The Oregon legislature convened for a short, five-week session starting Feb. 5, and if the weeks leading up to it are any indication, drugs are on the table. Elected leaders are increasingly desperate to placate voters who blame Measure 110 for the compounding crises of addiction, public drug use and homelessness. Driven in part by increased awareness of racial disparities in policing, Oregon voters passed the ballot initiative in November 2020. The aim of the measure was to dedicate funding to behavioral health resources while decriminalizing possession of small amounts of drugs.
Proponents of changes to the law say they are simply responding to voters' outrage about what they see as an increase in public drug use. Critics argue recriminalizing possession disrupts efforts to address drug addiction before public health infrastructure has a chance to ramp up. Additionally, they argue that a move to recriminalize possession would be a regressive return to harmful drug policies that have proven futile over the last 50 years.
Research shows a significant gap between the promising results revealed in early data, and the public's negative perception of Measure 110. Funding for services, a core component of Measure 110, did not begin until 18 months after voters approved the measure. The Oregon Health Authority is responsible for the grant application process, and bureaucratic setbacks led to a significant delay in treatment funding.
Since funding began in May 2022, 233 organizations were established statewide, representing 42 Behavioral Health Resource Networks, or BHRNs. BHRNs increased access to treatment, housing and harm reduction supplies like the highly-effective overdose reversal medication naloxone. Measure 110 has also drastically reduced racial disparities in drug arrests.
While overdose mortality has increased remarkably in Oregon since 2020, the state is statistically on par with national trends.
Opioid mortality has increased nationally since 2014, and fentanyl is wreaking havoc in all 50 states.
City, county and state leaders have voiced support for changing state law. Oregon House Bill 4002, proposed Jan. 23 by a joint legislative committee on addiction and community safety, seeks to recriminalize possession of a controlled substance by way of a class C misdemeanor. The bill would design a complicated and costly deflection program within the state’s criminal justice system. It also seeks to expand the definition of possession with intent to deliver and increase the amount of time a police officer can hold an intoxicated person from 48 to 72 hours.
Gov. Tina Kotek, Mayor Ted Wheeler, and Multnomah County Chair Jessica Vega Pederson declared a tri-governmental, 90-day fentanyl state of emergency for Portland’s central city Jan. 30, a week after the joint committee released its proposal and days before the legislative session began.
“The fentanyl crisis requires state and local governments to respond with the highest possible level of coordination,” Kotek said. “Together, we must do more to increase access to treatment, and we must do more to hold individuals accountable for selling fentanyl and other dangerous drugs.”
Neighboring states
The independent research nonprofit RTI International hosted a symposium in Salem Jan. 22, inviting local and national researchers, policymakers and experts to view early findings on the impacts and challenges of Measure 110. In short, Oregon’s removal of criminal penalties appears to leave the state no worse off than surrounding states, all of which maintain criminal penalties and face identical challenges with regard to the opioid epidemic.
Instead, researchers say Oregon’s decades-long disinvestment in behavioral health and addiction services, COVID-19 and the arrival of fentanyl on the West Coast coalesced in January 2021, just as the state moved from war on drugs policies to a new public health approach to addiction.
“This is a very challenging conversation,” Mike Schmidt, Multnomah County district attorney, told Street Roots. “We know historically, over the last five, six decades, we've approached drugs in a very specific, certain way — and that got us to where we are today.”
Research
Alex Kral is an epidemiologist and a distinguished fellow at RTI who has researched and evaluated drug policies and drug use for 30 years. He said just four to six months of data is available during which decriminalization, treatment, housing and harm reduction components of the measure were all in place at the same time.
Despite public perception and media reports of Measure 110 as the leading driver of surges in overdoses and drug use, Kral said it would be premature to draw any conclusions about the long term impacts of Oregon’s novel policy.
“I would want five years of data, really, and that's not sufficient,” Kral said. “But that would be my early look at this.”
Fentanyl did not saturate the drug market in every state simultaneously. The overall opioid mortality rate went up nationally beginning in 2014 and remained stable until 2019. It wasn’t until January of 2021 that fentanyl saturated the drug supply in Oregon — the same month the state removed criminal penalties for possession. Neighboring states Washington and California saw the highly potent drug closer to July and August 2020 respectively, while Idaho and Nevada followed in the summer of 2021, according to the research.
The introduction of fentanyl into the drug supply is a massive contributor to the rise in opioid deaths nationwide. As soon as fentanyl came to Oregon, it contributed to a precipitous rise in overdose deaths, following the exact same course as every other state when fentanyl was introduced, according to Brandon Del Pozo, a former police officer and researcher at Brown University.
Using Drug Enforcement Agency data from all 50 states, Del Pozo’s research demonstrates fentanyl deaths in every state rose at nearly identical rates upon introduction — regardless of each state’s penalties for possession of a controlled substance.
Schmidt said he talks to colleagues in neighboring states who say they’re dealing with similar issues as Oregon, despite no other state operating under a decriminalization framework.
Race and policing
Public opinion shifted in the U.S. during the national uprising in response to the murder of George Floyd in May 2020. Oregon’s vote to decriminalize possession of controlled substances is widely seen as a result of increased public awareness of racial disparities in policing, and a desire to reduce interactions between low-level offenders and police officers.
“When I was supporting 110 and talking to voters, we all wanted to move away from the carceral system to the treatment system,” Schmidt said. “We moved away from the carceral aspect of drug enforcement for possession but didn't, for a while, see the move to treatment.”
Researchers say the move to reduce racial disparities in drug-related policing has been a success. RTI research found no statistically significant differences by race and ethnicity among those stopped by law enforcement in the last year, according to respondents to a survey of 468 Oregonians who use drugs.
Still, people who use drugs experience a high level of interaction with police. 66% of respondents reported being stopped by law enforcement within the prior 12 months, and of those stopped, 47% reported law enforcement seized drugs.
Drug seizure can cause negative impacts, as coming off of drugs like fentanyl carries an increased risk of overdose.
Still, proponents of recriminalization say criminal punishments are necessary to compel people to seek treatment. Max Williams, a former Republican state legislator and former director of the Oregon Department of Corrections, founded the Coalition to Fix and Improve Measure 110 in 2023, seeking to aggressively bend the law back to the criminal justice system.
“Anything short of reclassifying deadly drugs as a Class A misdemeanor crime will be inadequate to effectively steer more people into more treatment more quickly,” Williams said in a statement Jan. 23.
In an October 18, 2023 interview with Street Roots, Williams said in a perfect world, there would be other ways to impose consequences without the involvement of law enforcement, but said he believes people need to be motivated to seek treatment.
“The idea here is to put some consequence and reward back into the system that will take people who will otherwise not be motivated to find access to treatment and recovery and to reinstitute some of those motivations that pre-existed but with better off ramps to diversion,” Williams said.
However, analysis draws into question whether the threat of criminal penalty is a strong motivator. Few people who use drugs in Oregon are aware Measure 110 decriminalized drugs, according to researchers. Just 13% of survey respondents knew all drugs were decriminalized, while just 7% knew possession of fentanyl carried no criminal penalty.
Public use
“I think we've heard loud and clear from our community that the open use on our streets is no longer acceptable,” Schmidt said. “On the other hand, we don't want to do any harm.”
Despite public outrage, researchers caution a return to the drug policies of the past will exacerbate issues of overdoses and homelessness. Kral said more time and research are needed to observe secondary data — like overdoses or crime rates — due to a lag in reporting of publicly available data. He noted criminologists typically think about at least five, and often 20-year trends.
“They don’t think about half a year,” Kral said. “Nothing moves that quickly.”
Since decriminalization happened before funding went out to BHRNs, the primary data offers a small glimpse of what to expect from a return to the criminal justice pathway.
“People think that, ‘Oh, good, we can just put them away,’” Kral said. “Well, they do come back out, and they come out way worse.”
Research shows those who were incarcerated in the 12 months prior to the survey were twice as likely to overdose than those who had not been incarcerated, according to researchers. Interaction with the criminal justice system can also contribute to a rise in homelessness. Jail time can lead to evictions due to inability to pay rent, and can create further barriers to obtaining housing upon release.
“We're not going to give more money to the policing system,” Oregon Rep. Rob Nosse said of House Bill 4002. “If there's more money allocated in the bill that's revealed, it will be for public defenders, and then it will be for housing and services.”
Nosse served on the joint interim committee on addiction and community safety, which developed the proposals. The Oregon Office of Public Defense Services is short nearly 1,300 public defenders, or 31% of what is needed to provide effective assistance, according to a 2022 American Bar Association report.
Visible homelessness
“It is hard to see what is happening on our streets,” Marisa Zapata, PSU Homelessness Research and Action Collaborative, or HRAC, director said. “It is depressing. It is upsetting. It is enraging for all sorts of different reasons.”
In 2022, 17,912 people experienced homelessness in Oregon, while 11,091 were unsheltered, according to the 2022 Oregon Point-In-Time, or PIT count. PIT counts are widely understood to be a substantial undercount of homeless residents, but provide a year-by-year baseline for researchers, policymakers and the public.
“Independent of substance use disorders, independent of overdose rates, independent of serious mental illness rates. Housing is what drives homelessness.”
— Marisa Zapata
Director, PSU Homelessness Research and Action Collaborative
In 2023, the number of people who experienced homelessness in Oregon rose 8.5% to 20,110, while 65% of those, 13,004 people, were unsheltered. That is the second-highest rate of unsheltered homelessness in the U.S., according to Zapata. In some regions, homelessness rose 300% from 2022 to 2023 for Native Hawaiian and Pacific Islanders.
“The more that housing prices go up and rent vacancies go down, we will see an increase in homelessness,” Zapata said. “Independent of substance use disorders, independent of overdose rates, independent of serious mental illness rates. Housing is what drives homelessness.”
The RTI survey of 468 people found that 93% of people experiencing housing insecurity wanted to get housing, and 30% said they were on a waitlist for housing, though the average length of time on a waitlist was 17 months.
“I think if we could scale up a lot more housing, this would be a lot easier,” Nosse said. “The addiction will be more manageable if we had a lot more affordable housing. I wish we could save the $5 billion in the kicker that we're sending back.”
Substance use disorder is high among people experiencing homelessness — 16% of people surveyed in the 2022 national PIT count and 26% in the 2023 Portland tri-county PIT count reported a substance use disorder.
While research shows a relationship exists between substance use disorder and homelessness, Zapata said the relationship is bidirectional rather than substance use as the cause of homelessness. In fact, some research indicates people who were developing substance use disorders on the street largely resolved without additional support once they moved inside, according to Zapata.
However, involvement in the criminal justice system creates barriers for people looking for housing, as applications often require people to submit background checks, provide references or other requirements beyond one’s ability to pay for housing.
Zapata said Oregon desperately needs more low-barrier affordable housing to address the homelessness crisis.
Kotek announced Senate Bill 1537 in January, a proposal including a $500 million investment in housing and infrastructure, climate incentives and a one-time tool for cities to add land to their urban growth boundary.
“Decades of underbuilding have left Oregon with a severe housing shortage that is driving up rents, home prices, and worsening our homelessness crisis,” Kotek said in a press release. “People that are ready to transition out of homelessness struggle to find housing.”
As leaders look to tweak Measure 110, Kotek said she supports efforts to add a low-level misdemeanor and create diversion programs for drug possession, but said it is imperative to continue focusing on providing services to those who need it.
“I'm really focused on making sure that individuals, depending on what they need, can get the services,” Kotek told Street Roots in December. ”It's complicated. There are a lot of barriers for folks to get into stability and housing.”
Some of those barriers are created when people face criminal penalties, according to Kral.
“People are progressively getting worse off, in part because of their involvement in the criminal legal system,” Kral said.
Despite supporting public use bans and deflection programs that put low-level offenders through the justice system, Schmidt said leaders are tasked with finding a balance between the public’s moral outrage and the data suggesting it’s too early to roll back the promises of Measure 110.
“We do have to be cautious and study things here locally,” Schmidt said. “But we should be guided by research and then actual outcomes and not as much just, you know … vibes.”
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