 In 1973, Oregon became the first state to decriminalize marijuana use, setting in motion a movement that has led to the unraveling of the disastrous U.S. drug war, with far-reaching consequences. We must wage what I have called total war against public enemy number one in the United States, the problem of dangerous drugs. No one goes to jail. No longer are our jails being occupied by young people that have done nothing more than smoke marijuana and have committed no other criminal offense. Today, Oregon is once again at the vanguard of reform. In February, it enacted a law ending prison sentences for all types of drug use and possession, whether it be cocaine, meth, heroin, or psychedelics. In 2019, before this new law was passed in a statewide referendum, more than 4,000 people were convicted of drug possession in Oregon, and many more cut deals with prosecutors, allowing them to avoid a conviction in exchange for supervised probation and some rehab. With the new law, not only does possession bring nothing more than $100 ticket, defendants can get them dismissed if they place just one phone call to a drug abuse assessment hotline. So far, only 29 people ticketed for possession have placed that call, according to the nonprofit that runs the hotline. The lack of accountability built into the measure, that would be my concern, is that we see a bunch of money in the system that isn't having an effect. Mike Marshall, who has a personal history with alcoholism and meth use, is executive director of Oregon Recovers, which lobbies for more funding for addiction treatment and opposed measure 110. I'm worried about the person living on the street in the tent right outside this window who's smoking meth all day long and they're destroying their system. We need to have a system of care to take care of them. Marshall believes Oregon should have more closely followed the example of Portugal, the first country to criminalize all drugs. It spent two years building a more robust treatment system before decriminalization went into effect. We have to learn our own set of lessons now, because we chose to ignore the lessons that were available to us. Portugal also required those caught with drugs to appear before a special committee of doctors and addiction specialists. Oregon's new law does require the state allocate at least $57 million in its first year to establish a comprehensive substance abuse treatment system that offers immediate rehab. The state legislature awarded $20 million in grants to treatment providers in June and approved spending $302 million over the next 20 years on substance abuse treatment. But today, Oregon, which has the third largest addiction problem in the nation, is 47th in addiction treatment access. In the introduction of the synthetic opioid fentanyl into the black market has made street drug use deadlier than ever, with an estimated 36,000 nationwide deaths involving the drug in 2019 and increasing by as much as 38% with the onset of the pandemic, according to the CDC. Marshall says the state should have bolstered its treatment infrastructure before moving forward with decriminalization. We hugely support decriminalization. The notion of criminalizing someone's addiction is terrible, particularly when we know that communities of color disproportionately arrested for drugs. So decriminalization is hugely important. But how you do decriminalization is equally important. He points out that an earlier decriminalization measure already allows judges to divert drug offenders to treatment, but believes that removing the threat of arrest takes away a vital tool for getting drug addicts the help that they need. If somebody down on the street on January 30th was using and a cop saw them and so busted them for having drugs out in the open, they ended up in jail. They then went to court. So there was a week's period of time where their drug use was interrupted versus the cop now just walking right by or giving them a ticket and walking on by and they continue to use drugs. The war on people who use drugs has not been fruitful. Haven Wieloch runs a needle exchange in Portland called Outside In. She says delaying decriminalization would have been morally unacceptable. Anything we do is better than doing nothing. We know the harms of criminalization are harming people on the regular. We know that these interactions between law enforcement and people who are using drugs can be deadly. And so for me, decriminalizing drugs is a priority in and of itself. Those harms are real. Those harms are happening today. We want to interrupt that prison cycle and offer services instead, which any doctor or clinical person would be recommending rather than prison. Monta Knudsen is the executive director of Bridges to Change, which helps drug offenders who've recently been released from jail or prison transition into housing like this and reintegrate into society. Bridges to Change is one of several nonprofits that will receive additional money through Measure 110 financed by marijuana taxes to provide services to drug users before they enter the criminal justice system. Knudsen says that some chronic drug users don't need the threat of prison, just easier access to treatment. And so while folks that might be engaged in the criminal justice will still kind of enter through that door, we'll be able to serve folks that might not be engaged with the parole or probation officer and hopefully maybe avoid that connection in the first place. As a drug user, however, Knudsen did find treatment through the criminal justice system. He struggled for years with a meth addiction, was arrested several times, and after a two-year prison stint for crimes related to his drug problem, he was released to a rehab program that provided the help he needed. But at that point, Knudsen had spent a total of 10 years behind bars. He sees the criminal justice system as an overly blunt tool for getting drug addicts help and thinks Measure 110 will allow others to avoid wasting so much of their lives in prison. Every time I was released from prison or jail, I always wanted to do the next right thing. I just didn't know how to do it. The deeper my addiction grew in those windows of time where I wanted needed help, help wasn't to be found in a way that was accessible to me. It finally was accessible in prison, which is backwards. Janie Gullickson, who is the executive director of a peer support group called the Mental Health and Addiction Association of Oregon, also thinks there are better ways to get drug addicts treatment than through the criminal justice system. She overcame a meth addiction that began at age 15 and continued until she ended up in prison at age 36. But I did want treatment and I had been in there for a year before I was accepted into the program. God, I wish that program would have been accessible to me before I wasn't able to raise my five kids. What happened in Portugal points to the effectiveness of decriminalization. The country saw treatment rates increase by 32% within the first eight years of enacting the policy. Its experience also belies the claim of drug war years that decriminalization leads to more consumption. In Portugal drug use rates stayed about the same and HIV rates decreased significantly. But Marshall says he expects Oregon's results to be worse. If somebody down on the street on January 30th was using and a cop saw them and so busted them for having drugs out in the open. They ended up in jail. They then went to court. So there was a weeks period of time where their drug use was interrupted versus the cop now just walking right by or giving them a ticket and walking on by and they continue drugs. The net effect of that is that they are using drugs more often in an unsafe environment and so the overdose rates could go up. In Portugal overdose rates fell after decriminalization before trending back up a few years later. But in Oregon needle exchange providers are hopeful that the passage of the new law will allow them to experiment with new initiatives to drive down overdose rates significantly. Clean needle exchanges like Wilox reduce disease transmission and prevent fatal overdoses because they distribute naloxone which aborts overdoses. Several studies have also shown that needle exchanges help connect users with substance abuse treatment programs. We regularly have clients come in and be like Haven I hate using drugs. And then the next question is okay what's next? Like what are we going to do? Just having that like non-judgmental open curious community of people ready to answer questions and be really honest and transparent really helps build trust, build therapeutic relationships, build hope for people who are using drugs. Wilox also hopes the new law will allow her to expand beyond needle exchanges and into safe consumption spaces where users can go to have their drugs checked for adulterants like fentanyl and be around workers who can help prevent overdoses. Vancouver has just such a site and there's also one operating in the United States that doesn't have government approval. A five-year study of that facility published in the New England Journal of Medicine found that with more than 10,000 injections there were 33 overdoses. None of them fatal or requiring hospitalization. Safe consumption sites may also help to bring the outdoor drug use and many of the associated problems rampant on the streets and sidewalks of Portland under a roof says Wilox. No one wants to see someone using on their front porch or in the doorway. And those people that are using there also don't want to be seen. They don't want to be there. Using drugs is something that's very private for folks. And so if they had a place where they could do that in a safer manner, people would. While Oregon will be the first in the nation to decriminalize all drugs, following Portugal's example as first in the world, neither go so far as to legalize drug sales. Leaving a black market and the crime, violence, and danger associated with it fully intact. Vancouver began trying to mitigate this problem in 2020 by allowing some of its safe consumption sites to dispense clean opioids to drug users so they no longer have to risk overdosing on street drugs. One argument for just not prosecuting any drug crimes is that the black market just makes things more dangerous. Is that worth considering? Have I personally pondered that? Sure. I'm, you know, I'm read about lots of different, you know, philosophies and that's, I mean, I think one step at a time. Let's see how this goes. How about recreational drug users who don't have a substance abuse problem? A 2018 meta-analysis of three major national drug use surveys found that 74% of those who've used heroin at least once don't ever become dependent. There's always going to be folks that are entering the addiction system that might not need treatment and might not want treatment. And to be honest, if they're not causing community harm, then why should they? I do think those people are few and far between and that having a system that provides treatment services is the best way to go. And while Oregon's 1973 marijuana decriminalization was decades ahead of its time, proponents believe that if the state succeeds now, the wave of complete drug decriminalization will spread across the country much sooner. Nothing launches perfectly. So what are the lessons learned? Maybe Washington, Colorado, other states look at what Oregon has done and implement something similar. I think we're going to see systems improve. I think we're going to see people have access to care that they currently don't have access to. I think we're going to see less people getting saddled with convictions that harm them for the rest of their lives. And to me, all of that is a win.