Oregon botched drug treatment plan tied to decriminalization

SALEM, Ore. (AP) — Efforts to get millions of dollars in funding to treatment centers and related services as part of Oregon's pioneering drug decriminalization have been botched even as drug addictions and overdoses increase, state officials and lawmakers said on Thursday.

Oregonians passed Ballot Measure 110 in 2020 decriminalizing possession of personal amounts of heroin, cocaine, methamphetamine and other drugs — the first in the nation to do so. A person found with drugs receives a citation, like a traffic ticket, with the maximum $100 fine waived if they call a hotline for a health assessment.

The ballot measure redirected millions of dollars in tax revenue from the state's legal marijuana industry to treatment. But applications for funding stacked up after state officials underestimated the work required to vet them and get the money out the door, officials testified Thursday before the House Interim Committee on Behavioral Health. Only a tiny fraction of the available funds has been sent.

“So clearly, if we were to do it over again, I would have asked for many more staff much quicker in the process," said state Behavioral Health Director Steve Allen. "We were just under-resourced to be able to support this effort, underestimated the work that was involved in supporting something that looked like this and partly we didn’t fully understand it until we were in the middle of it."

Allen, who works for the Oregon Health Authority, told lawmakers in the remote hearing that this $300 million project has never been done before. He insisted it has strong potential, saying officials have “over-relied on traditional treatment.”

“The service array, the types of services that are included, the approach, the harm reduction, etc., are all designed by people who have experienced this and have, I think, some really interesting, good ideas about what these service systems ought to look like," he said. "So it’s an experiment. I think we’ll know more in a few years.”

Rep. Lily Morgan, a Republican from Grants Pass, said lives are being lost while the state waits for the ballot measure to have a positive effect.

“Director, you’ve mentioned a couple of times that you’re waiting to see, and yet we have overdoses increasing at drastic rates, in my community a 700% increase in overdoses and a 120% increase in deaths," Morgan told Allen. "How long do we wait before we have an impact that we’re saving lives?”

Secretary of State Shemia Fagan appeared before the committee, and described her mother's struggles with heroin and methamphetamine addiction before she recovered. Fagan said Oregon remains in a drug abuse crisis, despite the ballot measure.

“When the voters of Oregon passed Measure 110, we did so because it was a change of policy in Oregon to improve the lives of people, to improve our communities," Fagan said. “And in the years since, we haven’t seen that play out. ... Instead, in many communities in Oregon, we’ve seen the problem with drug addiction get worse.”

Allen acknowledged there has been a “dramatic” increase in overdoses and overdose deaths statewide and attributed much of the cause to the recent arrival of methamphetamine laced with fentanyl, a synthetic opioid that is so powerful that a tiny amount can kill, and illicit pills containing fentanyl.

That adds urgency to the effort to provide treatment services and harm reduction, like medication to treat overdoses and needle exchanges, that the measure also pays for, he said. Advocates point out that the services are available to anyone in Oregon, not just those who were cited for possession.

“Getting these resources out to the community is incredibly important ... not just the harm reduction resources, but people who can support folks who are at risk for overdose," Allen said. "So time is of the essence.”

Ian Green, an audits manager, said the ballot measure lacked clarity around roles of the health authority and the Oversight and Accountability Council that were established.

That “contributed to delays, confusions and strained relations,” Green said. He also blamed the health authority for not always adequately supporting the council. Council co-chair Ron Williams said most of the available funds still haven't been released.

“I feel these challenges can be overcome and corrected with deliberate, intentional, focused effort and courageous, solution-oriented conversations,” Williams said.

The health authority said $40 million in funds have been disbursed.

But about $265 million set aside for the 2021-23 biennium still hasn't been spent, said Devon Downeysmith, spokeswoman for the Health Justice Recovery Alliance. Hundreds of providers, which screen the needs of people who use drugs, offer case management, treatment, housing and links to other services, are waiting for those funds.

Still, more than 16,000 Oregonians have accessed services through Measure 110 funding, according to the Drug Policy Alliance, which spearheaded the measure.