Housing, not drugs, is driving poverty

National media outlets have trained their sights on Portland, Oregon, releasing hit piece after piece. The New York Times published no fewer than three articles about the state's drug decriminalization in a single week. "Oregon's experiment to curb overdoses by decriminalizing small amounts of illicit drugs is in its third year, and life has changed for most everyone in the city of Portland," reads the subheadline of one. The mischaracterizations begin before the article does, starting out with the assertion the primary goal was to curb overdoses, reaching a fever pitch by the final clause, "and life has changed for most everyone…" Jan Hoffman's New York Times piece profiles Jennifer Myrle, a worker at a downtown coffee shop who recently saw a woman performing oral sex on a man in broad daylight on the street. What that has to do with drug decriminalization, no one knows. (Opioids cause impotence, if anyone is wondering.) Myrle says her downtown area can feel like "dealer central," but that "there's no point in calling the cops." Though The New York Times is spuriously implying drug peddlers have free reign in the city, unpacking why Myrle sees no point in calling the police is worthy of a few sentences. The New York Times would have you believe Measure 110 — which moved misdemeanor drug possession down to a Class E violation, similar to a traffic ticket — has given fentanyl dealers free reign, though a sale of even $5 of fentanyl remains a Class A felony. But Myrle is probably right — there's likely no point in calling the cops. They won't come, or can't, depending on who you ask. In June 2023, high-priority calls took the Portland Police Bureau (PPB) an average of 21 minutes to respond, up five minutes from last year. (My aunt approached a PPB officer in the park and complained that she had called them, repeatedly, and they just never showed up. He told her they're so short staffed they only come "if there's blood.") It's unlikely the police would respond to any of the nuisances described by Myrle, from her side-stepping "needles, shattered glass and human feces" to a man kicking off his shoes and laying down on the coffee shop's couch, refusing to leave. Hoffman devotes a single sentence to the main point: "…that [Myrle's] witnessing a confluence of longstanding societal problems, including mental health and housing crises." None of what she describes has anything to do with the fact drug possession no longer warrants a misdemeanor arrest like it did in 2020. The entire rest of the article implies causality between drug decriminalization and myriad other social ills, such as homelessness, petty crime and drug overdose. Oregon ranks 33rd in the nation for drug overdose, with 32 states experiencing higher levels of overdose deaths, and with all 32 of those states having more punitive drug policy than Oregon. It ranks last or next-to-last in access to drug treatment nationwide — a central tenet of the Yes on Measure 110 campaign, since in addition to decriminalization, it transferred most of the cannabis tax revenue into a fund for substance use services, including outpatient treatment, medications, peer mentoring, housing and harm reduction. Despite this low ranking, the state is in the bottom third for overdoses. You wouldn't know it by reading the national coverage. Getting the Role of Fentanyl Right Unlike most of the country, fentanyl was never cut into Oregon's heroin supply. (The West Coast was black tar heroin's last stand, which didn't lend itself to being adulterated with white powder fentanyl as easily as the white powder heroin sold on the East Coast.) When fentanyl showed up here, it showed up as just that: fentanyl. People buying the blue fentanyl pills known as "Blues," by and large, knew they weren't buying prescription oxycodone. It took the supply chain disruptions of pandemic-related shutdowns to finally push Oregon's opioid market, a heroin holdover, towards fentanyl. By 2021, heroin had nearly disappeared from the market, forcing droves of Oregonians to switch to fentanyl. It was one of the most rapid replacements in drug market history, with predictable consequences: Overdoses skyrocketed. (On the East Coast, heroin stayed on the market for years after fentanyl was first introduced, though now it's equally absent.) The entire country saw a 17 percent increase in overdoses, though the regions that first got fentanyl around 2014 are finally seeing their rates level off. The New York Times instead wrote Oregon's year-over-year overdose rate change and contrasted it to Vermont's, where users are long accustomed to fentanyl in their supply. Voters passed Measure 110 in November 2020, just as fentanyl was replacing heroin in the market. By the time the decriminalization element went into effect in February 2021, heroin was scarce. Oregon isn't unique; the entire West Coast experienced a similar shift, profoundly affecting addiction and the dynamics on the street. Unlike the rest of West Coast states, Oregon had a unique scapegoat to blame the changes on: decriminalization. The sole predictor of homelessness is how rent-burdened people are. From 2020 to 2022, Oregon saw a 56 percent increase in homelessness, one of the largest jumps in the country. In Portland, homelessness jumped another 20 percent between 2022 and 2023. The point-in-time homeless count for Multnomah County in 2023 shattered the previous record, with 6,279 people identified. Of our homeless population, we have the fourth-highest rate of unsheltered people in the country, meaning people are literally sleeping outside, increasing the visibility of our crisis compared to other jurisdictions. (Only California, Mississippi and Hawaii have more people living unsheltered, yet those three states have much higher average temperatures.) Nearly 15,000 Oregonians faced eviction in 2022, with a third of those coming from Portland's Multnomah County. With so many people sleeping outside, quality of life in the city has taken a hit. Homelessness is often blamed on drug addiction, but the data do not agree. "Arkansas, Tennessee and Missouri have high rates of disability and West Virginia has high rates of opioid use, but those states do not have high rates of homelessness since housing costs are much lower," writes Nicole Hayden in The Oregonian. The strongest predictor of homelessness is an increase in housing costs, full stop. Average rents in Portland increased 22.5 percent since January 2020. So when fentanyl hit Portland, it hit during an unprecedented housing crisis. It meant that the suffering of our neighbors is not occurring behind closed doors, but rather right in front of our faces. People do not use drugs in public when they have an alternative to doing so. It is an act of last resort. If you want people to make better choices, give them better options. It is commonplace to see people smoking fentanyl while crouching in stoops, sitting at bus stops. It should not be like this, of course, but people who are addicted and homeless have no alternative. Safe consumption sites would get drug use out of the public square, reducing the perception of permissiveness while simultaneously serving as a conduit to services for people who use drugs. Safe consumption sites would give people a better option for where to use the drugs they're going to use anyway — and with better options, most make better choices. Yet the same people who lament public drug use and decry it on the evening news will oppose safe consumption sites in the same breath — literally opposing the simplest known solution to their problem. Portland saw similar increases in crime as the rest of the nation. While many people tried to blame various types of petty crime on Oregon's drug decriminalization, the research organization RTI International sought to parse fact from fiction. When they compared 911 calls between 2018 and 2022 from Portland, Boise, Sacramento and Seattle, they found that calls to 911 did not increase in Portland after decriminalization. Trends in Portland were similar to that of the comparison cities, with normal seasonal fluctuations. Portland's calls for property crime directly mirrored that of Seattle's. "Sometimes perception is not reality when it comes to public policy and specifically drug decriminalization. This appears to be one of those cases," said Hope Smiley-McDonald, a senior sociologist and director of the investigative sciences research program at RTI. Punitive Policies Are Part of the Problem Another myth repeated in The New York Times is that Measure 110 has made Portland something of a mecca, a destination for drug use. Of the drug possession citations that police have issued, a whopping 95 percent went to Oregon residents, an indication that out-of-towners are not exactly flocking to the state. This is a variation on an even more pernicious notion, that progressive cities attract homelessness by being tolerant of it. A landmark study commissioned by California Gov. Gavin Newsom's office was published by University of California, San Francisco last month. It shows 90 percent of people that are homeless in the state lost their housing in California, with 75 percent of the people still living in the same county in which they first became homeless. The poorest among us are not moving across the country in search of slightly more favorable public policies — moving is expensive. Conflating drug addiction with homelessness is a long-standing practice of opponents in their attempt to victim blame. Only recently, with the passage of Measure 110, has it morphed into conflating drug decriminalization with homelessness. Officials and pundits persistently attempt to redirect our attention on the housing crisis to drug use, mental health or progressive permissiveness. Yet the fact remains: The sole predictor of homelessness is how rent-burdened people are. The language of compassion is being hijacked by reactionaries, who assert that it's cruel to leave people to suffer in their own addiction; that in fact, arresting and jailing them would be the kinder thing to do. (At age 24, I was sentenced to five years in federal prison for heroin. The eighth correctional officer at FCI Dublin, the nearest women's prison to Portland outside of Oakland, California, was just arrested for sexual abuse.) Yet again this overlooks the fact that five decades into the "drug war," the United States simultaneously incarcerates more of its residents than any other nation and loses more of them to drug overdose. Jail itself is a risk factor for drug overdose, and many jails and prisons still refuse to provide medications for opioid use disorder, the gold standard for treatment. Addiction is defined as continued use despite negative consequences. Increasing the negative consequences through the criminal legal system has not been shown to dissuade drug use, with a Pew research report showing no correlation between arrest rates and substance use rates. Punitive policies may make the problem less visible, but no less present. Even in Oregon, naysayers are reluctant to advocate a full-scale return to the war on drugs, as that's still being fought in 49 states and annual overdose numbers show it's not exactly working. Painting Oregon's problems as exceptional is uninformed at best, deliberately dishonest at worst. While the entire nation flounders under the weight of an overdose crisis so extreme it's bringing down our life expectancy, the only thing exceptional about Oregon is its courage to stop repeating the same failed strategies of the past. The same critical lens that is being trained on Oregon, albeit misleadingly, ought to be trained on the U.S. drug policy on a whole. From the time an "opioid crisis" was first identified, the government has taken a series of actions and policy decisions that left us with a death count 10 times higher than those early days. The more nuanced of the reactionaries instead talk about carrots and sticks. We need both positive incentives (carrots) alongside negative incentives (sticks), so their logic goes. Most people who have struggled with alcohol or substances at some point in their life managed to get a handle on their problem without ever needing a stick, though. Treatment is far more successful when the person receiving it actually wants it. As for the success of carrots, Measure 110 opened up a pot of nearly $300 million to organizations across the state. To be awarded a grant, the rules were clear: All treatment had to be low barrier and the philosophy of harm reduction was valued. We watched organizations that had historically been 12-step, abstinence-only focused finally embrace medications for opioid use disorder, rapidly increasing access in our rural areas. No stick required. Oregon has high rates of substance use disorder and low rates of treatment access, the same two facts that were used by the Yes on Measure 110 campaign. A single round of grant funding hasn't undone decades of disinvestment, to be sure. But it has stopped incarceration, a harm that has been shown time and time again to be futile in the fight against drug addiction. In total, 233 organizations received funding to form Behavioral Health Resource Networks in each county. Tens of thousands of Oregonians have received Measure 110-funded services. The average wage of the behavioral health workforce shot up as providers were required to pay a living wage. Drug decriminalization is just that: stopping arrests for people with low-level drug possession. It is wholly separate from petty crime or homelessness. If "life has changed for most everyone," it's not because a few thousand people have been spared arrest. It's more likely to be from the global pandemic, economic insecurity and a housing crisis. Arresting people for drug possession is what 49 of 50 states do. How well is it working for them? Copyright, Truthout.org. Reprinted with permission.