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A 23-year-old man sits on the sidewalk in downtown Portland, preparing what he says is heroin, on June 25, 2021. Measure 110, a drug recovery and treatment law, aims to connect the drug users to treatment and recovery services, including housing assistance. of serving time in prison for possessing small amounts of drugs.

Kristyna Wentz-Graff / OPB

Oregon health officials announced a remarkable milestone this week, revealing that they had awarded more than $300 million to expand services for people with drug addiction.

But a pair of addiction experts warned Wednesday that more than just services will be needed to curb the state’s high rate of drug use and the growing social costs that come with it. They told lawmakers that the state also needs to adjust its permissive approach.

“On the one hand we have very rewarding drugs that are widely available and on the other hand little or no pressure to stop using them,” Keith Humphreys, a professor of psychology at Stanford University, told the Commission of the State Senate on the judiciary and the electoral measure. 110 Implementation. “Under these conditions, we should expect to see exactly what Oregon is experiencing: widespread drug use, widespread addiction, and little treatment seeking.”

Neither Humphreys nor another expert who appeared before lawmakers — Oregon Health and Science University’s chief of addiction medicine, Dr. Todd Korthuis—, advocated overturning Oregon’s pioneering law decriminalizing low-level drug possession, passed by voters in 2020 as Measure 110.

But both said state leaders could and should do more to push people into treatment and end the easy availability of street drugs, including by stepping up police enforcement.

Measure 110 removed the criminal consequences for possessing low levels of illicit drugs, but authorized police to issue violations, similar to traffic tickets, for such possession. These tickets are punishable by a fine of up to $100, but are dismissed if recipients call a hotline that offers drug addiction screening. The measure was intended to reduce criminal consequences for drug use and addiction, which advocates argued should be treated as a public health issue.

The new services that were supposed to come with the legal change have been hampered by long delays. State health officials announced Tuesday that they just allocated more than $300 million to services like outreach, peer mentors, recovery housing and needle exchanges across Oregon.

Proponents of Measure 110 say these services will fundamentally reshape the state’s sparse treatment landscape and lead to far greater successes than the nation’s failed war on drugs. But they’re asking Oregonians for patience until those rewards are realized. The new services, now funded, will take time to roll out.

At the same time, drug possession tickets meant to drive people into treatment have failed. Most of the more than 3,169 tickets issued through August were ignored, according to state court officials, and the recipients failed to pay a fine or appear in court. Fewer than 200 people have called a hotline the state set up to help people who get possession tickets get treatment.

Humphreys and Korthuis spoke to lawmakers as part of the Legislature’s quarterly “legislative days,” when committees meet in the interim between legislative sessions. Both men painted a pretty dire picture of the state Oregon is in.

OHSU’s Korthuis noted that the state has the highest rates of drug use and the lowest access to treatment in the country, though he didn’t blame Measure 110 for either of those realities. The state saw a nearly 20 percent increase in overdose deaths in the year ending in April 2022, he said.

“Despite the best efforts and very good intentions of many people, our addiction treatment system has just been overtaken 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 more serious health conditions quickly seek treatment because of their personal suffering, he noted. “Furthermore, the balance of costs is often reversed with, for example, families, friends and the community suffering more than the person who is addicted.”

The answer, he suggested, was to increase social and legal pressure for people to end problem drug use. That’s a stance Portugal used, Humphreys said, in enacting a successful drug decriminalization law that is often cited by Measure 110 advocates.

“The open use and blatant drug dealing that we see in the west coast cities of this country is virtually absent in Portugal, which locks them up and uses judicial pressure to get treatment,” Humphreys said. “I have spent a lot of time in Portugal and I know the people who designed its policy. So please take it, Oregon is not following Portugal’s example and will not get their results.”

Humphreys’ central idea was that Oregon should work to prevent drug use in the first place, but also do more to reduce its social impacts. That includes, he said, encouraging police to shut down open-air drug markets that facilitate access to substances and enacting “swift, sure and fair” policies to target people who commit crimes because of their drug use. drugs in the treatment.

“This leaves the possession of drugs for personal use itself decriminalized … but pressure is applied to stop drug use in those cases where a drug user commits crimes that threaten public safety,” he said Humphreys.

The approach prompted concerns from Sen. James Manning, D-Eugene, about whether Humphreys was advocating a return to drug war policies that negatively affected communities of color.

Humphreys said it wasn’t.

“If anyone thinks the police can solve this problem by themselves, they haven’t been paying attention,” he said. “Healthcare people can’t solve it themselves either.”

It was unclear Wednesday how the outlook could 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,” Sen. Floyd Prozanski, D-Eugene, said as the hearing ended. “We’re going to have to continue to partner with each other and with different disciplines to make sure that we do in fact continue to take a holistic approach … one that holds individuals accountable.”

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Source: Addiction experts tell Oregon lawmakers the state has been too lax on drug use