I live in the Seattle area, which is struggling with public drug use just like Portland. Like Portland, we've lived for decades with very progressive politicians who have lead successful decriminalization efforts and spent huge sums of public funds on treatment and harm reduction programs. After several decades and many, many millions of dollars spent, the problem is, by every measure, absolutely the worst it's ever…
Because the country as a whole has been completely ravaged by opiate addiction. It's not just Portland and Seattle. West Virginia doesn't have anything like this, and it's just as badly afflicted. It may be less visible because it doesn't have the same population density.