Michelle McGinnis, LCSW


By following public health models rolled out in Portugal, Switzerland, and the Netherlands, Oregon is spearheading a new attempt to improve the ongoing opioid epidemic.

Oregon has particularly high rates of substance abuse and mental health disorders, which is only complicated further by limited access to treatment when compared to the rest of the country.

According to the 2017 National Survey on Drug Use, here’s how Oregon ranks nationwide:

  • The highest number of users of opioid pain relievers
  • The most marijuana users
  • Second highest for methamphetamine use
  • Fourth-highest number of cocaine users
  • Ranked fourth for the number of residents with alcohol use disorder

Job loss and economic uncertainty stemming from the pandemic saw the number of drug overdoses in Oregon surge by 70% compared to 2019 figures. As crime rates continued to soar, Oregonians realized a radical approach was necessary.

Radical Changes: Measure 110

On November 4, 2020, Oregon became the first state to decriminalize drug possession. Of 2 million Oregonians, 59% voted to decriminalize drug possession.

Measure 110, which comes into effect on February 1, 2021, rules that anyone found in possession of illicit substances will face a $100 fine.  Additionally, if an individual agrees to an assessment for substance use treatment, the fee may be waved.

This new law applies to anyone caught with:

  • Up to 1g heroin
  • Up to 2g cocaine or methamphetamine
  • Up to 12g psilocybin mushrooms
  • Up to 5 MDMA pills or 1g of MDMA powder
  • Up to 40 doses of LSD
  • Up to 40 pills or capsules of Oxycontin or methadone

Oregon voters acknowledged that a health-focused approach has more chance of reducing drug abuse in the long-term than current punitive measures often leading to fines and prison time.

The Drug Policy Alliance

The decriminalization of deadly substances like opioids and methamphetamine is not the same as legalization. The substances remain illegal, but the penalty for possessing small amounts of these drugs is reduced. Offenders can also choose to enter a treatment program rather than face legal charges.  This will not only encourage the treatment of addiction, but it will also reduce the strain on an already overburdened prison system. The Drug Policy Alliance draws on the experience of countries that have implemented an alternative approach with astounding success. By treating drug addiction as a health issue, an addicted individual can access treatment and support rather than being cycled through the prison system.

The Portugal Model

Though it may sound controversial, the decriminalization of drugs in Portugal, Switzerland, and the Netherlands has been shown to reduce rates of overdose deaths and new HIV infection rates.

In 2001, Portugal was in the midst of an overdose crisis similar to the one the U.S. is currently experiencing. Prisons were packed to the bursting point with people jailed for drug possession. HIV rates were the highest amongst drug users in Europe.

Today, Portugal has the fifth-lowest rate of overdose deaths in Europe. If successful in Oregon, this radical move could sweep through the rest of the US. Based on recommendations by a panel of public health experts, Portugal decriminalized drugs by removing jail time, police records, and large sanctions for possession of small amounts of drugs. Anyone caught in possession of drugs in Portugal must report to the Drug Dissuasion Commission rather than the court. After being assessed by a psychologist, the offender is then offered treatment.

Senior International Policy Manager at the Drug Policy Alliance, Hannah Hetzer explains that “The Dissuasion Commissions is solely run by the Ministry of Health, there’s no criminal justice arm to them. So, if you’re a drug user and you appear in front of the Dissuasion Commission, you are given access to treatment on demand. If stopping proves impossible, you’ll be provided with access to harm reduction services.”

Portugal began viewing the opioid crisis from a health and safety perspective in 1998. The suggested framework to deal with drug use was to shift the issue from the remit of the Ministry of Justice to the Ministry of Health. Portugal adapted its healthcare system to address the needs of the population, including those struggling with addiction. This led to a decline in overdoses, new HIV infections, viral hepatitis, violent crime, and adolescent substance use. At the same time, access to drug treatment increased by 60%.

Deborah Peterson-Snell, Executive Director of Break The Chains says, “We actually need to deal with people, not with drugs,” she continues “in reality what we claim to be a war on drugs is in fact a war on people.”

Improved Access to Treatment

Recovery treatment in Oregon is presently direly underprovided due to limited access.

With Measure 110, though, a share of the $57 million raised in taxes yearly from the legalized marijuana industry in Oregon will be accessible to individuals whose income is a barrier to treatment.

As the new bill offers those with drug offenses the option to get treatment, addiction recovery centers offering assessments, triage, intervention, and case management, will expand across the state. In addition, medication-assisted treatment centers are also expanding in Oregon to meet the demand for quality and effective residential inpatient programs.

While it may seem hard to imagine a world where drug possession is not punished, the cost of the war on drugs in the US continues to spiral out of control with little impact on the rates of substance use. The Portugal model shows that decriminalization can work, and it could be time for a more radical approach if we are going to make a real impact on substance use in the US.

Michelle McGinnis is the Chief Clinical Officer at Landmark Recovery, a drug and alcohol rehab organization. McGinnis is a Licensed Clinical Social Worker and has been working in the healthcare space since 2007.If you’re searching for help for you or your loved one, Landmark Recovery may be able to help you.