The short version: Oregon decriminalized personal drug possession in 2020 with Measure 110. In 2024, the state reversed course and recriminalized it. The measure was supposed to fund a network of addiction recovery centers with cannabis tax revenue. The legislature restructured those centers in 2021, before any opened. Two peer-reviewed studies since then found no evidence that decriminalization increased Oregon’s overdose deaths. In my view, the repeal punished a gap that was never filled.
By Peter H. Addy, PhD, LPC, LMHC
In November 2020, I wrote a post about Measure 110, and I listed what the addiction recovery centers were going to provide: triage around the clock, a health assessment built around what the client themselves said they needed, an individual plan made with a case manager, intensive case management with daily support, peer support, and outreach to people who could not get to the center.
I was optimistic at the time. None of those centers ever opened. Here’s why I think that happened.
What Measure 110 actually did
Two things, and people tend to remember only the first.
It decriminalized possession of small amounts of all drugs. Possession became a violation rather than a crime, with a fine that could be waived by completing a health assessment.
It also redirected cannabis tax revenue to build a treatment system. That was the trade. In my reading, decriminalization was less the point than the funding mechanism and the precondition for it. The intended point was the treatment system.
The centers were legislated away before they existed
In 2021, Senate Bill 755 replaced the addiction recovery center model. The program became the Behavioral Health Resource Network.
This is where the story usually gets told badly. The money was real, and it was distributed. Services exist. What didn’t happen was what voters saw on the ballot: a named center in every service area, opening on a stated date, doing the specific list of things I listed in 2020.
One detail about that bill is worth knowing. The summary legislators were first handed described it as form and style changes. The new model came in later, by amendment. I haven’t read the committee record, so I can’t tell you how much was said about it at the time.
By the time anyone asked whether Measure 110 worked, the version described to voters was not the version that was built.
What the research actually found
The claim that decriminalization drove Oregon’s overdose deaths is the reason the repeal passed. The evidence for that claim is weak.
A 2023 study in JAMA Psychiatry compared Oregon and Washington against a constructed comparison group built from the other 48 states and the District of Columbia. It found no association between the possession law changes and fatal overdose rates in the first year after they took effect.
A 2024 study in JAMA Network Open went further, and in my reading, it is the more important one. Looked at on its own, Measure 110 does correlate with rising overdose deaths, and the correlation is strong. But fentanyl swept into Oregon’s unregulated drug supply in the first half of 2021, which is exactly when Measure 110 took effect. When the researchers accounted for that, the association reversed direction and stopped being statistically meaningful.
Two things happened at once. Oregon blamed the visible policy change. The actual driver of overdose deaths was the drug supply.
None of this proves decriminalization helped. It does show that what everyone pointed at was not what happened.
Then it was reversed
House Bill 4002 passed in 2024 and made personal possession a crime again, with its possession provisions taking effect on September 1, 2024. The violation and the waivable fine are gone.
It is worth knowing how that bill made it to the legislature in the first place. The September before, a group called the Coalition to Fix and Improve Ballot Measure 110 filed two ballot initiatives backed by $700,000 in donations, all of it from four people and one family, including Nike co-founder Phil Knight and Columbia Sportswear chief executive Tim Boyle. They said at the time that there were two ways to get what they wanted: win a vote in November 2024, or have lawmakers change the law in the February short session and skip the vote. When the House passed House Bill 4002, the coalition said it would withdraw its initiatives once the bill became law, because the new law achieved, in its own words, “85% of what we proposed.” Oregonians never voted on any of it.
What replaced it, and what that is worth
What Oregon has instead, in some places, is deflection. County programs offer treatment as an alternative to prosecution. Deflection is county-level and discretionary. Most counties run a program. Not all do.
Deflection is the humane half of the repeal. It is the part I want to look at most closely.
The state’s own first report on deflection, published by the Oregon Criminal Justice Commission in April 2025, covered the first six months. Counties reported 894 referrals. Of those, 560 people actually enrolled. Forty-five completed. The rest were still in a program or had stopped.
Three hundred and thirty-four people were referred and never entered. That is the number I keep looking at. For more than a third of the people referred, deflection was a door that never opened.
Then there is what the money buys. When the legislature revisited deflection in 2025, it listed what grant funds may be spent on. The list begins with law enforcement employees and deputy district attorneys. Case management and outreach workers come later. Some of the money meant to route people away from the criminal system can pay the salaries of people inside it.
I want to be fair about what the same report shows, because it complicates my own argument and leaving it out would be dishonest. Most Oregon programs define success as meaningful engagement with a treatment plan, not a clean drug test. About half the counties interviewed said a citation gets dismissed on real engagement rather than on hitting a completion metric. One county coordinator put it this way: “He hasn’t had a clean UA yet, but he shows up every week and to every appointment.”
That is good practice. It is harm reduction, done intentionally by people inside a system that did not require it. It is also discretionary, unevenly distributed, and only available depending on which county you are in.
What I think this was about
In my view, Oregon passed a two-part measure. The state built the easy half immediately. It restructured the hard half before it opened. Then it judged the whole experiment by the results of the half that was missing.
Removing a criminal penalty is free and takes effect on a date. Building a treatment system is expensive, slow, and requires staff who do not exist in the numbers needed. It is not surprising which half arrived first. It is also not accidental. The cheap half is the half that can be delivered without funding workers, buildings, or years of operating costs.
Geographers who study prisons have a name for this pattern. I find it more useful than ‘the system failed.’ Ruth Wilson Gilmore calls it organized abandonment. The state’s withdrawal from a place or a population is not an absence of policy. It is a policy. Nobody has to decide to abandon anyone. It is enough to keep choosing the cheap half, year after year, and then point at the results.
And I think removing criminal penalties for personal possession was the right call, and I still think so.
I am a therapist working inside the same system. I am not standing outside it pointing. Most of us doing this work labor in a health system that decides what gets paid for and what does not. Oregon voted for a treatment system and got a policy change. A policy change is what the structure could produce cheaply. That is worth being angry about. It is not the same as saying decriminalization was a mistake.
What this means if you are the person this happened to
If you are reading this because of something in your own life rather than out of policy interest, two plain things.
Possession is a crime in Oregon again, and if you are facing a charge, you need a defense attorney, not a blog post.
The fact that the promised system did not arrive is not a fact about you. People end up believing that struggling with substances in a state that cuts support is a personal failure. It is not. Getting steadier makes it possible to be present to the people around you. It is worth doing for its own sake either way.
Questions people ask me
Did Measure 110 fail?
It depends on which part you mean. Decriminalization took effect as written. Two peer-reviewed studies found no evidence that it increased fatal overdoses. The legislature restructured the treatment system in 2021, before any of the promised recovery centers opened. In my view, judging the measure as a whole means judging a version that was never fully implemented.
Did decriminalization cause Oregon’s overdose deaths?
The best available research does not support that conclusion. A 2023 study in JAMA Psychiatry found no association in the first year. A 2024 study in JAMA Network Open found that, once fentanyl’s arrival in Oregon’s drug supply is accounted for, the apparent association reverses direction and is no longer statistically meaningful. As always, more research is needed.
Is drug possession legal in Oregon now?
No. House Bill 4002 made personal possession a crime again, effective September 1, 2024. Buying and using psilocybin inside a licensed Oregon service center is a separate program and remains lawful under state law.
What replaced Measure 110’s health assessment?
Deflection, in the counties that run it. These are county-level programs offering treatment as an alternative to prosecution. Participation is discretionary, not an entitlement, and availability depends on where the charge was filed. In the state’s first six months of data, 894 people were referred, and 560 entered a program. This is a patchwork, not a statewide guarantee.
Did the money go anywhere?
Yes. Cannabis tax revenue was redirected and distributed, and the Behavioral Health Resource Network exists. What did not happen was the specific recovery center model described to voters in 2020. That model was replaced before it opened. In my experience, this kind of midstream change is common when funding and political priorities shift.
Peter H. Addy, PhD, LPC, LMHC, is a licensed psychotherapist in Portland, Oregon, offering in-person and online sessions. He works with people around psychedelic harm reduction and integration, and with clients living with chronic pain. You can schedule a free 15-minute consultation.
This article is educational and includes my own opinions, which I have marked as such. It is not legal or medical advice.
