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This story is part of a series examining the drug and homeless crises plaguing Oregon. Read part one and part two.

McMinnville, Ore. — Ramshackle RVs, nondescript sedans, shopping carts, bicycles, tents and tarps line a street on the edge of the city, bordered by an open field and, beyond that, the Yamhill River. A lonely dumpster, lid thrown open, sits amid piles of trash.

Deputies recently responded to three overdoses at the camp in one day. Another overdose call sent them racing to a logging road in the Coast Range, a 35-minute drive from the sheriff’s office. Much too long for them to reach the person in time.

"There’s nothing out there," Yamhill County Sheriff Sam Elliott said. "They weren’t camping. They weren’t living up there. They just were up there specifically to smoke pills."

RVs, tents and other homeless items in McMinnville, Oregon

Many Yamhill county encampments cluster near McMinnville. At about 35,000 residents, it's one of the few cities in the area with services for homeless people or drug users seeking addiction treatment. (Hannah Ray Lambert/Fox News Digital)

CRISIS IN THE NORTHWEST: ARE VOTERS 'BEYOND A TURNING POINT' AFTER DECADES OF PROGRESSIVE POLITICS?

Homelessness and the fentanyl crisis have impacted every corner of Oregon, but many people living outside the Portland metropolitan area feel neglected by state policymakers.

"It’s like playing Whac-A-Mole … with the number of challenges that counties are facing," Association of Oregon Counties President Danielle Bethell said. From homelessness and addiction to affordability and a struggling workforce, she said rural communities have been "left out" of the conversation.

Gov. Tina Kotek, a Democrat who took office in January 2023, has made revitalizing downtown Portland one of her top priorities. Her task force recently released 10 recommendations for cleaning up and restoring economic vitality to the city. They included declaring a fentanyl emergency, bolstering police, expanding homeless shelter capacity, clearing trash and graffiti and putting a three-year pause on new taxes in Portland, which Kotek said was the second-highest taxed city in the country, behind only New York City.

The success of Portland is good for the entire economy of the state.

— Gov. Tina Kotek

Rose City leaders welcome the governor's ideas.

"Gov. Kotek knows what every governor has known before her — Portland is the economic center of our state," Portland City Commissioner Dan Ryan said. "How Portland goes, goes the rest of the state."

And things have not been going well in either Portland or the state as a whole.

"We have a crisis on our hands, and that’s easy to see," Republican Rep. Lucetta Elmer said, whether you’re driving past the graffiti and tents in Portland and on I-5 or the zombie RVs in Yamhill County.

Most counties vote conservatively, but are consistently outnumbered by urban liberals. Voters in 30 of the state's 36 counties opposed an ultimately successful gun control measure deemed America's "most extreme" by the NRA — and currently held up by constitutional challenges. A slimmer majority of counties opposed Measure 110 in 2020, the state's landmark drug decriminalization law now on the verge of being undone.

Only 29% of Oregonians polled by DHM Research last year said the state is headed in the right direction, a figure that dropped to 9% among Republicans.

PORTLAND LEADERS FRUSTRATED, SAY CITY ALLOWED TO SET HARSHER RULES FOR CIGARETTES THAN FENTANYL: ‘IT’S INSANE’

"We have drugs that are just rampant, and we're seeing public drug use daily," Elmer said. "Extreme homelessness and garbage everywhere. It's unsafe and it's unsightly, but it's also heartbreaking because literally, our fellow citizens are dying."

Kotek vowed to soften the urban rural divide in her inaugural address. In September, she signed a bill dedicating more than $26 million to expand shelter capacity in 26 rural counties. She also visited every Oregon county during her first year in office and said in an August press conference that "everyone cares about what's happening in Portland."

"They know that the success of Portland is good for the entire economy of the state. It is our entry point for tourists," she said. "So we believe that this focus allows us to make progress, and it's going to benefit the entire metro area, the entire city, as well as the entire state."

Kotek's office did not respond to a request for comment.

President Joe Biden holds Oregon gubernatorial candidate Tina Kotek's hand at an event

President Biden introduces then-gubernatorial candidate Tina Kotek during an event at SEIU Local 49 in Portland, Oregon, Oct. 14, 2022. (Saul Loeb/AFP via Getty Images)

Her critics have not been swayed.

Elmer hosted a roundtable in December to hear from leaders in her district, which includes most of Yamhill County. Overwhelmingly, she said they told her they wanted to see Kotek’s 10-point plan go beyond Portland.

"They want to see it get to all of Oregon," she said. "They’re crying for that. We need to see that things are going to change."

And what works in Portland might not work in counties where cows outnumber people.

"Commissioners are frustrated," Bethell said. "We're eagerly awaiting our turn to be at the table."

RURAL OREGON STRUGGLES TO CONTAIN FENTANYL CRISIS:

Crisis in the Northwest: Rural Oregon struggles to contain fentanyl epidemic Video

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Sheriff Elliott grew up in Yamhill County and has worked in law enforcement there for more than two decades. Though hardly the most rural area in the state — some counties have less than one resident per square mile — it's the kind of place where the nearest deputy could be one minute or one hour away from an emergency. A place with sprawling vineyards and vegetable fields, where the acronym BLM usually refers to land owned by the federal government and not a social justice movement.

Dormant winter farmland flashed by as Elliott drove along Highway 18, broken up by the occasional lumber mill with logs stacked high and finished boards strapped to flatbeds.

Red barn in field with forested hills and blue sky behind

Yamhill County is home to densely forested hills and sprawling vineyards. Its two biggest cities, McMinnville and Newberg, are at the epicenter of Oregon's wine production. (George Rose/Getty Images)

Drugs, mostly methamphetamine, have always been a problem, he said. Then deputies started to find people cutting up fentanyl pain patches and chewing them. Elliott recalled arresting a man who had a fentanyl pain patch stuck to his chest for driving under the influence.

But that was nothing compared to what happened once the "blues" — counterfeit pills — showed up. The number of fentanyl pills seized by Oregon and Idaho police soared from about 100,000 in 2019, to more than 3.6 million last year, according to preliminary data from the High Intensity Drug Trafficking Area (HIDTA). Police who participate in the HIDTA reported finding more than 180 kg (nearly 400 lbs) of fentanyl powder in 2023.

"Fentanyl has a nexus to a lot of what we do day in and day out," Elliott said. "Whether it's responding to burglaries and thefts, finding that it's people supporting habits, or people that are suffering overdoses."

All deputies carry overdose-reversing naloxone and use it regularly, like on a man who was smoking off a piece of foil while driving and crashed. He took off running after a deputy revived him, was ultimately caught, but then started overdosing again in the back of the police car. Jail staff gave three doses of Narcan to a man who started overdosing just after being booked.

Someone burned suspected fentanyl in a bathroom at Willamina High School last year. At least one student, as well as the deputy who went to investigate the smell, felt sick and went to the hospital. Elmer said the incident "sent alarm bells ringing" in the small, tight-knit community.

The drugs don't distinguish between a user in downtown Portland and a user up in the rural part of the county.

— Sam Elliott, Yamhill County Sheriff

Support for drug decriminalization has crumbled. While 58% of voters approved Measure 110 in 2020, polls show up to 74% of respondents now favor recriminalizing possession of fentanyl, heroin and meth and making treatment required, not voluntary, as an alternative to jail.

While it's difficult to determine how much Measure 110 contributed to the state's addiction crisis, Elliott said decriminalization has taken away one of law enforcement's best tools to coerce people into treatment: drug courts.

Pie chart showing Oregonians' support for re-criminalizing drugs

Numerous surveys show Oregonians support re-criminalizing hard drugs and making treatment mandatory, not voluntary, in order to avoid jail time. (Ramiro Vargas/Fox News Digital)

VOTERS’ REMORSE: BLUE STATE SURVEY SHOWS MAJORITY WANT TO RE-CRIMINALIZE DRUGS: 'WE MADE AN ENORMOUS MISTAKE'

"Even when simple possession of methamphetamine was a felony, those people did not wind up with felony convictions," he said, "because they went through drug court, because they followed through with the stipulations of their supervision."

Measure 110 also diverted hundreds of millions of dollars in marijuana tax revenue to pay for addiction services. But decriminalization took effect in February 2021, before any of those dollars could be put to use. Three years later, even urban hubs like Portland still lack adequate detox and treatment facilities. Resources are spread thinner yet in rural communities. 

"One of the biggest frustrations that I hear … is that there's nothing out here for individuals that are drug affected," Elliott said. "It's just too great of a distance for people in the rural parts of the county most of the time to be able to access those services … when it's raining and it's cold outside and they don't have reliable transportation."

Sam Elliott, rural Oregon county cop

Yamhill County Sheriff Sam Elliott serves a rural area in Oregon where fentanyl has taken hold. He says it serves as a "nexus" for many of the crimes and emergency calls his deputies respond to. (Hannah Ray Lambert/Fox News Digital)

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Lawmakers on both sides of the aisle are attempting to re-criminalize drug possession, though they disagree on how severely they're willing to punish drug users who refuse treatment. Many local leaders hope they'll also pass legislation allowing cities to ban public drug use, much in the same way they treat alcohol and marijuana.

Elliott hopes those policies will be "good for the entire state, not just for the Portland metropolitan area."

"The drugs don't distinguish between a user in downtown Portland and a user up in the rural part of the county," Elliott said. "We deal with the same problems that they do … it just looks a little bit different when you're spread out over a large area."

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