By Nancy Tannler
In November, 58 percent of Oregon voters approved ballot Measure 110. This yes vote is intended to provide the state with more addiction recovery services, partially financed by marijuana tax revenue. The measure also reclassified possession/penalties for specified drugs.
In a recent webinar sponsored by Oregon Health Forum, Oregon’s Pioneering Approach to Addiction: An Upstream Perspective, four professionals in this field gave perspective on what this means both pro and con for Oregon’s growing substance abuse situation.
Moderator Dawn Richardson, Dr. PH, MPH, clarified what Measure 110 means. Oregon is the first state to decriminalize the personal possession of small amounts of illicit drugs, including cocaine, heroin, Oxycodone and methamphetamine.
It also reduces the penalties for possession of larger amounts and the most an offender will receive is a $100 fine. The goal is to take people who are addicted to drugs out of the criminal justice system and to treat their addiction as a medical problem.
The other intent is to establish more treatment centers that can address a person’s overall health, as well as their substance abuse problem.
Unfortunately, Governor Brown has put off releasing the funding for this until 2022.
Richardson’s work as a social epidemiologist concludes that racism, health inequities and chronic stress are the reasons there are a disproportionate number of Black and Brown people in America caught up in the drug addiction problem.
Bobby Byrd was convicted for a drug offense 27 years ago even though he was not in possession when he was arrested. This blight on his record has made this ambitious, educated man’s life very difficult. He told of several instances of procuring a good job just to have it taken away when his past record was found out.
Today, Byrd is a community organizer on the Yes to Measure 110 campaign and a PAC board member of the National Association for the Advancement of Colored People. He believes the passing of Measure 110 will give more young people a chance to break the cycle of poverty and substance abuse.
This will be achieved by using what is referred to as an upstream approach. If someone is caught using, they are not prosecuted and put in the social justice system. Instead, they are offered treatment and a chance to reclaim their life.
James Schroeder, PA-C, MPAS, Chief Executive Officer Health Share of Oregon, has focused his career on helping others connect to the available medical services they need.
Schroeder hopes Measure 110 will decrease some of the hurdles he knows drug users experience when seeking help.
The fear of having Substance Abuse Diagnosis (SUD) on their record keeps many users away from seeking help. By decriminalizing the use of drugs and building better partnerships between health systems, behavioral health and criminal justice, more abusers will trust the system and seek help. This is especially true if there are more programs offering access to culturally specific providers and non-traditional approaches.
Schroeder gave a statistic drawn from a 2019 study of the 370,745 Health Share members his company serves. This study showed that people who have received some kind of treatment after being incarcerated for drug use are 65-70 percent less likely to be arrested as a repeat offender.
The Medical Director for Serenity Lane Treatment Center, Eric Geisler, MD, describes addiction as a treatable, chronic medical disease.
If addictions go untreated, people begin to behave compulsively despite the harmful consequences, he said. Geisler also emphasized that addiction is a mental health issue.
He explained the three stages in the addiction cycle that take place in the brain. The prefrontal cortex is where the person is preoccupied with and anticipates the next fix; the basal ganglia receives the satisfaction from the binge and the extended amygdala is the area where the negative affects of withdrawal are activated.
At Serenity Lane’s facilities, 60 percent of the admissions are for alcoholism. Geisler noted that alcohol has the most death related incidents and it is the deadliest to withdraw from.
According to Geisler, Measure 110 is intended to reduce the barriers that prevent most substance abuse users from seeking help. He is concerned that Measure 110 will increase drugs on the street; the consequences being more overdoses, deaths, ER visits, and HIV, HEP and STI infections that will overwhelm the drug courts with even more cases.
Geisler believes we should model our system after the one in Rhode Island where everyone who enters the correctional system is offered voluntary drug treatment. This includes medication assisted therapy, which has advanced over the years and is more effective now.
In Umatilla County, District Attorney Dan Primus, J.D., sees Measure 110 through a different lens and he explained it in legal terms.
The biggest change is that possession of small amounts of controlled substances has gone from a Class A misdemeanor (up to a 364-day jail sentence and/or $6,250 fine) to a Class E violation (no jail time and a $100 fine or completion of an assessment). He did note that the manufacturing, delivery and commercial drug offenses remain the same.
Primus’ concerns for the people in his community and other rural areas throughout Oregon is the lack of treatment opportunities, minimal street level law enforcement response and the ability of the drug court to adequately deal with people being charged.
In addition, the current COVID -19 pandemic has exacerbated the problem. There was a 70 percent increase in drug-related deaths in April and May of 2020.
Since addiction is a mental health issue, all of the presenters at this event repeated that the solution lies mainly in treating substance abuse as such. The promise of Measure 110 for funding to open more recovery facilities is still an elusive promise waiting to happen and for some, the wait will be too long.