by In February 2021, Oregon decriminalized the possession of small amounts of all drugs, through a ballot initiative known as Measure 110. The idea was to treat addiction as a public health problem, based on overwhelming evidence that imprisoning people for possessing small amounts of drugs for personal use is both ineffective and counterproductive.
Since then, decriminalization has been widely blamed for increased homelessness, rising rates of public drug use, and a 68 percent increase in the overdose death rate in its first two years. This peak was much larger than 14 percent increase in total overdose deaths in the country during the same period.
Although Measure 110 was approved with almost 59 percent support, many Oregon voters are now calling for drugs to be recriminalized, citing worsening conditions. The state legislature, which meets Monday, is considering new legislation that, among other things, would reinstate a criminal penalty of up to one month in jail for low-level possession.
Repealing decriminalization would be a mistake. Researchers studying the effects of Measure 110 recently presented compelling evidence that the current law is extremely unlikely to have caused the harm for which it is blamed. But rampant misinformation – often spread for political gain – means the legislature is likely to return to its old-school drug war approach. As overdose deaths continue to rise and other states consider decriminalization, a reversal could undo vital national progress in the fight against addiction, which is solved much more effectively with care, not coercion.
If we truly want to end the overdose and homelessness crises (in Oregon and across the country), we need to understand and follow the evidence, not scaremongering.
When events occur in rapid succession, it is easy to assume that the first caused the second. But correlation is not all that is needed to prove causation. For something like a change in drug laws to have an impact, certain conditions need to be met.
On the one hand, people need to know that the rules have changed. in a survey Of nearly 500 Oregonians who use stimulants, opioids or both, only 7 percent said they were aware that possession of fentanyl was no longer a crime. Less than half knew that methamphetamine had been decriminalized. Only 1.5 percent had started using drugs after Measure 110 went into effect. About 85 percent of survey participants were homeless or unstably housed, a population that typically pays no attention to the vagaries of legislative change.
Although opponents of the measure claim it has attracted homeless people from across the country, only 9 percent of drug users surveyed had moved to Oregon in the past two years, while nearly three in four had resided there for 11 years or more. Overall homelessness rates in the state have continued eviction policynot decriminalization, research shows.
Another claim frequently made by critics of the law and by journalists is that Measure 110 has eliminated a critical tool that law enforcement could previously use to force people into treatment: incarceration. In fact, less than one third of prisons in the United States offer buprenorphine or methadone medications (the gold standard in the treatment of opioid use disorder) to all who may benefit. Few detainees even have the opportunity to choose treatment instead of prison. And in prisons, where nearly half of all inmates have drug problems, only 10 percent have access to treatment beyond self-help groups, according to the Prison Policy Initiative.
So why did overdose death rates rise more in Oregon than in the rest of the United States immediately after the measure passed? And how can the answer help both Oregon and the rest of the country establish better policies?
“It all has to do with fentanyl,” says Alex Kral, a distinguished fellow in behavioral health and criminal justice at the think tank RTI International. Illicitly manufactured fentanyl is approximately 50 times stronger than heroin. And it is fentanyl and even more powerful synthetic opioids that have driven the unprecedented rise in overdose deaths since 2013. When milder substances are suddenly replaced by drugs that are orders of magnitude stronger, this, unsurprisingly, becomes the most powerful factor driving overdose deaths.
Each region of the country sample a nearly identical, skyrocketing death toll when fentanyl saturates its market, regardless of whether it’s a tough-on-crime state like Texas or a progressive bastion like California, according to data presented by Dr. Brandon Del Pozo of the University of Brown and his colleagues. as well as previously posted investigation. Washington state is an especially interesting example: When the state decriminalized drug possession for four months in 2021 due to a court order, overdose rates rose more sharply after Criminal sentences were reinstated.
Additionally, as recently as 2018, almost 90 percent of all synthetic opioid overdose deaths occurred in the 28 states east of the Mississippi. The drug and its analogs did not invade Western state markets until 2019 and after, and Measure 110 did not go into effect until February 2021. Oregon’s data follows the same trends as other states where fentanyl began to spread during a similar period .
Consequently, it is false to link decriminalization to an overdose rate that has increased in parallel with the prevalence of fentanyl in all communities studied that were penetrated by the drug, regardless of policy changes.
Recriminalizing drug possession in Oregon would not only reintroduce costly and ineffective punishments; It also threatens to roll back other non-coercive drug policies and harm reduction strategies promoted by the world’s leading experts on drug addiction, such as Dr. Nora Volkow, who directs the federal government’s National Institute on Drug Abuse. . Measure 110 allocated new spending to harm reduction initiatives that made the overdose antidote naloxone more widely available. a modeling study showed that without this change, even more lives would have been lost to fentanyl overdoses.
After a slow rollout, new funding for addiction treatment is just beginning to have an impact in the state. A Portland police officer, David Baer, has worked on the city’s bike squad in the neighborhoods most affected by drugs for the past four years. Recently, he was part of a pilot program that allows him to call community workers, whose jobs are paid for by Measure 110 funds, when he encounters people who use drugs and want help. Of the workers, he says: “These people are experts at this. They have experience. They are very compassionate. And so, through that program, we can get people into treatment.” Not everyone he stops seeks care, but a much higher proportion do so rather than calling the treatment hotline listed on the police tickets currently issued for drug possession.
These types of programs go hand in hand with decriminalization. Oregon can serve as a powerful example to other states if it stays the course and doesn’t hastily backtrack based on politicized misinformation.
“We can’t arrest our way out of this,” Officer Baer says. After decades of punitive policies, the United States has the The highest incarceration rate in the world. and the world highest overdose death rate. Oregon can lead the way by giving a humane drug policy the time it needs to show it can make a difference.
Maia Szalavitz (@maiasz) is a thought contributor and author, most recently, of “Undoing Drugs: How Harm Reduction is Changing the Future of Drugs and Addiction.”
Original photographs by CSA Images and Nathan Howard, via Getty Images.
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