SALEM, Ore. — (AP) — Oregon voters approved a 2020 ballot measure to decriminalize hard drugs after being told it was a way to create and fund drug rehab centers that would offer people help instead of incarceration.
Yet in the first year after the new approach took effect in February 2021, only 1% of people who received citations for possession of controlled substances sought help through a new hotline.
With Oregon being the first US state to decriminalize possession of quantities of heroin, methamphetamine, LSD, oxycodone and other drugs for personal use, its program is seen as a potential model for other states.
Some wonder if the approach is proving too lenient, but others say the new system has already had a positive impact, redirecting millions of dollars to facilities to help people with drug addiction issues. The funds come from taxes generated by Oregon’s legal marijuana industry and savings from reduced arrests, jail time and probation supervision.
Under Ballot Measure 110, possession of controlled substances is now a new Class E “violation,” instead of a felony or misdemeanor. It is subject to a maximum fine of $100, which can be waived if the person calls a hotline for a health assessment. The call can lead to addiction counseling and other services.
But of around 2,000 citations issued by police in the year since decriminalization took effect, only 92 of those who received them called the hotline as of mid-February. And only 19 have requested resources for services, said William Nunemann of Lines for Life, which operates the hotline.
Nearly half of those who got citations did not show up in court.
State health officials reported 473 unintentional opioid overdose deaths from January through August 2021, the most recent month for which statistics are available, with the vast majority of those occurring after the entry into force of decriminalization. This narrowly exceeds the total for all of 2020 and represents nearly 200 more deaths than the state recorded for all of 2019. The state reports that opioid overdose visits to ERs and to urgent care centers have also increased.
The Oregon Health Authority cites as possible reasons the greater presence of fentanyl, which has increased overdose deaths across the country, as well as a drop in reports during the pandemic in 2020.
Sen. Floyd Prozanski, chairman of the Oregon Senate Judiciary and Ballot Measure 110 Implementation Committee, said he was surprised that more people fined were not taking advantage of clawback options. Still, he thinks it’s too early to judge how the new approach will evolve.
“It’s a different model, at least for the United States,” Prozanski said, adding that he would like to wait at least six months before determining whether measures should be introduced to force people to seek treatment.
Proponents of decriminalization argued that putting drug addicts in jail and giving them criminal records, which hurt job and housing prospects, was not working.
“Punishing people and these punitive actions, all it does is put barriers on them and more stigma and more shame,” said Tera Hurst, executive director of the Oregon Health Justice Recovery Alliance, which represents more than 75 community organizations and focuses on implementing Measure 110.
The Drug Policy Alliance spearheaded Oregon’s election measure. With no US states to serve as an example, the New York-based group, which bills itself as the leading US organization promoting alternatives to the war on drugs, studied Portugal, which decriminalized possession drugs in 2000.
Portugal’s approach is more vigorous than Oregon’s in getting people to seek treatment.
There, “deterrence boards” pressure anyone caught using drugs – even marijuana – to seek treatment. These pressure points include fines, banning drug addicts from going to certain places or traveling abroad, seizure of personal property, community service and the obligation to report periodically to the services of health or other places.
Drug Policy Alliance has intentionally sought an approach that doesn’t force people to seek treatment, spokesman Matt Sutton said.
“We’ve seen that when people voluntarily access services when they’re ready, they see much more successful outcomes,” Sutton said.
According to the Oregon Health Authority, some 16,000 people accessed services through the ballot measure’s “Access to Care” grants in the first year of decriminalization.
Most – 60% – accessed “harm reduction services” such as needle exchanges and overdose medication, the health authority said. Another 15% received help with their housing needs and 12% got support from their peers. Only 0.85% entered treatment.
Critics say it’s just not good enough.
“Oregon’s ballot initiative was presented to the public as a supportive treatment, but it was a complete failure in that regard,” said Keith Humphreys, an addiction researcher and professor of psychiatry at Stanford University. and former senior adviser to the White House Office of National Drug Control Policy.
Brian Pacheco of the Drug Policy Alliance, however, said people with drug problems need a range of options, including harm reduction services, housing assistance, peer support and , for those who cannot get insurance or Medicaid, access to treatment centers.
“Measurement 110 funding has strengthened organizations in multiple ways, including securing mobile vehicles to deliver services in communities, helping programs keep their doors open, and helping other organizations purchase and distribute naloxone (which reverses opioid overdoses),” Pacheco said in an email. .
The $31 million in grants distributed so far have paid for thousands of doses of naloxone, thousands of needle exchanges, recovery housing, vehicles and the hiring of dozens of staff for the treatment centers. care, including recovery mentors, according to the health authority.
An example of where some of the money is going is Great Circle, a non-residential treatment center in Salem owned by the Grand Ronde Confederate Tribes, which received a $590,055 grant.
Recently, two Salem police officers checked on a homeless woman who had been assaulted a few days earlier. Still wearing a black eye, she confided that she had a drug problem and needed help. Police Lt. Treven Upkes called Great Circle to see if they could help. Bring her right away, she was told.
“Just the fact that they had an open door for us the moment someone said they were ready to help, that’s such an amazing step for us,” Upkes said. “That’s the kind of thing we’re hoping to come out of Measure 110.
If the answer had been to set up a date two weeks later, Upkes noted that he might have been unable to reconnect with the woman.
At Great Circle, a staff doctor and nurses check a person’s vital signs and do a urinalysis with an in-house lab. A nurse dispenses doses of methadone, which can relieve the terrible symptoms of “drug sickness” experienced by someone in opioid withdrawal.
Expert peers like Nick Mull describe their own life experiences to those with substance use disorders and inspire them. Mull’s parents were drug addicts and he himself fell into drug use at a young age.
“About six years ago I got into trouble and…I started wanting to change my life,” Mull said, wearing a black hoodie and jeans. “So I just started doing treatment, more treatment and more treatment. I learned a lot.”
Jennifer Worth, chief operating officer of Great Circle, said Mull plays an important role.
“What Nick brings to the job is a sense of hope,” Worth said. “And patients struggling with where he was can see that hope is possible.”
But with so few people seeking help after receiving citations, the legislature may need to consider requiring them to do more than call a hotline or pay a small fine, Prozanski said.
Humphreys thinks people should be pushed to seek treatment if they commit crimes like shoplifting and burglary, but not if they’re just using drugs.
“It’s about the threats to public safety that some people pose because of their problematic drug use,” Humphreys said. “And in those cases, pressuring people to seek treatment is absolutely legitimate.”
The office of Oregon Secretary of State Shemia Fagan will audit Oregon’s program. Fagan said she had a personal interest: her own mother had a lifelong struggle with drug addiction and homelessness.
AP writer Barry Hatton in Lisbon, Portugal contributed to this story.
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