Policy & Advocacy

All eyes on Oregon: the first US state to decriminalize drugs.

Hear from addiction providers on the front lines about what’s really happening in Portland, OR, and why it should matter to every town.

Listen to the full conversation →

As the national addiction crisis rages on, Oregon has become the nucleus of an emergent debate: will policies that lessen criminal punishment for drug use help, or hurt?

Our state recently became the first in the nation to decriminalize possession of small amounts of drugs, aiming to steer people with substance use disorders toward addiction treatment rather than jail.

American taxpayers spend ~$50 billion annually to enforce the “War on Drugs,” only to see prisons overflowing with nonviolent citizens, and overdose deaths rise for the last fifty years. The majority of Americans don’t support the War on Drugs

Still, entrenched biases are slow to change – particularly when for most of our lives, we’ve been taught false narratives about drugs and the people who use them.

A USAToday OpEd betrays its fallacy in the title: “Oregon voters chose a different approach toward drug use. It was never going to work.” Cynics had already written off the policy change before implementation.

Disappointingly, most media coverage on these issues fail to provide balanced analyses of early results that could help other states learn from what’s working and what’s not.

Similarly, Bret Stephens in the NYT asks, “How soon is too soon to call a progressive and libertarian policy obsession a public policy fiasco?” – admitting his unwillingness to examine new methods for insights they provide, and instead, jumping to a polarized political stance. 

Extreme positions on complex issues are almost never useful. They can be alluring and they can be satisfying – but they’re not productive in reaching new solutions.

Reducing the complexity of the drug war, poverty, addiction, mental health disease, and homelessness to “​​a progressive and libertarian… public policy fiasco” makes for entertaining writing – but does nothing to help solve problems.

And, as a country, we desperately need help. Hundreds of thousands are dying of overdose, living in the streets in abject poverty and despair, and suffering from both physical and mental disease that we can treat.

This is happening in Portland, it’s happening in New York City, it’s happening in Appalachia, and it’s happening in your town.

Stephens presents a false choice between war and surrender: “Some readers of this column will respond that...we don’t want to return to the cost, violence, and apparent fruitlessness of the old war on drugs. But that depends on whether the price of endless war exceeds or falls short of the price of permanent surrender.”

In reality, there’s no war to fight or surrender. There are people suffering: and there is a choice about whether to help them or jail them.

As a resident of Portland, OR and a leader in the addiction treatment sector for nearly ten years, I am deeply committed to helping my hometown and its citizens recover. Every day I see systemic failures, policy shortcomings, incremental improvements, and bursts of inspiring hope. 

We must examine the evidence and learn from what we try. 

To that end, we brought together a group of experts who are working on the ground in Oregon to have an open conversation about what’s happening. We will continue to report on our journey as a participant in the decriminalization ‘experiment,’ as a recent beneficiary of state funds to expand access to addiction treatment.

Listen to the full conversation.

What is M110 and Why Does it Matter?

In 2020, Oregon voters overwhelmingly supported Measure 110, a law which removed harsh criminal penalties for possession of small amounts of drugs, and earmarked nearly $300M to fund addiction treatment programs.

This referendum, in part, was citizens calling for justice system reform. Taxpayers felt the money spent arresting, prosecuting, and incarcerating people could be better spent helping those people recover from addiction and regain control over their lives – without the burden of a criminal record when seeking houses or jobs. 

And people all over the U.S. share a similar sentiment: two-thirds of Americans support eliminating criminal penalties for drug possession. Over 85% of drug arrests are for possession alone – ie, people who were not trafficking drugs, harming anyone by using them, or committing crimes.

In Portland, we are also confronting the state’s history of racism and inequality. Much like the rest of our nation, Oregon is grappling with the fact that Black Americans are disproportionately charged, sentenced, and incarcerated for the same actions involving drugs as White Americans, who more often avoid jail and receive medical care. Portlanders perceived M110 as an opportunity for restorative justice.

Black Americans are 24% of those arrested nationally, but only 13% of the U.S. population -- and people of all races use and sell drugs at similar rates. 

The US represents 5% of the world’s population, but 25% of all incarcerated people. 1 in 5 are there for a drug offense. And being locked up is not helping people recover from addiction, either: fatal overdose while incarcerated has increased 600% from 2001-18, and the overdose rate upon release is 50-100x higher than someone on the street.

After decades of the same failed tactics, shouldn’t we try something different? That’s exactly what Oregon has endeavored to do.

How is it going?

Measuring the impact of decriminalization is complex because of the extreme factors that coincided with the policy change. Further, one of the most critical components of the policy – the funding to expand addiction treatment services – was only just disbursed this year, years after the measure passed and drugs were decriminalized.

First, the good news:

  • More than 60,000 people have received helped for addiction 
  • Anemic treatment infrastructure is finally getting an infusion of capital as hundreds of treatment programs are starting to receive funds this year.
  • Drug arrests are down 70% overall, and nearly 80% for Black Oregonians. Thousands of people have avoided the lifelong barriers that may be caused by a drug possession arrest

But we also know that Portland is struggling, visibly so. So it's important to understand the multiple factors that coincided with and preceded Measure 110:

  • Fentanyl entered the drug supply. This happened later on the West Coast than other parts of the US – in 2021 – and overdoses skyrocketed. But Oregon saw lesser impacts than other states with a similar timeframe, and in fact, may have avoided the worst outcomes because of M110.
  • The global pandemic. COVID19 hit the same year that M110 was passed, and the city has been slow to recover: businesses closed and left, downtown hollowed out, and prolonged social isolation worsened addiction and mental illness.
  • Soaring rent prices make housing unaffordable, leading to unprecedented homelessness. Housing costs, not drug use, is the main factor that drives homelessness.

The bottom line:

  • The most crucial part of the “experiment” hasn’t even started: while drugs were decriminalized in 2020, treatment programs didn't receive funding until 3 years later, meaning that the impacts of expanding access to treatment haven't been felt yet
  • Many people seeking treatment are still not finding a link to care. It has yet to be seen how that will change with recent funding
  • For decades, Oregon has had some of the highest rates of substance use disorder and lowest access to addiction treatment in the country: it will take time and continued investment to close this gap.
We can’t help but notice that much of the harsh criticisms of M110 are focused on people who use drugs, rather than placing blame where it belongs: at the feet of the elected officials who promised to keep constituents safe, healthy, and housed.

In the audio discussion, we dispel some of the myths about M110, unpack what we’ve learned so far, and remind everyone that most of us — whether for M110, against it, or somewhere undecided — want the same thing: safe neighborhoods, support that keeps people alive and gives them opportunities to heal, and equity for everyone in our community.

For More reading about Measure 110, we recommend: 


About Boulder

Boulder Care is a digital clinic that offers long-term support and telehealth treatment for substance use grounded in kindness, respect, and unconditional support. Boulder is a recipient of M110 funding in 8 counties, and serves the full state of OR: the broadest reach of any addiction treatment program in the state. For more information, visit www.boulder.care

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