Oregon’s Drug Addiction Treatment and Recovery Act (DATRA), also known as Measure 110, decriminalized possession of small amounts of drugs for personal use and increased funding for substance use disorder treatment, harm reduction, and social services. This brief first summarizes the existing evidence on early implementation of the law, which aims to address substance use and substance use disorders from a health perspective rather than the traditional criminal legal perspective.

• Most of the funding, $270 million for services and treatment, was delayed for almost 18 months and not allocated until June to September of 2022, creating enormous implementation challenges. Only $33 million was awarded in 2021.
• No scientifically rigorous evaluations of the effects of this law have been published, but initial descriptive findings offer insight. Oregon Criminal Justice data show a decrease of 4,000 in felony and misdemeanor arrests for personal drug possession after DATRA compared with 2019 levels. Another study found that the rise in 911 calls following the implementation of the law in Oregon in February 2021 was comparable in both Portland and Seattle, and thus may be attributable to factors other than the new law.
• It’s too early to evaluate DATRA’s effectiveness, as systems for connecting drug users with assessment, treatment, and support services are still being established as of early 2023. Evaluating the law’s full impact will take time, considering past underfunding of services and treatment programs and the need for new infrastructure. Doubling the current treatment system has been found necessary to meet the demand for services. Yet some lawmakers are already communicating intentions to shift funding of related services to the state police.

The brief then describes the rationale and research evidence on three topics currently debated in the legislature and the media regarding early implementation of DATRA:

1. Overcoming stigma and stereotypes through a nonpunitive approach to engagement in and expansions of substance use–related services and treatment

• Negative stereotypes regarding individuals who use drugs or have substance use disorders have been used in discussions of DATRA. Research has shown such stereotypes to contribute to public stigma and negative attitudes, hindering effective approaches to substance use and reducing treatment engagement.
• Research highlights the factors contributing to substance use disorders, including childhood abuse, trauma, violence, and social isolation.
• The belief that individuals with substance use disorder are unlikely to voluntarily seek treatment is not supported by evidence. Survey data show that about half of clients in syringe service programs are very or somewhat interested in reducing or stopping their drug use, and many engage in treatment voluntarily when it is offered in a harm reduction setting.
• Voluntary treatment engagement can be supported by efforts to treat individuals with dignity and respect,clinical endpoints other than abstinence, such as reduced use, culturally and linguistically effective care, mental health and trauma care; addressing societal and social determinants of health; and providing harm reduction services.

2. Acknowledging the importance of harm reduction in DATRA

• DATRA has faced criticism for its emphasis on harm reduction. However, harm reduction services are not typically covered by health insurance, unlike substance use treatment services, leading to low access to these services, which have demonstrable positive effects.
• Research demonstrates that harm reduction services, as part of a public health strategy, have significant positive impacts on public health. In comparison, criminalizing drug use has serious negative consequences for individuals and society and does not provide a sustainable, long-term approach to the harms associated with drug use.
• Harm reduction services, such as syringe services programs, are associated with reduced overdose death rates, decreased rates of new HIV and hepatitis C infections, increased engagement in substance use disorder treatment and reduced drug use. Those using syringe services programs are about five times more likely to engage in treatment and three times more likely to stop using substances compared with those who do not use these programs. Harm reduction services have also been shown to protect first responders from needlestick injuries.

3. Coercion into substance use treatment has been found on balance to be ineffective and costly.

• Coercive policies such as drug treatment courts and involuntary drug treatment programs in residential settings are, on balance, ineffective, inequitable, and costly. Drug court program completion rates are low and descriptive studies show that drug courts often do not connect participants with effective treatment options and exacerbate racial disparities associated with criminal legal outcomes. Involuntary residential drug treatment programs are found to increase risk of overdose, potentially violate rights, and carry high costs.
• Although evidence supporting coercive interventions to promote treatment and safety is weak, voluntary treatment in the US is unstudied and could have unintended consequences, both positive and negative. Therefore, robust analysis of the effects of DATRA is essential.

By presenting the latest research on the potential impact of DATRA, this brief aims to evaluate the characteristics of effective, evidence-based drug policies that prioritize the health and well-being of individuals and communities.