Three and a half years after passing an unprecedented drug decriminalization ballot initiative, Oregon has reversed its radical experiment, criminalizing drug use and possession once more [1]. Proponents hailed the referendum as a way to reverse racial disparities in drug policy and provide necessary help to drug users. After failing to live up to expectations, however, the Oregon State Senate rolled back the measure, reverting state drug policy to criminalization. While this reversal may seem like proof that drug decriminalization is a doomed enterprise in America, lawmakers should instead see Oregon as a lesson and springboard for future reforms.

Oregon’s Measure 110 passed with 58 percent of the vote in 2020, setting into motion an unprecedented two-pronged approach to countering illicit drug use. Personal possession of controlled substances like heroin was punishable by a ticket and a $100 fine instead of arrest and criminal charges. At the same time, money from taxes on recreational marijuana (which was legalized in the state in 2015) was redirected toward funding addiction services [2]. In total, Measure 110 funneled $300 million into expanding addiction services across the state [3].

In the context of current U.S. drug policy, Oregon’s measure appears radical. Federal law classifies drugs into five schedules based on medical use and abuse potential. Schedule I contains highly addictive substances like heroin and LSD, while Schedule V mostly consists of mild drugs used for medical purposes, such as cough medications [4]. Under federal law, the possession or trafficking of any controlled substance is punishable by civil fines and prison time, with penalty strength dependent on the schedule [5].

In 1971, President Nixon announced the war on drugs. The campaign resulted in the creation of the Drug Enforcement Agency, the arrest of hundreds of thousands of drug offenders, and federal spending of billions of dollars each year on enforcement [6]. Criticism has mounted, that these policies disproportionately target minority populations. Indeed, Black people have been disproportionately arrested and punished for offenses related to drug possession. The sentencing disparity between users of cocaine in its crack and powder forms highlights the pervasive racism underlying American drug policy. The 1986 Anti-Drug Abuse Act established a 100:1 sentencing disparity for users of crack cocaine (who are more likely to be Black) versus powder cocaine; the federal ratio as of 2022 is 18:1 [7]. Additionally, evidence indicates that the War on Drugs simply does not work. Drug-related deaths remain high and the U.S.’s current fentanyl crisis has overdoses rising year after year [8].

The debate over decriminalization inevitably leads to discussion over true safety versus perceived protection. The historical argument for drug incarceration has been protecting communities, and indeed, civilians may feel safer with substance users and dealers behind bars. In reality, however, countless studies show that the prison system is ineffective in preventing addiction or recidivism. In 2018, the Pew Charitable Trusts disproved the deterrence theory—the idea that the threat of imprisonment deters potential drug users from actually using illicit substances—by concluding that states with higher rates of drug imprisonment did not have lower rates of drug use [9]. In contrast to cyclical policy effects, proper community-based rehabilitation programs can counter addiction and lower drug-related crime [10].

Naloxone, an opioid overdose reversal drug, and fentanyl test strips, which allow users to check if their drugs are laced with the deadly synthetic opioid, are key resources that must be more easily accessible. Contrary to popular belief, harm-reduction tools do not lead to increased drug use [11]. The current fentanyl crisis—wherein drug users are increasingly purchasing unregulated drugs laced with fentanyl, a potent synthetic opioid that severely increases the chances of overdose—highlights the danger of black market substances and the severe impact of stigma and nonregulation on drug abuse [12]. If able to eradicate their fear of being convicted and imprisoned for drug possession, users would be less likely to turn to dangerous sources for their drugs and more likely to seek out publicly available resources to ensure their safety during usage.

Drug decriminalization has been empirically proven to save lives. Across time and borders, people have sought out controlled substances regardless of criminalization, making it of utmost importance to increase the safety of drug usage while encouraging users to seek help. To many, then, Oregon’s progressive experiment seemed logical and promising. In retrospect, its resounding failure can be attributed to multiple factors. 

For one, the state began implementing its policy with an ill-prepared status quo, ranking 49th among U.S. states in civilian access to social services. Health officials were also tasked with setting up new services while struggling to juggle the explosive issues of the COVID-19 pandemic. With personnel and resources stretched thin, Measure 110 programs struggled to serve everyone in need. Indeed, surveys found severely inadequate numbers of facilities and inpatient beds in facilities across the state, as well as insufficient funds to expand and handle any unexpected issues that could arise [13]. The lack of standardization in funding and facilities across counties as Measure 110 policies came into existence created a confusingly unequal patchwork of access and resources [14]. Lastly, drug users received little push to attend referred treatments, with law enforcement not receiving any standardized training on how to issue new citations or encourage rehab attendance [15]. As a result of this lackluster implementation, drug users underutilized resources, and overdose deaths grew by 41.6 percent in one year as opposed to a 2.1 percent growth nationwide [16]. Both anecdotally and statistically, Oregonians felt that their streets were more unsafe after drug decriminalization, with a rise in homelessness, petty theft, and open drug markets—although research indicates this shift may be more correlational than causational [17, 18].

One of the most successful case studies of drug decriminalization is Portugal, which decriminalized personal drug use in response to the HIV/AIDS epidemic in 2001. Under the Portuguese model, enforcement officers and officials in Dissuasion Committees (which operate under the Ministry of Health, not the criminal justice system) work with drug users on a case-by-case basis and strongly promote rehab, which 90% of referred people actually attend [19, 20]. Over the years, this policy has removed the association between drug use and crime, allowing for destigmatization and less shame in seeking help. Increased use of harm-reduction resources has cut Portugal’s drug deaths in half since 2001. In recent years, however, the government has pulled resources from drug programs, correlating with a strong decline in public health results [21].

The Portuguese model demonstrates the efficacy of addiction services and the need for more resources to be invested in widening public access to rehab and safe injection sites. Resources and regulations must also be standardized and adequately funded across counties and states to allow for proper, hands-on enforcement and make seeking help easier. Police, like those in Portugal and unlike those in Oregon, must receive proper training and play more assertive roles in encouraging and enforcing rehab attendance. At the same time, law enforcement must continue pursuing major drug gangs and open drug markets to take dangerous black market drug dealers off the streets.

Proper commitment to a reformed program will not see immediate results. Still, gradual improvements will help to destigmatize drug use over time. As seen in Portugal, it is possible for society to evolve its understanding of drug use so that addiction is officially recognized as an illness that can be humanely cured instead of a crime.