In March, lawmakers in Oregon made a significant decision to reverse a groundbreaking reform that had been supported by voters in 2020. The recriminalization of low-level drug possession was approved by legislators, despite critics of the ballot initiative, Measure 110, claiming that it had led to a rise in drug-related deaths. However, there is limited evidence to support the notion that decriminalization was a contributing factor to this issue.
The number of opioid-related deaths has been steadily increasing across the country for over 20 years. This alarming trend was further exacerbated by the introduction of illicit fentanyl, which is used as a potent enhancer and alternative to heroin. Initially affecting other regions, this dangerous development eventually made its way to Western states.
According to epidemiologist Alex Kral from RTI International, overdose mortality rates in the Northeast, South, and Midwest began to rise in 2014, coinciding with an increase in deaths related to fentanyl. Kral made this observation during a conference in Salem, Oregon. Interestingly, it wasn’t until 2020, during the COVID pandemic and a year after the introduction of fentanyl, that overdose mortality rates started to climb in Western states.
After 2019, Oregon experienced a significant increase in opioid-related deaths, which can be attributed to the delay in implementing drug decriminalization laws. However, this trend was not unique to Oregon, as neighboring states like California, Nevada, and Washington also witnessed a similar rise in opioid-related fatalities despite drug possession still being considered a crime.
At the Salem conference, public health researcher Brandon del Pozo from Brown University reported that there was no association between Measure 110 and fatal drug overdose rates, after adjusting for the rapid escalation of fentanyl. Kral, in agreement, stated that there is no evidence linking the decriminalization of drugs to the increase in overdose mortality in Oregon. These findings align with a 2023 study published in JAMA Psychiatry, which found no evidence of Measure 110 being associated with changes in fatal drug overdose rates in the year following its implementation in February 2021.
A study conducted by RTI International, which involved 468 drug users in eight Oregon counties, challenges the notion that decriminalization leads to increased drug use. The findings revealed that only 1.5 percent of the participants had started using drugs since Measure 110 was implemented. Furthermore, contrary to the belief that decriminalization attracted a significant influx of drug users to the state, the median length of residence among the subjects was 24 years.
Measure 110’s failure to address the questionable quality and unpredictable strength of illicit drugs is a significant factor contributing to the continued increase in overdoses. These issues are a direct result of drug prohibition and are further amplified by enforcement efforts.
The government’s efforts to control the distribution of pain pills led nonmedical users to seek out riskier alternatives. They turned to substances with uncertain origins and compositions, replacing the previously reliable and regulated pharmaceuticals. Unfortunately, this crack down occurred at the same time as the emergence of illicit fentanyl, a significantly more potent drug than heroin. As a result, ensuring safe and accurate dosing became even more challenging.
The prevalence of this phenomenon can be attributed to prohibition, which encourages the production and distribution of potent drugs that are easier to hide and transport. By treating drug users as criminals, we only exacerbate the negative consequences of prohibition, while turning a blind eye to the detrimental effects of current policies.
