Thanks to mismanagement and naive assumptions about the propensities of drug abusers, a new public health program associated with Oregon's decriminalization of drugs is falling flat on its face.
The state has only managed to spend a small fraction of a $305 million budget meant to expand substance abuse and recovery services. The money, which comes from cannabis tax revenue, was diverted from schools, mental health services and state police but now much of it sits idle.
As OregonLive reports:
So far not a single new treatment bed has been funded since Measure 110′s passage to decriminalize the possession of small amounts of heroin and other street drugs and set up a system to refer and treat those suffering from addiction.
Ballot Measure 110 was approved by Oregonians in 2020, making it the first state to decriminalize possession of personal amounts of heroin, cocaine, meth, LSD, ecstasy, oxycodone and other drugs. Under decriminalization, which took effect on Feb. 1, 2021, people found in possession receive a citation—akin to a traffic ticket—rather than jail time.
Consistent with viewing addiction as a health problem and not a criminal justice issue, Measure 110 aspired to create a robust statewide network of resources for those with substance abuse problems. It isn't even close to materializing.
Responsibility for selecting service providers and distributing hundreds of millions of dollars falls to a citizen-led council. The law requires that, among others, the council must include a social worker, a physician, "an evidence-based substance abuse disorder provider," an academic researcher and "at least two people who suffered or suffer from a substance abuse disorder."
That's not exactly stacking the deck for success in overseeing a multifaceted, $300 million government program serving towns, cities and counties all over the state.
The council has been overwhelmed by applications from some 330 organizations eager for state money, and grant timelines have been revised multiple times. Council member Caroline Cruz described a recent meeting as "total chaos."
Another council member, Morgan Godvin, told state officials, "I don’t know grant-making. That was [the Oregon Health Authority's] duty, but you did not fulfill it and the goalposts just keep moving. I have whiplash trying to keep up with this, but at no point do I hear an acceptance of responsibility from OHA saying 'we dropped the ball'.”
Buried under the deluge of grant requests, the council opted to start by awarding grants to sparsely populated eastern Oregon counties, rather than to Portland, Salem and other major population centers. That doesn't strike anyone as sound triage for a health emergency.
So far, just $40 million of the $305 million have been allocated for the 2021-23 biennium. At this pace, the council won't be even halfway finished making allocations for this biennium before the next one starts.
Distancing itself from the fiasco, the office of Governor Kate Brown told The Oregonian that the governor doesn't appoint the council or oversee its work, directing questions to the OHA.
Finger-pointing abounded in Salem this week. Mike Mike Marshall, executive director of Oregon Recovers, a statewide coalition focused on addiction, characterized the rollout as a "debacle" and blamed both OHA and the governor.
The shoveling of money at addiction treatment isn't the only aspect of the program that's faltering. So too is a feature meant to encourage cited possessors to avail themselves of help.
In Oregon, the maximum penalty under a drug possession citation is $100, but that's waived if the individual calls a health assessment hotline to complete a substance abuse disorder screening. So far, police across Oregon have issued roughly 2,000 citations and only 91 people—something like 4.5%—have called the hotline.
Though reporting doesn't make it clear, it's not hard to imagine that most of the others didn't bother paying the citation either.
Meanwhile, in a Thursday hearing of Oregon's House behavioral health committee that focused on the botched rollout, Republican representative Lily Morgan, of the southern Oregon town of Grants Pass, pointed to rising overdoses as she expressed skepticism about Oregon's new approach.
“Director, you’ve mentioned a couple of times that you’re waiting to see, and yet we have overdoses increasing at drastic rates, in my community a 700% increase in overdoses and a 120% increase in deaths,” said Morgan, addressing Oregon Behavioral Health Director Steve Allen. “How long do we wait before we have an impact that we’re saving lives?”
It may seem counterintuitive, but much of that spike springs from the fact that, while possession of drugs has been decriminalized, the sale of drugs in Oregon is still illegal. That leaves users vulnerable to the particular perils of black market drugs.
Consistent with that reality, Allen attributed much of the increase in overdoses and overdose deaths to a recent wave of both methamphetamine and illegal pills laced with fentanyl, an opioid that can be deadly in small doses.
Allen may not have made this point, but we will: In a competitive, fully legal drug market where users (and their estates) could use courts to hold professional producers accountable for failing to provide products with clearly delineated dosages and uniform ingredients, overdoses would plummet.