Measure 110 forced Oregon to build a new drug addiction services model. Here’s how that’s going

Sitting in a downtown Pendleton, Oregon, motel parking lot eating a bag of Doritos and drinking a Mountain Dew, Michael Hamilton, 33, paid little attention to the rain as he talked on the phone with his stepfather for the first time in over a month. He was sober and hoping to stay that way.

“I had seven months last time, then I went on a little bender,” he told him. “I’m feeling pretty good now.”

Drugs had taken too much of his life, he said, perched on a concrete barrier and taking drags on a vape pen.

“I’m just trying to put a stop to all of it.”

Earlier that morning, he had walked out of Umatilla County jail, past a family of bunnies snacking on the manicured lawn, crossed the parking lot and entered the parole and probation offices for a cognitive behavioral therapy class led by his parole officer. In a plastic bag under his arm, Hamilton carried a Bible and four Ashley & JaQuavis books about a drug cartel in Miami.

“Stuff like that still entertains me, but it’s not something that I want to be a part of anymore,” Hamilton said.

The books he carried were among the 42 he read over the past 36 days he’d spent in jail for a parole violation — he had briefly, and without permission from his parole officer, moved to Portland.

That morning, Hamilton had been sober for just over two months. This was his fourth attempt at kicking a fentanyl habit that snuck up on him the same way it has so many Americans: an injury and a prescription.

“Snapped my right foot in four places and they prescribed me Oxycontin. That was it for me,” he said. “I did it for about three months and then they pulled my prescription and then everything I could find on the street was fentanyl laced.”

Addiction, particularly to opioids, is maddeningly persistent. Getting someone into treatment often only happens after multiple encounters with equally persistent service providers. Motivations for staying in recovery vary, but fear of incarceration seldom tops the list.

Up until 2020, police and the courts would often interact with people with addictions who ran afoul of the law. But when Oregon voters decriminalized drugs through Measure 110, the criminal justice system lost a lot of its power to coerce people into treatment. For more than two years since, courts have oftentimes not been able to force people into treatment.

In May 2017, Hamilton was one of 1,483 people arrested on a drug possession charge in Oregon. Five years later, in May 2022, that number had plummeted to 176 arrests. In the same time, fentanyl seizures in Oregon and Idaho increased from 27 doses in 2018 to 32 million in 2022, a 118 million percent increase.

For the past four years, Hamilton has been going through monthslong stretches in recovery then relapsing. One memorable relapse happened after his girlfriend since college sold his belongings and moved in with a new boyfriend.

“So, that’s kind of how it goes,” he said.

For decades, Oregon has incarcerated people with addictions, making the problem invisible but saddling drug users with felony convictions and making sobriety that much more unattainable. Even short stints in jail can be enormously detrimental. And while some say it can be a welcome chance to detox, the disruption can make managing addiction post-release a near impossibility. An earlier stretch in jail left Hamilton broke.

“It resets everything for you. This last time, I lost a car while I was gone, lost the house that I was staying in,” he said, explaining he also lost his job. “So now I’m back to square one.”

But it wasn’t the threat of jail, or even the lost jobs, that made Hamilton finally want to quit using drugs. After serving a year and a half for possession of cocaine and a probation violation, Hamilton said 30 days does little to deter an entrenched fentanyl addiction. Instead, he’s motivated by his kids. He wants his daughters — ages 10 and 5 — to see he’s doing well and “stacking good days and sober days back to back.” If they see that, “they’ll come around,” he hopes.

Few think the old system, which so often turned people sick with addiction into felons, was effective. Even fewer think the new system is working.

Since Measure 110 passed with 58% of the vote, support has steadily eroded. Today, 63% of Oregonians support bringing back criminal penalties for drug possession.

In rural Oregon, revamping addiction services has meant navigating a community more skeptical of alternative approaches. In Multnomah County, 74% of voters supported Measure 110, but in Umatilla County, it was rebuffed by 56% of the county. Voters in the rest of Eastern Oregon were even more skeptical and voted against decriminalization by close to 70% in some counties.

Parole and probation officials say they have fewer people under supervision and the people they do have are coming to them with more entrenched addictions and more serious offenses, a byproduct of not getting arrested for previously illegal low-level drug possession. The threat of consequences, they say, was instrumental in getting people into treatment.

But decriminalization also happened suddenly. Just 13 weeks elapsed between Oregon voters passing Ballot Measure 110 in November 2020 and the law going into effect on Feb 1, 2021. It happened so fast, service providers say the systems meant to replace arrest and jail were nowhere near ready to assume their increased responsibilities.

“We were sunk before we even started because of that,” said Lisa Weigum, who oversees Community Counseling Solutions’ Measure 110 programs in five Eastern Oregon counties. There’s nothing wrong with the concept behind Measure 110, she said, but changing the system overnight was never going to work.

The timing could not have been worse. Drugs were decriminalized just as a ruinous surge in cheap, highly addictive and often deadly fentanyl was accelerating and the state was in dire need of rehab services.

When the measure passed, outreach organizations started the slow, complex work creating new programs to pull people into treatment where once they were pushed. Only now, over two years in, are Weigum’s programs nearly fully staffed.

Forced into treatment

At 6 feet 3 inches and 265 pounds, Mike Graber is an imposing presence standing in front of the behavior change class Hamilton walked into on the morning he was released from jail.

Graber, a competitive powerlifter, is also Hamilton’s parole officer. He’s been both a juvenile and adult parole officer since 1998 and is trained in cognitive behavioral intervention, a process where people learn to identify and then change negative thoughts.

“What we’re trying to do right now is just try to identify the thinking behind the behavior,” Graber explained to the nine people in his class. He said he wants them to be able to confront their beliefs in order to “bring them out from behind the curtain.”

“From there, hopefully we can start to question their validity but first we have to recognize them,” he said.

The group went around the room updating Graber on the week since they had last met. One person hadn’t scheduled counseling yet because he didn’t have the money to pay for the assessment. Graber explained the Oregon Health Plan should cover it. He’d need to get registered.

Another person was having problems finding work and hoped a coming job fair at the Wildhorse Resort and Casino might bear fruit. Another person said they’d been getting methadone treatment after four years on suboxone had done little to help him quit opioids. He’d been sleeping outside but thought he might soon have a job at either Dairy Queen or the dollar store.

Hamilton, barely an hour out of jail, said he was looking forward to getting back to work, seeing his kids, and not using drugs.

The challenges raised in Graber’s class reflect a common criticism of parole and probation: Complying with all of the requirements can be unreasonably difficult.

There are home visits, drug tests and weekly visits to the parole office four miles from the center of town. And accessing services can be an ordeal for anyone, but the challenges are magnified for someone with little money, no car and often no support system.

A person on parole may also have to pay thousands of dollars for anger management or batterer’s intervention classes that aren’t covered by insurance. In Umatilla County, the Social Security office is in Pendleton but the housing authority, where people get signed up for low income housing, is 30 minutes away in Hermiston. Housing also requires a birth certificate, eight years without a felony and a reference saying you’re a good tenant.

It’s a high, perhaps impossible, bar for someone who just got out of prison, is trying to stay sober and also managing the routine needs of everyday life.

Drug related felony convictions also imperil access to Section 8 housing and supplemental nutrition assistance, critical portions of the social safety net low-income people rely on to survive. The burden becomes even more pronounced should a convicted felon move to a less forgiving state with more restrictive laws limiting what felons can and can’t do.

Parole officers in Umatilla often intervene with landlords, offer rides or help their clients overcome the bureaucratic hurdles standing between them and the services for which they qualify. That’s a lot of individual attention that goes beyond their mandated mission.

As of January, there were 548 people on parole or probation supervision in Umatilla, down from 684 people in February 2021, the month Measure 110 took effect. The decline means the parole officers can give more time and attention to each person. But because their budget is tied to the number of people on their roster, it also prompted a budget cut, putting that extra attention and things like Graber’s class at risk.

The Oregon Department of Corrections biennial budget passed this month allocates $252 million for parole and probation offices around the state. That’s a significant reduction from the previous $284 million budget.

“I still have a core responsibility of doing community supervision. I still have that obligation,” said Dale Primmer, director of Umatilla County Community Justice, the county’s parole and probation department. He said the budget cut could impact grants or his agency’s ability to provide additional assistance like helping pay for temporary housing or treatment programs.

Sitting in his office down the hall from Graber’s class, talking about “wheels of change” and “contemplative action,” Primmer sounds more like a social worker than a parole officer.

“We’re not going to arrest our way out of it. We’re not going to incarcerate our way out of it,” Primmer said. “The way we have the opportunity to make our community safer, is to work with the clients that would otherwise be committing crimes and work with them in a way…that makes less of that [crime] happen.”

Success can be tricky to measure. Recidivism rates are the most common metric. A person either reoffends or they don’t. It’s a binary Primmer resists. If someone comes to his office and has historically been getting arrested 10 times a year, and after getting help and staying engaged with his parole officer, that goes down to once a year, Primmer sees that as a success despite it still counting as recidivism.

Next to him is Jenni Galloway, who works for the county. She offers a different measure of success that reflects the dire state of American health care and the addiction crisis: “Are they alive?”

Primmer then draws a graph on a piece of paper with time on one axis and on the other, the rate at which people on supervision skip out on their parole officer. The graph curves sharply down and he explains that the longer people stay engaged with their services, the less likely they are to run off or end up back in jail. The faster he can provide people with services they find valuable, the better.

“On the whole, people change when they’re ready to or want to,” Primmer said. At the same time, he fears that without the threat of going back to jail, people may never make it through the door and have the chance to engage. “You’ll hear a lot of people at our drug court graduation say, I’m here, I’m alive, I’m graduating this program because somebody made me do it.”

But even for people on parole, it’s not always the criminal justice system cajoling them into treatment.

Darby Scott squeezed down the narrow staircase from his bedroom, past a framed decorative sign reminding him to “enjoy the little things,” and into his mom’s living room to meet his parole officer Josh Paullus. Paullus visits everyone he supervises weekly to make sure living situations are safe and conducive to staying out of trouble.

“Mind if I check out your room?” Paullus asked.

He followed Scott up the stairs, glanced around his bedroom, and the two made their way back down to the living room where Scott’s mom was waiting.

She beamed proudly at her son, who was standing in front of a table with a teddy bear, a framed star-spangled placard that said “families are forever” and religious writings on the importance of family.

He hasn’t used drugs for over a year but in March 2022, nearly 20 years into his addiction, Scott and his family were estranged. That month, he estimates he spent $30,000 on drugs. Soon after, he was couch surfing south of Pendleton in Pilot Rock when he took a hit of fentanyl and realized he was done. He was sitting on the couch, alone and crying.

“I’d just had enough. I was ready to throw it all away,” he said.

Scott checked himself into a detox center in Eugene and spent seven days there. He threw up for the first 12 hours. He had missed a court date for an assault charge and had a warrant out for his arrest so after detoxing, Scott spent 30 days in jail. He got out and relapsed for about two weeks.

“I was like, ‘What am I doing?’” he remembers thinking, before checking himself back into detox and addiction treatment. “And then I started my adventure.”

This is his second time on probation. The possibility of going back to jail helped jumpstart his sobriety, but he’s not afraid to go back and said it isn’t a big factor in him not using drugs

“All your meals are paid for and you can sleep all you want,” he said. “Then again, I’d rather have money in my pocket. I’d rather be working towards buying a house, a car again.”

Scott just turned 40. To celebrate, he had a steak dinner with his family. Along with his new job, they’re his motivation to stay sober, he said, not the threat of jail.

“I was just sick of being alone,” Scott said. “I wanted to get back with my family.”

After the visit, Paullus sat in the car outside Scott’s house and reflected on his work. He doesn’t see himself as a cop, although he does “feel the legal obligation for community safety.” And he’s not technically a social worker, although he helps people connect to services.

“You’re the teacher, you’re the coach, you’re the mentor, you’re the cheerleader,” he said. Whatever his role, he says his goal is to get people to understand how their behavior affects themselves and the people around them.

Choosing treatment

A few blocks away from Scott’s house, across the street from a motel where parole officers sometimes put people up right after they get released from jail, is Community Counseling Solutions, an Eastern Oregon agency that provides an expansive range of services including addiction counseling and mental health treatment. Along with two other organizations, CCS provides Measure 110 services in Umatilla County.

Melissa Barnes and another counselor help people in addiction recovery find employment — both jobs were created in November by an infusion of Measure 110 money. Before 110 passed, CCS only provided employment support to people in mental health treatment.

“Our goal is zero exclusion,” Barnes said, sitting in a shared office with a towering box full of donated winter clothes in the corner. “It doesn’t matter where they’re at in their recovery. They can be actively using, they can be not using, it’s wherever they’re at.”

That can be a challenge. If someone drinks in the evenings, Barnes will try to find them a job during the day. Other people only use on weekends so she tries to find a weekday job.

“We have a lot of tough discussions about how those kinds of things would affect their employment,” Barnes said. “But we would never discourage them from finding employment.”

It took two months for Barnes to help land Bobbie Jeffers her first job. Soon after starting at a gas station, she started a second job driving a taxi.

Jeffers exemplifies the path into rehab envisioned by proponents of Measure 110. After multiple phone calls from a rehab center, she chose to get help. She has taken advantage of a broad range of services available to her including drug addiction counseling. In the past few months she has gotten her GED and is registered for college classes.

Jeffers, whose cheerful disposition and enthusiasm for her recovery leads even the most serious conversations to end in laughter, talks about her addictions as if they’re unwanted clutter.

“I accumulated a gambling problem,” she said. “Your addiction manifests in so many different ways.”

She gets counseling at CCS for gambling too. Jeffers also accumulated a theft problem, first because she was homeless and had to feed herself. Then, it became a way to support her drug habit.

In early May, she stood in the kitchen of the self-run recovery house where she lives, toasting an All American sub sandwich in the oven. A whiteboard in the living room lists the six women who live there and their assigned chores for the week. She’s in charge of collecting rent. Roommates passing through stop to give her their check or talk about their plans for Mother’s Day, which is just 10 days away.

Jeffers had just come home from depositing money into a savings account she recently opened. She’d saved $200.

Her addiction started when she was 13 and living with her mom in Mountain Home, Idaho. As a child, Jeffers was sexually abused. She said her mom was usually “stuck in her bedroom getting high all the time” or sleeping with a revolving cast of boyfriends to whom she paid more attention than her children.

When Jeffers was 22, things spiraled. After a bad relationship and surfacing mental health struggles, she started injecting meth. Her daughter was taken from her, but in the clutches of her addiction and weighed down by self-loathing, her initial thought was that her daughter was better off without her. Drugs helped take away all those feelings of inadequacy, pushing her deeper into her addiction.

“It gives you confidence,” she said of using meth. “But it only does it for a short period of time. Then you just feel like a piece of shit all over again. So then you just keep using so that it takes it away.”

Nine months passed from when her daughter was taken away until she seriously considered rehab. And even then, she said they called her four times to try to coax her into treatment before she actually showed up. She got her daughter back and was in recovery for two and a half years when a bad break-up derailed her and she relapsed.

Last August, eight days after her 30th birthday and newly pregnant with her son, she went back to rehab. She said she’s doing everything different this time and “working my ass off now to stay sober.”

“When I first got into rehab, I didn’t want to be sober. I was getting sober because I wanted my kid back,” she said. “This time, I was going to rehab because I hated myself so much that I just couldn’t do drugs anymore.”

The first time Jeffers tried to quit using, she said she was “white knuckling” her recovery. She wasn’t going to meetings or counseling or getting any form of assistance. Since leaving in-patient care in Corvallis, moving to Pendleton and enrolling with services from CCS, her life is saturated with help and support.

“I’m kind of a wreck sometimes,” she said. “They love me and accept me no matter what. I can go in there freaking out, crying and they’re just going to be like, ‘Oh, well she’s on a bad day.’ And they’re not going to judge me.”

For now, Jeffers is an exception. CCS gets most of its clients through referrals from parole and probation rather than through voluntary admission or peer outreach. When the number of people being put on court ordered supervision went down, the number of referrals to CCS followed suit. So far, there hasn’t been a corresponding increase in people seeking voluntary treatment. Getting people through the door still largely depends on the criminal justice system.

Ballot Measure 110 diverted some tax dollars to fund a range of services meant to reduce the individual and community harm wrought by drug addiction. That could mean more addiction counseling, short and long term housing assistance and employment support.

It also means finding new ways of reaching substance users. For the first time, CCS counselors are connecting with paramedics to ensure they have treatment center information to distribute and they’re building a vast network of peer support specialists — people who have experience with drug use and recovery and who can help others find the help they need. They do things like circulate among the unhoused community providing education and treatment information. Or they go to community events and make sure doctors and impacted families are aware of and know how to access their services.

Weigum, who oversees CCS’ Measure 110 programs, said a lot of the infrastructure providing rehab services is being built from scratch in Eastern Oregon. The additional money means people in Eastern Oregon with substance use disorders have access to resources that have never been available before, Weigum said. For example, with money from Measure 110, CCS has created a rental assistance program for people who are in danger of losing their housing.

Readily available addiction counseling, housing services, and employment support are slow to build at the scale the current crisis demands and communities are growing impatient. In the counties where CCS operates — Gillum, Morrow, Grant, Wheeler and Umatilla — it has taken all of the past two and a half years to staff the new programs, get new outreach programs up and running and start to spread the word to places like emergency rooms and food pantries about new services available.

A plea for time

A month after his parole officer dropped him off at the Motel 6, Michael Hamilton was on his way to his daughter’s preschool graduation. He had a job making electrical conduit and had moved out of the motel and into a sober living house with five other people.

“I call it God because I’m super faithful and I go to church but other people would call it hard work,” he said. “I’m doing the right thing and treating people the way I’m supposed to and good things happen to good people.”

But Hamilton will likely be weighed down by a felony conviction for the rest of his life, a high cost Ballot Measure 110 is meant to blunt — if it’s given the chance to work.

Community Counseling Solutions’ executive director Kimberly Lindsay is torn on what success for her organization looks like. Helping 200 people use drugs less often, finding housing for people who didn’t have it before or helping them land fulfilling employment, are tangible achievements that improve lives and benefit the community. But she also thinks that number could be orders of magnitude higher.

“I think that there’s people out there that would’ve benefited even though they might not have wanted to come in to see us or go through [the Department of] Corrections,” she said. “I can’t say that I’m looking out into the communities feeling that these funds are hitting home in the way that we all hoped that they would.”

State lawmakers are growing impatient too. In June, they passed a bipartisan bill reducing the amount of fentanyl someone can have without facing criminal penalties. Currently, a person can have five grams or about 25 pills and not be charged. If Oregon Gov. Tina Kotek signs HB 2645, a person found with more than one gram or about five pills could face a Class A misdemeanor and be forced into treatment.

But little else about Measure 110 has changed. The law and additional money are all still very new and Lindsay is cautiously hopeful that things will turn around now that they are fully staffed.

“I’d like to see where we’re at in an additional year when we have 15, 16, 17 months of doing the work,” she said.

There’s a sizable body of research backing up what Hamilton and Scott said: Harsh penalties do little to prevent drug use and addiction-related crimes. Treatment, on the other hand, has been shown to dramatically reduce recidivism.

Weigum, who runs Measure 110 programs for CCS, believes dislodging long held beliefs around drug use and transitioning from a punitive to preventative approach will prove successful in time.

“We’ve been doing the same thing for 50 years,” she said. “Change is hard.”