Debate for Decriminalizing Drugs
A new study suggests that the passage of Oregon's Measure 110 was not the primary driver of the rise in drug overdose deaths in the state.
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The debate over whether to decriminalize controlled substances has been ongoing in the United States for years. Oregon became the first state to do so with Measure 110, enacted on February 1, 2021, decriminalizing possession of small amounts of drugs for personal use. This policy faced significant opposition, with many concerned that drug use and overdose rates would surge.
Michael Zoorob and colleagues studied the impact of Measure 110 on fatal overdose rates, factoring in the sharp rise in fentanyl-related deaths. They compared overdose data from states that did not decriminalize drugs, both before and after Measure 110, and tracked fentanyl’s spread using forensic toxicology reports and 15 years of CDC mortality data.
The figures below compare drug overdose deaths in Oregon from 2008 to 2022, showing both actual and estimated death rates under drug decriminalization. The first graph (A) shows the actual overdose death rate (black line) alongside an estimate of what the rate might have been without decriminalization (blue line). The second graph (B) adjusts for the increasing presence of fentanyl, a powerful opioid that has driven overdose deaths nationwide.
After accounting for fentanyl (B), the estimated overdose death rate was actually higher than the real death rate. This suggests that decriminalization may have resulted in fewer deaths than expected, though the findings were not statistically significant; between 2021 and 2022, the estimated impact ranged from 289 fewer deaths to 117 more deaths. The analysis also confirmed a strong link between fentanyl exposure and rising overdose deaths.
This evaluation suggests that the passage of Measure 110 was not the primary driver of the rise in drug overdose deaths in Oregon. However, it has also not produced a decline in overdose rates. While the law aimed to reduce overdose deaths and expand access to substance use treatment, the lingering effects of drug criminalization and deeply rooted stigma may take time to overcome. The full impact of Measure 110 may only become clear as these barriers to care are addressed and support systems continue to develop.
