In 2020, Oregon embarked on a bold experiment by becoming the first state in the U.S. to decriminalize the possession of small amounts of all drugs through Measure 110. The measure, supported by nearly 60% of voters, was presented as a progressive step toward a more humane and effective approach to drug addiction and mental health care. The War on Drugs had long been criticized for its punitive policies, which disproportionately affected marginalized communities, and Measure 110 promised to rectify some of these harms by redirecting funds from law enforcement to addiction services. However, by 2024, Oregon had reversed course, re-criminalizing drugs and signaling a dramatic shift in the state’s drug policy.

This reversal, after only 4 years of being passed, has left many wondering: was Oregon’s approach too ambitious, or simply ahead of its time?

The original measure: why it was passed

Measure 110 was passed in November 2020 with the intent to fundamentally change how Oregon addressed drug use. Instead of focusing on punishment, the measure decriminalized the possession of small amounts of substances like heroin, methamphetamine, cocaine, and psilocybin. Advocates of the measure envisioned a public health approach that prioritized rehabilitation over incarceration. Rather than facing jail time, individuals caught with small amounts of drugs were issued a $100 fine, which could be waived if they completed a health assessment. This approach was a direct rebuke to the War on Drugs, which critics argue has exacerbated addiction, fueled racial disparities in the criminal justice system, and done little to address the root causes of drug dependency.

Measure 110 was also designed to funnel savings from reduced law enforcement expenditures and marijuana tax revenue into addiction services. Over $260 million was allocated to harm reduction services, including naloxone distribution, housing assistance, and voluntary treatment programs. Proponents argued that decriminalizing drugs would reduce the stigma surrounding addiction, making it easier for people to seek help. By removing the threat of arrest, the measure aimed to encourage drug users to access services that would help them quit or use drugs more safely.

At the heart of Measure 110 was a belief in the power of harm reduction. Supporters hoped that Oregon’s shift from punitive policies to rehabilitation would reduce overdose deaths, lower incarceration rates, and lessen racial disparities in the criminal justice system. The state’s addiction treatment infrastructure, long underfunded and under-resourced, was poised to receive a much-needed infusion of funds.

Why did Oregon change its mind?

Despite the lofty goals of Measure 110, the implementation and results were less than promising. One of the key reasons Oregon reversed its decriminalization policy was the unintended rise in drug-related issues, particularly overdose deaths. In the first year of the measure’s implementation, drug overdose deaths in Oregon increased by 43%, with the state seeing an additional 41.6% increase in the following year, making it the highest increase in the nation. Oregon’s approach, which removed penalties for drug possession and relied on voluntary treatment, seemed ill-equipped to address the growing fentanyl crisis sweeping the state and the nation.

Another factor was the lack of accountability in the system. Individuals who were caught with drugs could opt to pay a $100 fine or undergo a health assessment, but more than 95% of people simply ignored the citations. Without the threat of meaningful consequences, many drug users did not engage with the treatment options available to them. Oregon also saw an increase in violent crime and the emergence of open-air drug markets, which caused public dissatisfaction and concern about the state’s safety and livability.

The state’s leaders also faced mounting political pressure. Homelessness and public drug use became more visible in the wake of the COVID-19 pandemic, and many critics blamed Measure 110 for exacerbating these issues. Despite evidence that the measure did not directly cause increases in crime or homelessness, the perception that it had failed to address Oregon’s broader social problems gained traction. In response, Governor Tina Kotek pledged to sign legislation that would recriminalize drug possession and return to a system where courts mandated treatment for offenders.

The future of psychedelic therapy in Oregon

While Oregon has recriminalized the possession of small amounts of drugs, it is important to note that this reversal does not affect the state’s existing legal framework for psychedelic-assisted therapy. In 2020, Oregon also passed Measure 109, which legalized the therapeutic use of psilocybin under controlled, supervised conditions. This program is distinct from Measure 110 and remains intact despite the broader rollback of drug decriminalization efforts.

Psilocybin-assisted therapy, which is used to treat mental health issues such as depression and PTSD, will continue to be available in licensed facilities with trained facilitators. However, the broader recriminalization of drugs may lead to a more cautious approach to the expansion of such therapies, especially as public sentiment shifts toward a more conservative stance on drug use.

Arguments for and against drug decriminalization

The debate over drug decriminalization is highly polarized, with both sides presenting compelling arguments.

In favor of decriminalization:

  • Public health focus: Proponents argue that addiction should be treated as a public health issue rather than a criminal one. By decriminalizing drug possession, the state can focus on providing the treatment and social services necessary to help people recover from addiction.
  • Reduction of racial disparities: The War on Drugs has disproportionately affected Black, Indigenous, and Latino communities, leading to higher rates of incarceration and long-term consequences such as barriers to employment and housing. Decriminalization is seen as a way to reduce these disparities and promote racial justice.
  • Harm reduction: Decriminalization advocates believe that removing the stigma and fear of arrest will encourage people to seek help. This can reduce overdose deaths, prevent the spread of diseases such as HIV and hepatitis, and improve overall public health.

Against decriminalization:

  • Increased drug use and public disorder: Critics argue that decriminalization leads to an increase in public drug use and open-air drug markets. The absence of legal consequences for drug possession can embolden drug users and dealers, leading to a rise in addiction-related issues.
  • Failure to address addiction: Some opponents believe that addiction is a condition that requires intervention and that decriminalization removes the necessary pressure for people to seek treatment. Mandated treatment through the criminal justice system, they argue, can be an effective way to help people recover from addiction.
  • Public safety concerns: Rising crime rates and a growing sense of disorder in communities were key factors in Oregon’s decision to reverse Measure 110. Critics argue that decriminalization can make communities less safe and harm the quality of life for residents.

The impact on U.S. drug policy

Oregon’s reversal of its drug decriminalization policy could have ripple effects across the U.S. In recent years, several cities and states have experimented with their own versions of drug decriminalization. Denver, Seattle, and other cities have decriminalized psychedelics, while states like California and Washington have considered broader drug policy reforms. Oregon’s experience may cause other states to approach drug decriminalization with caution, especially given the rise in fentanyl-related overdose deaths across the country.

While some states may be discouraged from pursuing full-scale decriminalization, Oregon’s case also highlights the need for a more comprehensive approach to drug policy. Simply removing criminal penalties without providing robust, well-funded treatment options is not enough to address the complexities of addiction. States looking to reform their drug policies may consider hybrid models that combine decriminalization with mandated treatment and increased funding for addiction services.

Navigating the future of U.S. drug reform

The rise and fall of Oregon’s drug decriminalization experiment offers important lessons for policymakers across the U.S. While Measure 110 represented a bold step toward addressing addiction as a public health issue rather than a criminal one, its shortcomings—namely, the rise in overdose deaths and lack of treatment engagement—highlight the complexities of drug policy reform. Oregon’s experience highlights that decriminalization alone is insufficient without robust and efficient systems of care, accountability, and support in place. As states continue to grapple with the challenges of addiction and drug-related harm, a balanced approach that integrates harm reduction, mandatory treatment, and adequate resources may offer a more effective path forward. Oregon’s journey serves as both a cautionary tale and a reminder that progressive policies require careful planning, sustained investment, and ongoing adaptation to succeed.