Overdoses Up 700% After Oregon Decriminalizes Hard Street Drugs. Officials Mystified.

In November 2020, Oregon voters approved ballot measure 110, making Oregon the first state in the nation to decriminalize the possession of hard drugs. M110 made the possession of personal use amounts of hard street drugs like heroin or meth punishable by a citation of up to $100, and directed funding to drug treatment programs. The voters bought the argument that the state could better disburse resources to treatment rather than prosecuting offenders criminally. In addition, the citation and fine could be waived if the offender called a hotline that would offer a “health assessment.”

Guess what happened next?

Officials at the Oregon Health Authority testified to legislative committees this week about the results of the program. It isn’t good. According to the Daily Mail:

Oregon’s first-in-the-nation scheme to decriminalize drugs and encourage those caught possessing them to seek medical help has been blighted with problems, officials admitted on Thursday – as one Republican politician said there had been a 700 percent in overdoses in her district in the last year.

Of the 1,885 people who got tickets in the first year of the program, only 91 called the hotline. Of those who called, only a handful had any interest in getting treatment.

According to an earlier report in January by Oregon Catalyst, of the 68 people who had called the hotline by that point, 49 expressed zero interest in getting help, and only 11 got connected to treatment services.

Eleven.

A report by OPB notes that the program comes with some hefty strings, with rural areas struggling to provide sufficient resources:

Under the measure, providers applying for funds in different regions of the state, in many cases by county, must jointly form “Behavioral Health Resource Networks.” Each network must provide a range of services that includes needs screening, intervention planning, low-barrier substance use treatment, peer support, housing services, harm reduction and supported employment.

And, providers must provide services in a way that aligns with the spirit of Measure 110. For example, services must be culturally competent, inclusive and low barrier. This means that programs can’t eject a patient for a single relapse, and that harm reduction services — such as overdose reversing drugs, fentanyl testing strips and clean syringes — should be available for people who are not ready to abstain from substance use. In some regions, a single provider serves as the entire network.

Oregonians were sold a bill of goods when they approved Measure 110. In exchange for legalizing small amounts of hard street drugs, Oregon voters were assured that M110 would allocate significant funding for drug treatment, which has badly lagged in the state for years. Voters were told nonviolent drug users didn’t deserve to be locked up, and that marijuana tax money could pay for treatment. A report in April revealed the Oregon Health Authority (OHA) had gone AWOL. Treatment service providers were told when they applied for funds in December 2021 that OHA would make a decision by February 2022. By April, OHA was telling them to expect applications to be processed by the fall. Some non-profit treatment programs, relying on the promised grants, feared they might not stay open long enough to receive the funds.

In legislative testimony this week, Oregon Health Authority officials admitted they had no idea how complex the program would be to implement. They, of course, requested higher staffing levels to deal with it. Of the $276 million they received in funding for drug treatment grants to non-profits, only $40 million had been disbursed. The Secretary of State’s office is conducting an audit of the implementation of Measure 110. They’ve issued a Risk Letter to Patrick Allen, director of the Oregon Health Authority, which oversees the new program. They made the following observations/recommendations:

• The Oversight and Accountability Council did not receive information about individual grantee performance and did not receive public comments from meetings, despite asking the health authority for these items.
• Measure 110 does not provide clarity around the roles and of the health authority and the council, therefore the Legislature should provide that clarity.
• The Oregon Health Authority “has not always provided adequate support” to the council and has experienced staffing issues. That has contributed to delays in funding. Therefore auditors recommend that sufficient and dedicated staff support the council and that the authority provide timely and clear responses to the council’s questions.
• The council “developed an inefficient grant evaluation process, due in part to a lack of support and guidance.” Again, more support from the health authority is recommended.
• “Insufficient grant management and monitoring pose a risk that providers will not use funding in alignment with the equity and treatment support goals” of Measure 110. Auditors recommend the health authority “develop robust grant management and monitoring processes, including ensuring sufficient data is collected to enable those processes,” and that it give the oversight council sufficient support “while developing and voting on rules for data collection and reporting.”
• Ongoing ethics and conflict of interest training was also recommended for the council.

Oregon will continue to try to make this program a success. Is it even possible? Rachel Dawson, a policy analyst at Cascade Policy Institute, has doubts:

What’s missing in this equation is any kind of personal accountability. Many of those who need help won’t seek it out. Drug courts were helpful in this regard because they pushed addicts into treatment which reduced substance use and drug-involved crimes. Officials should consider adding similar “teeth” to this program.

Given Oregon’s soft-on-crime approach over the past several years, personal accountability seems like a bridge too far.