“All carrots and no stick”: Perceived impacts, changes in practices, and attitudes among law enforcement following drug decriminalization in Oregon State, USA

Smiley-McDonald, Hope M.; Attaway, Peyton R.; Wenger, Lynn D.; Greenwell, Kathryn; Lambdin, Barrot H.; Kral, Alex H.

doi:10.1016/j.drugpo.2023.104100

Cited by 4 publications

(2 citation statements)

References 39 publications

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“…Funded programming has the potential to decrease risky drug-related behaviors and support pathways to addiction recovery, which can reduce nonfatal and fatal drug overdose. Additionally, there have been few calls for the Measure 110 treatment hotline, potentially due to variability in law enforcement practices on Class E citations and associated referrals . Furthermore, the influence of arrest and criminal legal system involvement may be cumulative and attenuated, such that reductions in fatal drug overdose might be lagged.…”

Section: Discussionmentioning

confidence: 99%

One-Year Association of Drug Possession Law Change With Fatal Drug Overdose in Oregon and Washington

Joshi,

Rivera,

Cerdá

et al. 2023

JAMA Psychiatry

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ImportanceTwo states modified laws to remove or substantially reduce criminal penalties for any drug possession. The hypothesis was that removing criminal penalties for drug possession may reduce fatal drug overdoses due to reduced incarceration and increased calls for help at the scene of an overdose.ObjectiveTo evaluate whether decriminalization of drug possession in Oregon and Washington was associated with changes in either direction in fatal drug overdose rates.Design, Setting, and ParticipantsThis cohort study used a synthetic control method approach to examine whether there were changes in drug possession laws and fatal drug overdose rates in Oregon and Washington in the postpolicy period (February 1, 2021, to March 31, 2022, in Oregon and March 1, 2021, to March 31, 2022, in Washington). A counterfactual comparison group (synthetic controls) was created for Oregon and Washington, using 48 states and the District of Columbia, that did not implement similar policies during the study period (January 1, 2018, to March 31, 2022). For 2018-2021, final multiple cause-of-death data from the National Vital Statistics System (NVSS) were used. For 2022, provisional NVSS data were used. Drug overdose deaths were identified using International Statistical Classification of Diseases and Related Health Problems, 10th Revision underlying cause-of-death codes X40-X44, X60-X64, X85, and Y10-Y14.ExposuresIn Oregon, Measure 110 went into effect on February 1, 2021. In Washington, the Washington Supreme Court decision in State v Blake occurred on February 25, 2021.Main OutcomeMonthly fatal drug overdose rates.ResultsFollowing the implementation of Measure 110, absolute monthly rate differences between Oregon and its synthetic control were not statistically significant (probability = 0.26). The average rate difference post Measure 110 was 0.268 fatal drug overdoses per 100 000 state population. Following the implementation of the policy change in Washington, the absolute monthly rate differences between Washington and synthetic Washington were not statistically significant (probability = 0.06). The average rate difference post Blake was 0.112 fatal drug overdoses per 100 000 state population.Conclusions and RelevanceThis study found no evidence of an association between legal changes that removed or substantially reduced criminal penalties for drug possession in Oregon and Washington and fatal drug overdose rates. Additional research could examine potential other outcomes as well as longer-term associations with fatal drug overdose overall and across racial and ethnic groups.

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Section: Discussionmentioning

confidence: 99%

One-Year Association of Drug Possession Law Change With Fatal Drug Overdose in Oregon and Washington

Joshi,

Rivera,

Cerdá

et al. 2023

JAMA Psychiatry

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“…In 2021, Oregon’s rate of fatal overdose increased by about 50% compared to the previous year, addiction treatment capacity has not yet expanded to meet the state’s needs, and police officials report decriminalization has hampered their ability to address concerns about public disorder. 8 As a result of these challenges, the future of M110 is uncertain. As Oregon’s legislators consider re-criminalizing drug possession, 9 other jurisdictions look to its outcomes in considering their own responses to overdose.…”

Section: Introductionmentioning

confidence: 99%

Drug decriminalization, the introduction of fentanyl to drug markets, and fatal overdose in Oregon

Zoorob,

Park,

Kral

et al. 2024

Preprint

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Importance: With the implementation of Measure 110 (M110), Oregon became the first state in the United States to decriminalize personal possession of all drugs. No analysis of the effect of this law on overdose mortality has fully accounted for the introduction of fentanyl to Oregon's unregulated drug market, a substance known to drive fatal overdose rates. Objective: To evaluate whether the decriminalization of drug possession in Oregon was associated with changes in fatal drug overdose rates after accounting for the timing and spread of fentanyl through Oregon's unregulated drug market. Design, Setting, and Participants: The association between fatal drug overdose and enactment of M110 in Oregon was analyzed using a matrix completion synthetic control method. The synthetic control unit was imputed from the 48 US states and Washington DC that did not decriminalize drugs. The rapid escalation of fentanyl in unregulated drug markets was determined using the state-level percentage of all samples reported to the National Forensic Laboratory Information System that were identified as fentanyl or its analogs. A changepoint analysis was used to determine when each state experienced a rapid escalation of fentanyl in its unregulated drug market. Mortality data were obtained from the Centers for Disease Control and Prevention from 2008-2022. Exposures: M110 took effect on February 1, 2021. Main Outcome: Fatal drug overdose rates per half-year. Results: Analysis indicated a rapid escalation of fentanyl in Oregon's unregulated drug supply occurred in the first half of 2021, contemporaneous with the enactment of M110. The crude association between decriminalization and fatal overdose rate per 100,000 per half-year was significant (Tau = 1.83; SE = 0.39; p < 0.001); however, adjusting for the rapid escalation of fentanyl as a confounder, the effect of drug decriminalization on overdose mortality in Oregon was null (Tau = -0.51; SE = 0.36). Sensitivity analyses were consistent with this result. Conclusions and Relevance: After adjusting for the rapid escalation of fentanyl, analysis found no association between M110 and fatal drug overdose rates. Future evaluations of the health effects of drug policies should account for confounding changes in the composition and potency of unregulated drug markets.

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Emerging models of de facto drug policy reforms in the United States

Rouhani,

Zhang,

Winiker

et al. 2024

Drug and Alcohol Dependence

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“All carrots and no stick”: Perceived impacts, changes in practices, and attitudes among law enforcement following drug decriminalization in Oregon State, USA

Cited by 4 publications

References 39 publications

One-Year Association of Drug Possession Law Change With Fatal Drug Overdose in Oregon and Washington

One-Year Association of Drug Possession Law Change With Fatal Drug Overdose in Oregon and Washington

Drug decriminalization, the introduction of fentanyl to drug markets, and fatal overdose in Oregon

Emerging models of de facto drug policy reforms in the United States

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