The decriminalization of low-level drug possession in Oregon was not associated with a statistically significant increase in drug-related deaths during the first year after that policy took effect, according to a study reported today in JAMA Psychiatry. The researchers reached a similar conclusion regarding fatal overdoses in Washington, where simple possession was decriminalized as a result of a February 2021 decision by the Washington Supreme Court. That decision prompted legislation enacted three months later that recriminalized simple possession but downgraded it from a felony, its classification under prior law, to a misdemeanor.
These results are obviously relevant to the ongoing debate over the impact of Measure 110, the 2020 ballot initiative that eliminated Oregon's criminal penalties for possessing small amounts of illegal drugs. Opponents of Measure 110, who have proposed initiatives aimed at reversing that reform, cite the continuing rise in opioid-related deaths as evidence that decriminalization encouraged drug use, with lethal consequences. But if that increase was consistent with preexisting trends, as the JAMA Psychiatry study found, this charge against Measure 110 does not hold water.
One possible outcome of reducing or eliminating criminal penalties for drug possession, New York University public health researcher Spruha Joshi and her co-authors note, is a drop in fatal overdoses. That might be expected for two main reasons: Reduced criminal liability might encourage bystanders to call 911 in response to overdoses, and reduced incarceration of drug users might mitigate the post-release danger of overdose due to lower tolerance caused by compelled abstinence.
To test that hypothesis, Joshi et al. compared Oregon and Washington to "synthetic controls" consisting of jurisdictions with similar preexisting overdose trends. For Oregon, the study covered the period from February 1, 2021, when Measure 110 took effect, through March 31, 2022. For Washington, the study period began on March 1, 2021, shortly after the Washington Supreme Court issued its decision in State v. Blake, and ended a year later. The latter period includes about 10 months when simple possession was recriminalized but subject to substantially less severe penalties than had been prescribed prior to Blake.
The researchers found no evidence to support the hypothesis that decriminalization reduced drug-related deaths. But they also found no evidence suggesting that decriminalization had the opposite effect.
"The findings of this study suggest that legal changes to remove or decrease criminal penalties for drug possession are not associated with the fatal drug overdose rate 1-year post implementation," Joshi et al. write. "We found no evidence that either Measure 110 in Oregon or the Washington Blake decision and subsequent legislative amendments were associated with changes in fatal drug overdose rates in either state." Although "further research is needed to examine the medium- and long-term consequences of these legal changes," they say, their findings were "robust to variations in the donor pool and the modeling strategy."
Even before this study, it was clear that decriminalization could not be blamed for the hazards of black-market drugs, which have been magnified by the proliferation of illicit fentanyl, a development fostered by the economic incentives that prohibition creates. The government's crackdown on prescription opioids, meanwhile, made that situation even worse by driving nonmedical users toward substitutes that are far more dangerous because their potency is highly variable and unpredictable. The root of that problem is continuing prohibition, not decriminalization.
Another study, reported this month in the International Journal of Drug Policy, found that the penalty changes in Oregon and Washington were, unsurprisingly, associated with large reductions in arrests for drug possession. But "there were no significant changes in overall arrests, non-drug arrests or arrests for violent crime in either state, relative to controls." That analysis, according to the authors, "demonstrates that it is possible for state drug decriminalization policies to dramatically reduce arrests for drug possession without increasing arrests for violent crimes, potentially reducing harm to people who use drugs and their communities."
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