PORTLAND In February 2021, politicians and activists celebrated Oregon’s implementation of Measure 110, the nation’s first law to decriminalize drugs like fentanyl, heroin, cocaine, and meth. It’s not a surprise what happened next: a dramatic increase in overdoses. /Comments by Kevin Sabet, President, Foundation for Drug Policy Solutions.
Fast forward to last week: Oregon Governor Tina Kotek and Portland Mayor Ted Wheeler declared a state of emergency in Portland due to sharp rises in overdose deaths, public drug use, and crime. Though the state of emergency is a step in the right direction, more must be done to undo the harm caused by Measure 110 and help more Oregonians live safe and healthy lives.
Now that Democratic and Republican state legislators have introduced bills to increase penalties for the possession of drugs—effectively reversing decriminalization and conceding it has failed—it is a good time to look back at what led to this state of emergency.
Overdose deaths in Oregon have spiraled out of control. Between 2020 and 2022, overdose deaths increased by 75 percent, compared to only 18 percent nationally. In Oregon, opioid-involved overdoses increased by 101 percent, accounting for more than 70 percent of overdose deaths in 2022. Likewise, meth-involved overdoses increased by 112 percent, accounting for 55 percent of overdose deaths in 2022.
Though the state of emergency cited ”widespread fentanyl use” specifically, it is worth noting that more than 40 percent of overdose deaths in Oregon in 2022 involved the co-use of an opioid and a stimulant, either meth or cocaine. The growth of polysubstance use is alarming, because Narcan cannot reverse overdoses that are induced by non-opioid substances.
Violent crime also increased by 17 percent in Oregon since Measure 110 passed, despite decreasing nationally. Measure 110 has made communities less safe, as those with an untreated substance use disorder often resort to burglary and other crimes to fund their addiction.
Alongside the rise in overdose deaths and crime has come a rise in public drug use. Last month, the Associated Press reported that there is ”rampant public drug use” in the state. I saw it firsthand when I visited Portland last July. This trend shouldn’t be a surprise to anyone. When our laws send a message that drugs are not of public concern, what did we think would happen?
Homeless encampments and people injecting drugs like fentanyl are all too common on the streets of Portland. It explains why public opinion has soured so quickly on Measure 110. A poll late last summer found that nearly two-thirds of Oregonians––including 79 percent of Hispanics and 74 percent of Black Oregonians––want to repeal parts of Measure 110 and bring back penalties. A majority wants to repeal Measure 110 completely.
Rather than treating addiction and helping vulnerable individuals achieve recovery, Measure 110 brought the drug crisis even more clearly into the public’s view and failed to achieve its stated goals. It has failed those with addiction, as well as concerned bystanders who want a safe and clean community.
Hence the state of emergency declaration. Beyond immediate harms like overdose deaths, Governor Kotek’s executive order cited ”trauma to downtown residents who wish to avoid fentanyl” in addition to ”economic and reputational harm to the City of Portland, Multnomah County, and the State of Oregon” as reasons for the declaration.
Given the fact that the state of emergency will last for only 90 days, there is reason to doubt any significant progress will be made. If there were a quick 90-day solution, officials would have already solved the problem. Furthermore, the declaration only applies to ”Portland City Center”—a select few neighborhoods in Portland—even though 75 percent of overdose deaths in Oregon in 2022 occurred in other counties.
The U.S. first declared a public health emergency for opioids in 2017, and has renewed it to the present. The overdose epidemic has nevertheless continued to worsen. But while Oregon’s 90-day state of emergency is unlikely to deliver any immediate solutions, it will generate additional attention and put the state’s needs into focus. It will hopefully set the posture needed for the legislature to reverse Measure 110.
It should go without saying that if Measure 110 had delivered as promised, the state of emergency would not have been needed. It has been an unquestionable failure—resulting in more overdose deaths, crime, and public drug use. If Governor Kotek and the legislature are serious about bending the curve of the drug crisis, they should learn from their missteps and take an evidence-based approach premised on prevention and treatment.
• Footnote: This article was also published in News Week (February 2024).
by Dr. Kevin Sabet
– the President of the Foundation for Drug Policy Solutions (FDPS), also co-founder of Smart Approaches to Marijuana, (SAM), and a former drug policy advisor to Presidents Obama, Bush and Clinton.