"How Oregon Became a Linchpin for the Country?s Drug Policies

Feb. 5, 2024, 5:02 a.m. ET

By Maia Szalavitz

Ms. Szalavitz is a contributing Opinion writer who covers addiction and
public policy.

In February 2021, Oregon decriminalized possession of small amounts of
all drugs, via a ballot initiative known as Measure 110. The idea was to
treat addiction as a public health problem, based on overwhelming
evidence that jailing people for having small amounts of drugs for
personal use is both ineffective and counterproductive.

Since then, decriminalization has been widely blamed for increased
homelessness, soaring rates of public drug use and a 68 percent rise in
the overdose death rate in its first two years. This spike was far
greater than the 14 percent rise in the nation?s overall overdose deaths
during the same period.

Although Measure 110 passed with nearly 59 percent support, many Oregon
voters are now calling for drugs to be recriminalized, citing these
worsening conditions. The state legislature, which convenes on Monday,
is considering new legislation that would, among other things, restore a
criminal penalty of up to a month in jail for low-level possession.

Repealing decriminalization would be a mistake. Researchers studying
Measure 110?s effects recently presented compelling evidence that the
current law is extremely unlikely to have done the harm for which it is
being blamed. But rampant misinformation ? often being spread for
political gain ? means that the legislature is likely to return to its
old-school drug war approach. With overdose deaths still on the rise and
other states considering decriminalization, a reversal could undo vital
national progress in fighting addiction, which is far more effectively
resolved with care, not coercion.

If we really want to end the overdose and homelessness crises ? in
Oregon and around the country ? we have to understand and follow the
evidence, not the fearmongering.

When events occur in rapid succession, it?s easy to assume that the
first one caused the second. But correlation isn?t all that?s needed to
prove causation. For something like a change in drug laws to have an
impact, certain conditions need to be met.

For one, 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 that they were aware that it was no longer a criminal
offense to possess fentanyl. 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 ? not a population that typically pays
attention to the vagaries of legislative change.

Although opponents of the measure claim that it has attracted homeless
people from around the country, only 9 percent of the surveyed drug
users 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 tracked with eviction policy, not decriminalization,
the research shows.

Another claim made frequently by critics of the law and by journalists
is that Measure 110 has taken away a critical tool that law enforcement
could previously wield to force people into treatment: incarceration. In
fact, less than one-third of jails in the United States offer medication
with buprenorphine or methadone ? the gold standard in treating opioid
use disorder ? to all who could benefit. Few arrestees are even given
the chance to choose treatment instead of jail. 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 they did 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 set better
policy?

?It?s all about the fentanyl,? says Dr. Alex Kral, a distinguished
fellow in behavioral health and criminal justice at the think tank RTI
International. Illicitly manufactured fentanyl is roughly 50 times
stronger than heroin. And it is fentanyl and even more powerful
synthetic opioids that have driven the unprecedented rise in overdose
fatalities since 2013. When milder substances are suddenly replaced with
drugs that are stronger by orders of magnitude, this unsurprisingly
becomes the most powerful factor driving overdose deaths.

Every region across the country shows 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 Brown
University and his colleagues, as well as previously published research.
Washington State is an especially interesting example: When the state
decriminalized drug possession for four months in 2021 because of a
court order, overdose rates rose most sharply after criminal penalties
were restored.

Furthermore, as recently as 2018, nearly 90 percent of all overdose
deaths involving synthetic opioids occurred in the 28 states east of the
Mississippi. The drug and its analogues didn?t overrun Western state
markets until 2019 and later, and Measure 110 did not go into effect
until February 2021. Data from Oregon follows the same trends as other
states where fentanyl began to spread during a similar period.

Consequently, it?s spurious to link decriminalization to an overdose
rate that has risen in parallel with fentanyl prevalence in every
community studied that was penetrated by the drug, regardless of policy
changes.

Recriminalizing drug possession in Oregon wouldn?t merely reintroduce
expensive and ineffective punishments; it also threatens to turn back
the clock on other noncoercive drug policies and harm reduction
strategies promoted by the world?s leading experts on drug addiction,
like Dr. Nora Volkow, who heads 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 only just
starting to make an impact in the state. A Portland police officer,
David Baer, has worked on the city?s bike squad in the neighborhoods
hardest hit by drugs for the past four years. Recently, he became part
of a pilot program that allows him to call in outreach workers, whose
jobs are paid for with Measure 110 funding, when he encounters people
using drugs who want help. Of the workers, he says: ?These folks are
experts in this. They have lived experience. They?re so compassionate.
And so through that program, we?re able to get people into treatment.?
Not everyone he stops seeks care ? but a far larger proportion do than
call the treatment hotline listed on police tickets currently handed out
for drug possession.

These types of programs go hand in hand with decriminalization. Oregon
can serve as a powerful example to other states by staying the course
and not hastily reversing itself based on politicized misinformation.

?We can?t arrest our way out of this,? says Officer Baer. After decades
of punitive policies, the United States has the world?s highest
incarceration rate, and the world?s highest overdose death date. Oregon
can lead the way by giving humane drug policy the time it needs to prove
it can make a difference.

https://www.nytimes.com/2024/02/05/opinion/oregon-decriminalization-
drugs-reversal.html

About all the retrumplicans have going for them is fearmongering
and resentment.

TB

On 2/5/2024 7:42 AM, Technobarbarian wrote:
>
>
> "How Oregon Became a Linchpin for the Country?s Drug Policies
>
> Feb. 5, 2024, 5:02 a.m. ET
>
> By Maia Szalavitz
>
> Ms. Szalavitz is a contributing Opinion writer who covers addiction and
> public policy.
>
> In February 2021, Oregon decriminalized possession of small amounts of
> all drugs, via a ballot initiative known as Measure 110. The idea was to
> treat addiction as a public health problem, based on overwhelming
> evidence that jailing people for having small amounts of drugs for
> personal use is both ineffective and counterproductive.
>
> Since then, decriminalization has been widely blamed for increased
> homelessness, soaring rates of public drug use and a 68 percent rise in
> the overdose death rate in its first two years. This spike was far
> greater than the 14 percent rise in the nation?s overall overdose deaths
> during the same period.
>
> Although Measure 110 passed with nearly 59 percent support, many Oregon
> voters are now calling for drugs to be recriminalized, citing these
> worsening conditions. The state legislature, which convenes on Monday,
> is considering new legislation that would, among other things, restore a
> criminal penalty of up to a month in jail for low-level possession.
>
> Repealing decriminalization would be a mistake. Researchers studying
> Measure 110?s effects recently presented compelling evidence that the
> current law is extremely unlikely to have done the harm for which it is
> being blamed. But rampant misinformation ? often being spread for
> political gain ? means that the legislature is likely to return to its
> old-school drug war approach. With overdose deaths still on the rise and
> other states considering decriminalization, a reversal could undo vital
> national progress in fighting addiction, which is far more effectively
> resolved with care, not coercion.
>
> If we really want to end the overdose and homelessness crises ? in
> Oregon and around the country ? we have to understand and follow the
> evidence, not the fearmongering.
>
> When events occur in rapid succession, it?s easy to assume that the
> first one caused the second. But correlation isn?t all that?s needed to
> prove causation. For something like a change in drug laws to have an
> impact, certain conditions need to be met.
>
> For one, 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 that they were aware that it was no longer a criminal
> offense to possess fentanyl. 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 ? not a population that typically pays
> attention to the vagaries of legislative change.
>
> Although opponents of the measure claim that it has attracted homeless
> people from around the country, only 9 percent of the surveyed drug
> users 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 tracked with eviction policy, not decriminalization,
> the research shows.
>
> Another claim made frequently by critics of the law and by journalists
> is that Measure 110 has taken away a critical tool that law enforcement
> could previously wield to force people into treatment: incarceration. In
> fact, less than one-third of jails in the United States offer medication
> with buprenorphine or methadone ? the gold standard in treating opioid
> use disorder ? to all who could benefit. Few arrestees are even given
> the chance to choose treatment instead of jail. 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 they did 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 set better
> policy?
>
> ?It?s all about the fentanyl,? says Dr. Alex Kral, a distinguished
> fellow in behavioral health and criminal justice at the think tank RTI
> International. Illicitly manufactured fentanyl is roughly 50 times
> stronger than heroin. And it is fentanyl and even more powerful
> synthetic opioids that have driven the unprecedented rise in overdose
> fatalities since 2013. When milder substances are suddenly replaced with
> drugs that are stronger by orders of magnitude, this unsurprisingly
> becomes the most powerful factor driving overdose deaths.
>
> Every region across the country shows 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 Brown
> University and his colleagues, as well as previously published research.
> Washington State is an especially interesting example: When the state
> decriminalized drug possession for four months in 2021 because of a
> court order, overdose rates rose most sharply after criminal penalties
> were restored.
>
> Furthermore, as recently as 2018, nearly 90 percent of all overdose
> deaths involving synthetic opioids occurred in the 28 states east of the
> Mississippi. The drug and its analogues didn?t overrun Western state
> markets until 2019 and later, and Measure 110 did not go into effect
> until February 2021. Data from Oregon follows the same trends as other
> states where fentanyl began to spread during a similar period.
>
> Consequently, it?s spurious to link decriminalization to an overdose
> rate that has risen in parallel with fentanyl prevalence in every
> community studied that was penetrated by the drug, regardless of policy
> changes.
>
> Recriminalizing drug possession in Oregon wouldn?t merely reintroduce
> expensive and ineffective punishments; it also threatens to turn back
> the clock on other noncoercive drug policies and harm reduction
> strategies promoted by the world?s leading experts on drug addiction,
> like Dr. Nora Volkow, who heads 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 only just
> starting to make an impact in the state. A Portland police officer,
> David Baer, has worked on the city?s bike squad in the neighborhoods
> hardest hit by drugs for the past four years. Recently, he became part
> of a pilot program that allows him to call in outreach workers, whose
> jobs are paid for with Measure 110 funding, when he encounters people
> using drugs who want help. Of the workers, he says: ?These folks are
> experts in this. They have lived experience. They?re so compassionate.
> And so through that program, we?re able to get people into treatment.?
> Not everyone he stops seeks care ? but a far larger proportion do than
> call the treatment hotline listed on police tickets currently handed out
> for drug possession.
>
> These types of programs go hand in hand with decriminalization. Oregon
> can serve as a powerful example to other states by staying the course
> and not hastily reversing itself based on politicized misinformation.
>
> ?We can?t arrest our way out of this,? says Officer Baer. After decades
> of punitive policies, the United States has the world?s highest
> incarceration rate, and the world?s highest overdose death date. Oregon
> can lead the way by giving humane drug policy the time it needs to prove
> it can make a difference.
>
> https://www.nytimes.com/2024/02/05/opinion/oregon-decriminalization-
> drugs-reversal.html
>
> About all the retrumplicans have going for them is fearmongering
> and resentment.
>
> TB

Here's a tip for you...

"Brevity is the soul of wit" - Polonius