A man, 23, sits on the sidewalk in downtown Portland, preparing what he says is heroin, June 25, 2021. Measure 110, a drug treatment and recovery act, aims to connect drug users to treatment and recovery services, including housing assistance instead of serving time in jail for possessing small amounts of drugs.
Kristyna Wentz-Graff / OPB
Oregon health officials announced a notable milestone this week, revealing they’d awarded more than $300 million meant to expand services for people with drug addiction.
But a pair of addiction experts warned Wednesday that more than just services will be necessary in order to stem the state’s high rate of drug use — and the growing societal costs that come with it. They told lawmakers the state also has to adjust its permissive approach.
“On the one hand we have highly rewarding drugs which are widely available, and on the other little or no pressure to stop using them,” Keith Humphreys, a psychology professor at Stanford University, told the state’s Senate Committee on the Judiciary and Ballot Measure 110 Implementation. “Under those conditions we should expect to see exactly what Oregon is experiencing: extensive drug use, extensive addiction and not much treatment seeking.”
Neither Humphreys nor another expert appearing before lawmakers — Oregon Health & Science University head of addiction medicine Dr. Todd Korthuis — advocated for undoing 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 toward treatment and end the easy availability of drugs on the street, including through stepped-up police enforcement.
Measure 110 eliminated criminal consequences for possessing low levels of illicit drugs but authorized police to issue violations, akin to traffic tickets, for that possession. Those tickets are punishable by up to a $100 fine but are dismissed if recipients call a hotline that offers screening for drug addiction. The measure sought to reduce criminal consequences for drug use and addiction, which advocates argued should be treated as a public health problem.
New services that were meant to come with the legal change have been hampered by long delays. State health officials announced Tuesday that they’d only just finished allocating more than $300 million to services like outreach, peer mentors, recovery housing and needle exchanges throughout Oregon.
Advocates for Measure 110 say that those services will fundamentally reshape the state’s meager treatment landscape, and lead to far greater successes than the country’s failed war on drugs. But they are asking Oregonians for patience until those rewards are realized. The new services, now funded, will take time to get going.
At the same time, the tickets for drug possession meant to steer people to treatment have failed. Most of the more than 3,169 tickets issued through August were ignored, according to state courts officials, with recipients neither paying a fine nor showing up in court. Fewer than 200 people have called a hotline the state set up to help people who receive possession tickets receive treatment.
Humphreys and Korthuis spoke to lawmakers as part of the Legislature’s quarterly “legislative days,” when committees meet in the interim period between legislative sessions. Both men painted a fairly dire picture of the state Oregon finds itself in.
Korthuis, of OHSU, noted the state has the highest rates of drug use and the least access to treatments in the nation — though he didn’t blame Measure 110 for either of those realities. The state saw a nearly 20% surge in overdose deaths in the year that ended in April 2022, he said.
“Despite the best efforts and very good intentions of many people, our addiction treatment system has just been outpaced 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 most serious health maladies are quick to seek treatment because of their personal suffering, he noted. “In addiction, the balance of the costs is often reversed with, for example, families, friends and the community suffering more than is the person who is addicted.”
The answer, he suggested, was increasing societal and legal pressure for people to end problematic drug use. That’s a stance that Portugal used, Humphreys said, in enacting a successful drug decriminalization law that is often cited by Measure 110 advocates.
“The open use and flagrant drug dealing that we see in West Coast cities in this country are virtually absent in Portugal, which shuts them down and uses court pressure to get people into treatment,” Humphreys said. “I’ve spent a lot of time in Portugal, and I know the people who designed their policy. So please take it from me, Oregon is not following Portugal’s example and will not get its results.”
Humphreys’ central takeaway was that Oregon should work to prevent drug use in the first place, but also do more to reduce its societal impacts. That includes, he said, encouraging police to shut down open-air drug markets that make substances easy to access and enacting “swift, certain and fair” policies for steering people who commit crimes because of their drug use into treatment.
“That leaves drug possession for personal use itself decriminalized ... but applies pressure to stop drug use in those cases where a drug-using individual is committing crimes that threaten public safety,” Humphreys said.
The approach prompted concern from Sen. James Manning, D-Eugene, about whether Humphreys was advocating a return to drug war policies that negatively impacted communities of color.
Humphreys said he was not.
“If anyone thinks police can solve this problem themselves, they haven’t been paying attention,” he said. “Health people can’t solve it themselves either.”
Unclear on Wednesday was how the perspectives might shape future policy, as state lawmakers prepare to fine-tune Measure 110 in next year’s legislative session.
“This is a brand new program. It’s a program that has never been tried or tested in the United States,” said Sen. Floyd Prozanski, D-Eugene, as the hearing came to a close. “We will need to continue to partner up with each other and different disciplines to ensure that we are, in fact, continuing to take a holistic approach … one that does hold individuals accountable.”