Oregon health officials announced a major milestone this week, revealing they had awarded more than $300 million earmarked to expand services for people with addictions.
But a pair of addiction experts warned Wednesday that more than just services will be needed to stem the state’s high rate of drug use – and the growing social costs that come with it. They told lawmakers that the state also needed to adjust its permissive approach.
“On the one hand, we have very rewarding drugs that are widely available, and on the other hand, little or no pressure to stop using them,” Keith Humphreys, a professor of psychology at Stanford University, told Reuters. State Senate Committee on Ballot Justice and Measurement. 110 Implementation. “Under these conditions, we should expect to see exactly what Oregon is going through: high drug use, high addiction, and little treatment seeking.”
Neither Humphreys nor another expert appearing before lawmakers — head of addiction medicine at Oregon Health & Science University Dr. Todd Korthuis — advocated for the repeal of Oregon’s pioneering law decriminalizing low-level drug possession, approved by voters in 2020 as Measure 110.
But both said state leaders could and should do more to push people into treatment and end the easy availability of drugs on the streets, including by beefing up the police.
Measure 110 eliminated the criminal consequences of possessing low levels of illicit drugs, but allowed police to issue offences, similar to tickets, for such possession. These tickets are subject to a fine of up to $100, but are rejected if recipients call a hotline offering drug testing. The measure was aimed at reducing the criminal consequences of drug use and addiction, which advocates say should be treated as a public health problem.
The new services that were to accompany the legal change were hampered by long delays. State health officials announced on Tuesday that they just finished allocating more than $300 million to services such as outreach, peer mentors, recovery housing and exchanges. syringes throughout Oregon.
Proponents of Measure 110 say these services will fundamentally reshape the state’s meager treatment landscape and lead to successes far greater than the nation’s failed war on drugs. But they’re asking Oregonians to be patient until those rewards are realized. The new services, now funded, will take time to start.
At the same time, drug possession tickets intended to direct people to treatment have failed. Most of the more than 3,169 tickets issued through August have been ignored, state court officials say, with recipients not paying fines or showing up in court. Fewer than 200 people called a hotline set up by the state to help people who receive possession tickets get treatment.
Humphreys and Korthuis spoke to lawmakers as part of the Legislative Assembly’s quarterly “legislative days,” when committees meet in the interval between legislative sessions. Both men painted a pretty bleak picture of the state Oregon is in.
Korthuis of OHSU noted the state has the highest rates of drug use and least access to treatment in the country – although he did not blame Measure 110 for either of these realities. The state saw a nearly 20% increase in overdose deaths in the year ending April 2022, he said.
“Despite the best efforts and very good intentions of many people, our addiction treatment system has just been overtaken by these trends,” he said.
Humphreys, who advised the Obama White House on drug policy, described drug addiction as often the opposite of other health problems. People with the most serious illnesses seek treatment quickly because of their personal suffering, he noted. “In addiction, the balance of costs is often reversed with, for example, families, friends and the community suffering more than the person who is addicted.”
The answer, he suggested, was growing social and legal pressure for people to end problematic drug use. It’s a position that Portugal has used, Humphreys said, in passing a successful drug decriminalization law that is often cited by supporters of Measure 110.
“The open use and blatant drug trafficking that we see in the cities of the west coast of this country is practically absent in Portugal, which closes them down and uses the pressure of the courts to get people to seek treatment,” said said Humphreys. “I spent a lot of time in Portugal and I know the people who designed their policy. So please believe me, Oregon is not following Portugal’s lead and will not get its results.
The main takeaway from Humphreys was that Oregon should work to prevent drug use in the first place, but also do more to reduce its societal impacts. This includes, he said, encouraging police to shut down open-air drug markets that facilitate access to substances and adopting “prompt, certain and fair” policies to steer people who commit crimes as a result of their drug use towards treatment.
“This leaves drug possession for personal use itself decriminalized … but applies pressure to stop drug use in cases where an individual who uses drugs commits crimes that threaten public safety,” Humphreys said.
The approach sparked concern from Sen. James Manning, D-Eugene, about whether Humphreys was advocating a return to drug war policies that were negatively impacting communities of color.
Humphreys said he wasn’t.
“If anyone thinks the police can solve this problem on their own, they haven’t paid attention to it,” he said. “The health care people can’t solve it on their own either.”
It was unclear on Wednesday how the outlook could shape future policy, as state lawmakers prepare to fine-tune Measure 110 in next year’s legislative session.
“This is a brand new program. This is a program that has never been tried or tested in the United States,” Sen. Floyd Prozanski, D-Eugene, said at the conclusion of the hearing. “We will have to continue to partner with each other and different disciplines to ensure that we continue, in fact, to take a holistic approach…an approach that holds individuals accountable.”