USA: Decriminalization Experiment In Trouble.

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Oregons pioneering drug decriminalization experiment is now facing the hard test

By Eric Westervelt (NPR) June 20, 2021

For years Oregon has ranked near the top of states with the highest rates of drug and alcohol addiction and near the very bottom nationally in access to recovery services. And while critics everywhere have long called the drug war a racist, inhumane fiasco that fails to deliver justice or health, Oregon is the first to take a leap toward radically changing those systems.

But five months since decriminalization went into effect, the voter-mandated experiment is running into the hard realities of implementation. Realizing the measure’s promise has sharply divided the recovery community, alienated some in law enforcement and left big questions about whether the Legislature will fully fund the measure’s promised expansion of care.

Even many recovery leaders here who support ending the criminalization of addiction are deeply concerned the state basically jumped off the decriminalization cliff toward a fractured, dysfunctional and underfunded treatment system that’s not at all ready to handle an influx of more people seeking treatment.

Advocates for decriminalization “don’t understand the health care side, and they don’t understand recovery,” says Mike Marshall, co-founder and director of the group Oregon Recovers.

“Our big problem is our health care system doesn’t want it, is not prepared for it, doesn’t have the resources for it and honestly doesn’t have the leadership to begin to incorporate that [expanded treatment],” says Marshall, who is in long-term recovery himself.

In fact, Marshall and others worry the treatment and harm reduction horse isn’t even on its feet in Oregon, which is leaving too many stuck in a dangerous pre-treatment limbo and at potential risk of overdosing.

“There were no resources and no mechanisms in [Measure] 110 to actually prepare the health care system to receive those folks,” Marshall says.

There’s also shockingly little state data to determine what programs work best or to track treatment outcomes and share best practices. There’s also no agreed upon set of metrics or benchmarks to judge treatment efficacy, both in Oregon and nationally.

Indeed, even some closely involved with implementing the new measure are privately voicing growing concerns. “I really hope we don’t spend the next 10 to 12 months with open air drug markets and nowhere to send” those seeking help, said one official who asked not to be named because he wasn’t authorized to speak publicly.

Measure 110 did allocate millions in new treatment funding – money funneled from the state’s marijuana tax along with expected savings from reductions in arrests and incarceration.

But Marshall and others are alarmed that it did not require those funds be spent in a strategic way to expand capacity for a system that has too few detox beds, not enough residential or outpatient treatment and recovery chairs, not enough sober housing and too few harm reduction programs.

It’s a slow start for the addiction recovery phone line

Mines says she has yet to see anyone come in to one of Miracles’ thrice daily recovery meetings because of a possession citation and health screening under the new decriminalization policy.

That sluggish start is mirrored statewide. So far Measure 110’s new 24/7 addiction recovery help line – where people who get a possession citation can call – is mostly quiet. Nearly five months in, just 29 people who’ve been issued a possession citation by police have called the line for an addiction health screening, according to Dwight Holton, CEO of Lines for Life, the Oregon nonprofit that runs what’s formally called the Telephone Behavioral Health Resource Network.

proposal in the Legislature would address some of Measure 110’s implementation challenges and sharpen rules and oversight. But that, too, has stoked controversy. Among other things, the bill proposes changing the addiction health assessment for those caught with hard drugs into what critics call a less rigorous screening. The bill would also reduce the drug citation fine from $100 to a minimum of $45. Fines would continue to be dismissed if the person completes a substance use disorder screening.

Some police leaders are alarmed and frustrated

Meanwhile, many Oregon police leaders, while mostly staying out of the public fray as implementation debates roil, are privately worried.

“They’re frustrated, they’re annoyed, they’re concerned,” says Jim Ferraris, immediate past president of the Oregon Association Chiefs of Police. He spent more than four decades in Oregon policing.

The state’s Criminal Justice Commission records show about 9,000 people were arrested each year in Oregon for simple drug possession before Measure 110. Despite the drop in arrests, Ferraris says, “People are still committing crimes to get money, to buy dope, to support their habit. So how is this [decriminalization] going to impact that cycle?”

Efforts to stop large-scale trafficking in Oregon continue as usual. Local and multiagency and regional drug interdiction task forces say their work goes on apace.

“Measure 110 has not affected our work at all,” says a regional spokeswoman for the Drug Enforcement Administration.

The Oregon Legislature in 2017 had already made possession of small amounts of hard drugs here a misdemeanor, not a felony. But some say full decriminalization has had a demoralizing effect on that work.

“We’re already hearing of people coming into Oregon to use because they know they can do drugs and sleep outside and police can’t do anything about it,” says a frustrated central Oregon officer who asked not be named because of his work in drug interdiction.

Preliminary state numbers show that opioid overdoses were up sharply in 2020, though officials say that likely has more to do with the deadly pandemic’s social, emotional and financial impact than decriminalization.

Still, the experiment here has launched with the pandemic’s shadow still very much hanging over the recovery community. Several organizations contacted by NPR said the number of people relapsing, anecdotally anyway, has skyrocketed.

In fact, some groups say they’re having trouble finding enough peer counselors because so many are back using.

“The relapse numbers have gone up so much,” says Elly Staas with the 4th Dimension Recovery Center in Portland. “For a lot of people the [pandemic’s] isolation especially is what took them back out” of sobriety.

Now with decriminalization, one law enforcement official who asked not to be named because he wasn’t authorized to speak publicly predicts within a year Oregon “will be inundated with (more) folks who have substance use disorder.”

Can the recovery community unite around a common vision?

Tony Vezina, executive director of 4th Dimension Recovery Center and chair of the Oregon Alcohol and Drug Policy Commission, is nine years sober. “Now we need to rapidly design a new system strategically,” he says. “But Oregon doesn’t operate strategically around this issue.”

We haven’t built anything new, so now we need to rapidly design a new system strategically. But Oregon doesn’t operate strategically around this issue. So we don’t have a new intervention system. We don’t have a recovery-oriented system of care,” Vezina says. “We’ve just decriminalized.”

“We’re going to see more and more people needing help because drugs are going to be more readily available and there’s no one keeping it in check,” says Ferraris, recently retired as police chief in Woodburn, Ore. “Overdoses will go up, crime will go up and cartel drug dealing will continue to flourish up and down the I-5 corridor.”

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