Is Measure 110 to blame for increased overdoses?
Probably not. Missing from the NYT reporting and commentary is that overdose deaths spiked even more in states like Washington and Wyoming.
Let justice roll down like waters.
Amos 5:24
Dear Friends and Colleagues,
This week, we are interrupting our series on psychedelics to discuss Oregon.
In 2020, Ballot Measure 110 passed in the state of Oregon, decriminalizing possession of a small amount of any drugs. Instead of arrest and jail time, offenders would receive a $100 citation and the opportunity to waive the fee if they sought treatment.
Recent reporting in the New York Times has highlighted that since the measure passed, overdoses in Oregon are way up, as is public drug use in places like downtown Portland. The reporting paints a grim picture, and a recent opinion piece by Brett Stephens has declared Measure 110 a “disaster.”
We’ve gotten a lot of questions about what is happening, so let's dive in.
Is Measure 110 to blame for increased overdoses?
Probably not. Missing from the NYT reporting and commentary is that overdose deaths spiked even more in states like Washington and Wyoming. Substantial increases have also happened in “tough on crime” states like Texas. Oregon isn’t an outlier or even the leader regarding increased overdose deaths or overall overdose rates. In fact, the drug overdose rate in Oregon is still lower than the national average.
A rapid increase in overdose deaths is a national problem, and blaming a state-level policy for national trends ignores the facts. Clearly, Measure 110 is not the problem.
Is Measure 110 part of the solution?
Hopefully.
I wrote about some of my concerns for Oregon back in November. Peace, Nelson Mandela reminded us, is not just the absence of conflict but the presence of what is necessary for human flourishing. Not arresting people who need health care and housing is an important step, but it doesn’t actually give them healthcare or housing.
Right now, as the Times reporting does highlight, it still takes far too long for people looking for help to access it. There are legitimate concerns about how the policies were rolled out. And there are large gaps in the services provided. While Measure 110 has become known for the decriminalization side, the most important part of the initiative is only just starting to take effect, investment in solutions.
While the money faced major delays, 300 million dollars has been dispersed to build a more robust public health response to problematic drug use. While some numbers are difficult to track, stats from the Oregon Health Authority show a 44% increase in people seeking treatment, and 125% increase in housing support, and 136% increase in employment services. And not locking people up for minor drug offenses has saved the state an estimated $37 million dollars already.
These numbers are promising but could take time before your average resident sees the benefits. There are still a lot of folks living on the streets and using drugs publicly. Up until recently, I lived in a neighborhood where this was a daily reality. It isn’t fun to deal with, and we’ll dive into this topic more in a future newsletter. But it’s important to consider what the status quo is.
Right now, across most of the country, we spend a massive amount of money temporarily jailing people and then sending them back onto the streets. Every time someone spends time in jail or in prison, their risk of overdose goes up. Every time someone goes to prison for drug use, their likelihood of recovery goes down.
This isn’t cheap. There are costs for the police, jails, courts, prosecution, public defenders, and prison. The average state spends more than $45,000 annually to keep one person locked up.
Oregon may not get everything right in the rollout of Measure 110. But I am strong in my conviction that we can do a lot better for people who use drugs and people with substance use disorders than spending $45,000 a year on putting them in cages that only increase their risk of overdose and make it harder for them to recover.
Ultimately, decriminalization is not the answer, decriminalization frees up resources for finding answers. Decriminalization removes barriers to accessing long-term solutions like rapid access to high-quality treatment, employment opportunities and supportive housing.
Portugal, the country that has been cited as a model for the law in Oregon, saw great success in its program to decriminalize drugs and invest in treatment. Then, funding supportive services from an estimated 76 million euros ($82.7 million) to 16 million euros ($17.4 million). The result? Rising overdose rates and increased challenges with public drug use.
The problems we face are decades in the making, solutions aren’t going to come quickly. But we can’t blame national trends on local policy decisions. At the same time, we can’t mistake lowering barriers to receiving help for the help itself. Solutions lie in prevention, creating alternatives to the illicit toxic drug supply, high-quality treatment and long-term supportive services.
As always, feel free to respond with your own thoughts, questions, or policy models you think might be effective. Rev. Sharp and I have had a few conversations recently about the challenges cities face when it comes to quality-of-life issues and community safety. These issues are complex, and we might have more coming on that topic if there is interest!
Keep the faith,
Timothy McMahan King
Senior Fellow, CNDP
There is no quick fix and there never is. As Jack Holmes describes the situation in Oregon since Measure 110, “[n]ow drug users don’t catch felonies that harm their future employment and housing prospects. The traditional model—arrest people, threaten them with prison if they don’t go to drug court, and thereby force them into treatment—works for some people, though its effectiveness varies widely depending on the place and the program. And where do we draw the finish line? Six months sober? A year? And how do we make sure people keep on running after we call the race?”
Holmes goes on to say “[a]sk the people doing their smaller experiments within the broader one of Measure 110 and they’ll tell you that for many people struggling with drug use, it’s not about twelve steps or doctors in lab coats or paperwork. We’ve made progress on treating drug abuse as a health issue, but for many people it’s about creating a less medicalized—less formal—approach. It’s about a sandwich or a couch where you can watch football on a Sunday, about building a little community for people to live inside. It’s about stabilizing people long enough that you can start to deal with the traumatic wounds that often lie beneath a layer of powder and pills. The solution is as hard as the work is. There’s no quick fix, because it never really ends, and yet they’re just asking for some time—more than America’s politicians and voting public like to give anything—to try something new.”
‘It’s crazy out there’: The reasons behind Oregon’s deepening drug crisis
One reason Measure 110 may not have been as effective as possible is its timing, Dr. Andrew Mendenhall, CEO and president of Central City Concern, describes Measure 110 as being passed during the “perfect storm.” Additionally, many of the expanded treatment options that should have been part of Measure 110 are still not available. Further, “supporters argue that while Measure 110 is unique to Oregon, it cannot be blamed for a new wave of the opioid epidemic that has hit every state in recent years. The spike in overdose deaths also coincided with the coronavirus pandemic, which destabilized the state’s health care systems, further reduced treatment options for substance-use disorder and created a perfect storm of isolation and social disruption that contributed to increased drug use. Overdose deaths spiked nationally during the pandemic.”
As the graphic above illustrates, it is important to remember that Oregon had a lower drug overdose rate in 2021 than neighboring Washington state.
U.S. drug overdose deaths hit a record in 2022 as some states see a big surge
In fact, in 2022, eight states saw drug deaths surge by nine percent or more, with the greatest increases of 21 percent coming in Washington state and Wyoming—not Oregon. Instead, Texas and Washington state saw the biggest increases in the number of drug fatalities with both states suffering roughly 500 additional deaths linked to overdoses.
Report on Measure 110 shows more than 60,000 people struggling with addiction were helped
Perhaps less important to America’s politicians and voting public and certainly less important to the media, a report published in February 2023 shows Measure 110 is making an immediate impact for people struggling with substance abuse across the state including housing, access to treatment, and increasing outreach staff. Part of Measure 110 called for the creation of at least one Behavioral Health Resource Network (BHRN) in each county in Oregon. In 2022, funding was approved to form 42 BHRN’s. These BHRN’s served thousands of clients in 2022 alone.
“A More Loving, Just Church”: Harm Reduction and Faith Communities
Be sure to check out this interview with Reverend Erica Poellot, Director of Faith in Harm Reduction, one of our partners, about what it looks like when a church embraces harm reduction.
Worse than Futile: What’s Wrong with Using the U.S. Military to Counter Fentanyl
The folks at Cato are hosting a live webinar on Friday, August 18th, to do a deep dive into all the reasons it is a terrible idea to use the military to address a public health crisis.