced homelessness in Oregon, with 2,157 individuals being youth under 18, 6,671 being female, 10,931 being male, and 131 being transgender. Also among the 17,959 total homeless in 2022, 15,876 were Non-Hispanic/Non-Latino, 2,083 were Hispanic/Latino, 13,960 were white, 1,172 were Black, African American, or African, 101 were Asian or Asian American, 880 were Native American, and those of multiple race were 1,619. Oregon has seen an increase in its total homeless population consistently every year since 2010. In last three years specifically Oregon has seen a 98.5% increase 2021-2022, 22.5% increase 2020-2021, and a 13.1% increase 2019-2020.
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Multnomah County is the governmental body that funds the exchange program. There are five documented needle exchanges on the Multnomah County web pege:i. outside in 1219 sw Main st .......
Fentanyl can be smoked on foil or with a glass pipe (e.g. the 'hammer' pipe
said Haven Wheelock, Outside In's harm reduction manager. She said they hand out smoking supplies like glass pipes, tin foil and straws
Outside In separately reports that during fiscal year 2015-2016, of the 988,399 needles issued, 967,437 were returned — a difference of 20,962 needles.
Employees at Central City Concern, Volunteers of America, Outside In, and Cascadia Behavioral Healthcare, all private nonprofits heavily funded by government contracts, are also AFSCME members.
Outside In runs a downtown needle exchange for drug addicts
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