Terrence and D.Shot sit outside on a bustling street in Portland, Ore., keeping warm over the American Thanksgiving weekend with a barrel fire on the sidewalk.
Next to them, a shopping cart full of wood and refundable cans promises a few dollars and a few more hours of heat as the pair finds “the means to survive” over winter.
“We got to live. It’s cold outside,” said Terrence, who has been unhoused for nine months. “It’s all about survival out here because we’re not getting any help from these folks. No mental health help.”
On Feb. 1, Oregon will mark two years since it made history as the first U.S. state to decriminalize personal-use possession of drugs like heroin, cocaine, methamphetamine, and oxycodone.
The west coast state made headlines around the world when it passed the legislation amidst a concerning spike in overdose deaths. Under Measure 110, instead of incarceration, people found with drugs are given a ticket with a fine that gets waived if they call a treatment hotline.
Terrence and D.Shot said they know about Measure 110, but doubt the effectiveness of the landmark policy in treating addiction. D.Shot suggested it’s more of a boon for taxpayers than users, because it means less costly paperwork and fewer court dates.
Meanwhile, use and black market dealing continue on the streets.
“All of us are not idiots, man. I think they thought we were asleep when they did that,” D.Shot told Global News. “People are going to do drugs. It’s not going to stop because it’s decriminalized.
“All it’s doing is making it easier for people to hold drugs, you know what I’m saying? And get drugs.”
Despite the passing of Measure 110, Oregon continues to suffer from some of the worst rates of untreated addiction in the U.S.
A recent survey from the country’s Substance Abuse and Mental Health Services Administration found nearly one in five of its residents struggle with addiction. According to the advocacy group Oregon Recovers, the state loses five people a day to alcohol, and one or two a day to drug overdoses.
Terrence estimated half that of the city’s homeless grapple with substance use challenges.
“This stuff mess with your mental state. They’re not helping these people out here,” he said.
Decriminalization may have received mixed reviews in its first two years, but some advocates working in mental health and addiction in Oregon believe it’s still too early to draw conclusions.
“Ultimately, when we pass laws, everybody anticipates that everything is going to be solved the next day,” said Tera Hurst, executive director of the Health Justice Recovery Alliance.
“Obviously that is just not a reality in any policy, especially a big policy shift.”
One of the “game-changer” elements of Measure 110 is its deployment of tax revenue from the state’s cannabis industry to a network of treatment programs, Hurst said. According to the Health Justice Recovery Alliance’s website, more than $300 million has been invested in overdose prevention, housing, peer support, harm reduction, and addiction recovery in just two years.
Hurst estimated the ticketing and treatment policy has helped some 7,000 people avoid long-term “barriers on their records” that would prevent them from accessing jobs and housing. She has also heard stories of families staying together and accessing same-day beds through Measure 110’s funding.
“You don’t need a (drug possession) ticket to get those,” she said of the treatment services. “An outreach worker could come out and they’re the ones we want assessing somebody who might be in crisis.”
That’s where “the magic” happens, Hurst added — when someone with lived experience, who has dedicated their life to supporting others with the same struggle, extends a helping hand.
Lived experience is what drove Tony Vezina, co-founder of Oregon’s 4D Recovery, to open his arms to those in need. He said he “grew up in a family of addicts” and has been in recovery for more than a decade.
“I dropped out of high school, wound up getting addicted to prescription pain pills, OxyContin and then heroin, and was homeless for a while,” he told Global News from Portland.
“Whether I went on my own or was intervened on by the criminal justice system, I went to treatment several times, got into recovery and started giving back to the community I had harmed.”
In addition to his community work through 4D, Vezina chairs Oregon’s Alcohol and Drug Policy Commission, an independent state government agency that aims to improve the effectiveness of statewide and local treatment, prevention and recovery services.
Like Hurst, he lauded the funding that came with Measure 110. However, he said there is room for improvement in the legislation, citing Portugal’s system as an example.
In 2001, Portugal became the first country in the world to decriminalize the personal use and consumption of all drugs. In the European country, those caught with a personal supply may receive a warning, small fine, or instructions to appear before a commission to learn about treatment, harm reduction and support services.
“There’s the potential consequence, but they rarely use it, and then people get referred right into treatment as many times as they want, and that seems to be a good strategy to me,” said Vezina.
“In Oregon, we kind of did that model, but not really — we turned possession of user amount into a like a violation, like a traffic ticket, where people get a ticket and they’re supposed to call a number and get help, which is all right in theory.
“But the tickets haven’t been useful mechanism to get people into treatment. Very few people have called or sought treatment or help through the ticket.”
Oregon must do more to address the social justice issues that contribute to addiction in the first place, Vezina added, estimating “less than one per cent” of state funds dedicated to substance misuse are directed to prevention, rather than treatment.
Oregon’s path to decriminalization was very different from British Columbia’s.
In May, B.C. became the first province to be granted an exemption to the federal government’s Controlled Drugs and Substances Act, removing criminal penalties for possession of some hard drugs. Measure 110, by contrast, was passed after a majority of the state’s voters approved it in a referendum.
Reporter Blair Best, who covers homelessness for Portland’s KGW News, said Measure 110 has “good intentions,” but there isn’t enough housing to support those exiting its treatment services. Two years in, she said a lack of education on the legislation remains problematic.
“I think a lot of homeless people don’t keep up on new laws that are being passed … what they do know is that they can smoke fentanyl and get away with it,” she explained.
“All they get is cited a $100-fine and they have to show up to court, many of them don’t show up to court, then they have a warrant out for them — so it’s just this cycle that continues to happen.“
As in Vancouver’s Downtown Eastside, Best said some businesses in downtown Portland have closed down due to a dual crisis of homelessness and drug use at their doorstep. Some business owners blame Measure 110, but Best believes that’s misguided.
“I believe that these drugs would be on the streets regardless,” the Emmy Award-winning journalist told Global News. “And a lot of times, the reason that they’re doing these drugs is because they’re homeless — it’s not that they’re doing the drugs and that’s why they became homeless.”
For many, drugs are a survival tool, allowing users to stay awake at night and protect their tents and belongings from theft or removal, she explained. There’s been an increase in overdose deaths in the past two years, Best added, but it’s unclear whether that’s related to Measure 110.
Overall, Hurst and Vezina agree decriminalization has put Oregon on the right path, but much more work lies ahead, particularly when it comes to prevention.
Hurst said some organizations have been able to access lifesaving tools through Measure 110, like Naloxone, and to reverse up to 500 overdoses a month. It will take a “really long time,” however, to put a substantive dent in addiction while other obstacles — like soaring rent prices — remain in the way.
“Every day that’s delayed, people are dying,” Hurst said. “Let’s stop idolizing a war on drugs and let’s start really focusing our attention on why are people using. We have a lot of an untreated trauma.”