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Matt Sutton, the director of external relations for the Drug Policy Alliance, which helped write Measure 110 and spent more than $5 million to pass it, told me that reform advocates viewed the measure as the start of a nationwide decriminalization push. The effort started in Oregon because the state had been an early adopter of marijuana legalization and is considered a drug-policy-reform leader. Success would mean showing the rest of the country that “people did think we should invest in a public-health approach instead of criminalization,” Sutton said.

To achieve this goal, Measure 110 enacted two major changes to Oregon’s drug laws. First, minor drug possession was downgraded from a misdemeanor to a violation, similar to a traffic ticket. Under the new law, users caught with up to 1 gram of heroin or methamphetamine, or up to 40 oxycodone pills, are charged a $100 fine, which can be waived if they call a treatment-referral hotline. (Selling, trafficking, and possessing large amounts of drugs remain criminal offenses in Oregon.) Second, the law set aside a portion of state cannabis tax revenue every two years to fund a statewide network of harm-reduction and other services. A grant-making panel was created to oversee the funding process. At least six members of the panel were required to be directly involved in providing services to drug users; at least two had to be active or former drug users themselves; and three were to be “members of communities that have been disproportionately impacted” by drug criminalization, according to the ballot measure.

Backers of Measure 110 said the law was modeled on drug policies in Portugal, where personal drug possession was decriminalized two decades ago. But Oregon’s enforcement-and-treatment-referral system differs from Portugal’s. Users caught with drugs in Portugal are referred to a civil commission that evaluates their drug use and recommends treatment if needed, with civil sanctions for noncompliance. Portugal’s state-run health system also funds a nationwide network of treatment services, many of which focus on sobriety. Sutton said drafters of Measure 110 wanted to avoid anything that might resemble a criminal tribunal or coercing drug users into treatment. “People respond best when they’re ready to access those services in a voluntary way,” he said.

Almost immediately after taking effect, Measure 110 encountered problems. A state audit published this year found that the new law was “vague” about how state officials should oversee the awarding of money to new treatment programs, and set “unrealistic timelines” for evaluating and funding treatment proposals. As a result, the funding process was left largely to the grant-making panel, most of whose members “lacked experience in designing, evaluating and administrating a governmental-grant-application process,” according to the audit. Last year, supporters of Measure 110 accused state health officials, preoccupied with the coronavirus pandemic, of giving the panel insufficient direction and resources to handle a flood of grant applications. The state health authority acknowledged missteps in the grant-making process.

The audit described a chaotic process, with more than a dozen canceled meetings, potential conflicts of interest in the selection of funding recipients, and lines of applicant evaluations left blank. Full distribution of the first biennial payout of cannabis tax revenue—$302 million for harm reduction, housing, and other services—did not occur until late 2022, almost two years after Measure 110 passed. Figures released by the state last month show that, in the second half of 2022, recipients of Measure 110 funding provided some form of service to roughly 50,000 “clients,” though the Oregon Health Authority has said that a single individual could be counted multiple times in that total. (A study released last year by public-health researchers in Oregon found that, as of 2020, more than 650,000 Oregonians required, but were not receiving, treatment for a substance-use disorder.)

Meanwhile, the new law’s enforcement provisions have proved ineffectual. Of 5,299 drug-possession cases filed in Oregon circuit courts since Measure 110 went into effect, 3,381 resulted in a recipient failing to pay the fine or appear in court and facing no further penalties, according to the Oregon Judicial Department; about 1,300 tickets were dismissed or are pending. The state audit found that, during its first 15 months in operation, the treatment-referral hotline received just 119 calls, at a cost to the state of $7,000 per call. A survey of law-enforcement officers conducted by researchers at Portland State University found that, as of July 2022, officers were issuing an average of just 300 drug-possession tickets a month statewide, compared with 600 drug-possession arrests a month before Measure 110 took effect and close to 1,200 monthly arrests prior to the outbreak of COVID-19.

“Focusing on these tickets even though they’ll be ineffective—it’s not a great use of your resources,” Sheriff Nate Sickler of Jackson County, in the rural southern part of the state, told me of his department’s approach.

Advocates have celebrated a plunge in arrests. “For reducing arrests of people of color, it’s been an overwhelming success,” says Mike Marshall, the director of Oregon Recovers. But critics say that sidelining law enforcement has made it harder to persuade some drug users to stop using. Sickler cited the example of drug-court programs, which multiple studies have shown to be highly effective, including in Jackson County. Use of such programs in the county has declined in the absence of criminal prosecution, Sickler said: “Without accountability or the ability to drive a better choice, these individuals are left to their own demise.”

The consequences of Measure 110’s shortcomings have fallen most heavily on Oregon’s drug users. In the two years after the law took effect, the number of annual overdoses in the state rose by 61 percent, compared with a 13 percent increase nationwide, according to the Centers for Disease Control and Prevention. In neighboring Idaho and California, where drug possession remains subject to prosecution, the rate of increase was significantly lower than Oregon’s. (The spike in Washington State was similar to Oregon’s, but that comparison is more complicated because Washington’s drug policy has fluctuated since 2021.) Other states once notorious for drug deaths, including West Virginia, Indiana, and Arkansas, are now experiencing declines in overdose rates.

In downtown Portland this spring, police cleared out what The Oregonian called an “open-air drug market” in a former retail center. Prominent businesses in the area, including the outdoor-gear retailer REI, have announced closures in recent months, in part citing a rise in shoplifting and violence. Earlier this year, Portland business owners appeared before the Multnomah County Commission to ask for help with crime, drug-dealing, and other problems stemming from a behavioral-health resource center operated by a harm-reduction nonprofit that was awarded more than $4 million in Measure 110 funding. In April, the center abruptly closed following employee complaints that clients were covering walls with graffiti and overdosing on-site. A subsequent investigation by the nonprofit found that a security contractor had been using cocaine on the job. The center reopened two weeks later with beefed-up security measures.

Portland’s Democratic mayor, Ted Wheeler, went so far as to attempt an end run around Measure 110 in his city. Last month, Wheeler unveiled a proposal to criminalize public drug consumption in Portland, similar to existing bans on open-air drinking, saying in a statement that Measure 110 “is not working as it was intended to.” He added, “Portland’s substance-abuse problems have exploded to deadly and disastrous proportions.” Wheeler withdrew the proposal days later after learning that an older state law prohibits local jurisdictions from banning public drug use.

Despite shifting public opinion on Measure 110, many Oregon leaders are not ready to give up on the policy. Earlier this month, Oregon Governor Tina Kotek signed legislation that strengthens state oversight of Measure 110 and requires an audit, due no later than December 2025, of about two dozen aspects of the measure’s performance, including whether it is reducing overdoses. Other bills passed by the legislature’s Democratic majority strengthened criminal penalties for possession of large quantities of fentanyl and mandated that school drug-prevention programs instruct students about the risks of synthetic opioids. Republican proposals to repeal Measure 110 outright or claw back tens of millions of dollars in harm-reduction funding were not enacted.

The fallout from Measure 110 has received some critical coverage from media outlets on the right. “It is predictable,” a scholar from the Hudson Institute told Fox News. “It is a tragedy and a self-inflicted wound.” (Meanwhile, in Portugal, the model for Oregon, some residents are raising questions about their own nation’s decriminalization policy.) But so far Oregon’s experience doesn’t appear to have stopped efforts to bring decriminalization to other parts of the United States. “We’ll see more ballot initiatives,” Sutton, of the Drug Policy Alliance, said, adding that advocates are currently working with city leaders to decriminalize drugs in Washington, D.C.