As COVID-19 continues to rage, another health crisis persists — one that is decades long. In the first year of the pandemic, the United States hit the devastating milestone of 100,000 overdose deaths, a nearly 28.5 percent surge from the record numbers we saw the previous year. Now, fentanyl is the leading cause of death in Americans ages 18-45. The reaction from many of our leaders has been to call for more arrests and criminalization, but this response is rooted in fear, not science. We have spent the last 50 years trying to treat a public health issue with a criminalization response, yet people are dying of overdose at record rates. This response is clearly not working.
The evidence is clear: Criminalization worsens public health outcomes. From making the drug supply more dangerous, to deterring people from getting help out of fear and stigma, to denial of economic opportunities and supports for people with drug arrests, the associated consequences have been dire. Besides, sending someone to jail or prison doesn’t keep people from using drugs. In fact, deaths due to drug and alcohol intoxication have increased more than 600 percent in state prisons between 2001 and 2018.
It’s time for a new approach. Oregon has taken the bold step that we should adopt across the U.S.: Decriminalize drug possession and increase access to health services. In the year since the state decriminalized drugs through a ballot initiative (Measure 110), and with only about 10 percent of the allotted funding distributed to 70 community-based organizations so far, Oregon has already been able to provide peer support, harm reduction, evidence-based treatment, housing and job assistance to more than 16,000 people.
Prior to this measure passing, Oregon ranked last in access to treatment and recovery services.
And yet, since the passage of decriminalization, many local media outlets in Oregon have fixated on a lack of citations from police for drug possession. (Under Measure 110, people found in possession of small amounts of all drugs receive a citation and $100 fine instead of being arrested.) This is a distraction, and the wrong way to measure the program’s success.
In fact, decriminalization efforts shouldn’t involve police. Police involvement often harms people who use drugs. Addressing drug use through the criminal legal system has contributed to mass incarceration and family separation, and has saddled people with criminal records that affect their ability to get housing, employment and live full lives. It has allowed public officials to neglect their responsibility to support people, and instead inflate police departments to become military-style operations while continually divesting from health and support services that people desperately need. Even some police will tell you that their options for response are limited and that a different set of tools are needed. Since decriminalization has taken effect in Oregon, thousands of harmful drug arrests have been avoided.
Some call Oregon’s efforts an “experiment,” but they are already grounded in evidence: They’re largely based on the successful model adopted in Portugal over 20 years ago. Within a few years of implementing decriminalization in Portugal, the number of people voluntarily entering treatment increased significantly, while overdose deaths, HIV infections, problematic drug use and incarceration for drug-related offenses plummeted. And Portugal is not an anomaly. Many other countries, including Switzerland and the Czech Republic have implemented varying degrees of decriminalization with similar success.
The logic is simple. When people are given access to health services and no longer fear being criminalized if they seek them out, they are more likely to do so. And if we address the full range of people’s needs — including harm reduction services, housing and even job assistance — versus just mandating abstinence, we are able to actually get people on solid footing and better address the underlying factors that contribute to chaotic drug use. We’ve seen this in Portugal and are getting a glimpse of it in Oregon.
Even though Oregon’s move is a huge step forward, there remains more work to do, such as removing quantity thresholds and police altogether, inclusion of expungement and resentencing for past drug arrests and convictions, and ensuring access to things like overdose prevention centers and safe supply. As we work to decriminalize drugs in other states and federally, these additional provisions, such as increasing the amount of drugs that would qualify as personal possession — should be strongly considered, in order to truly embrace the public health alternative this is meant to be.
Decriminalization is a shift a majority of people want to see. According to the latest polling, 66 percent of Americans support removing criminal penalties for drug possession and investing in health services. While Oregon may be the first in the U.S., it certainly won’t be the last. Since this measure passed, we have seen over half a dozen other states and Congress introduce legislation that would decriminalize drug possession.
Amid the twin crises of overdose and criminalization, we owe ourselves and our communities a different approach — one that empowers people to live healthy and free lives. Decriminalizing drugs and creating access to care are necessary steps in that direction.