FILE - Portland police central bike squad Officer Joey Yoo issues a citation for drug possession in the city’s Old Town neighborhood in downtown Portland, Ore., Nov. 15, 2023.
Kristyna Wentz-Graff / OPB
An audit by the Oregon secretary of state’s office has found gaps in the state health authority’s implementation of Ballot Measure 110, the state’s landmark drug decriminalization law.
The audit found that the state has dedicated approximately $800 million in cannabis tax dollars and other funding to programs established by Measure 110, but cannot answer questions about how many people have received services or how much those programs have helped Oregonians with substance use disorders.
One major challenge in implementing and evaluating Measure 110 and the programs it created, auditors found, is that it has been revised heavily over the past five years.
Voters passed Measure 110 in 2020, after advocates of drug decriminalization gathered signatures to get it on the ballot. It was repeatedly amended by the state Legislature over the years. Then in 2024, amid rising backlash, the Legislature reversed the best known part of the law — recriminalizing possession of smaller amounts of illicit drugs through House Bill 4002.
The new law also allowed for drug users to be deflected away from the criminal justice system and into treatment programs. Those deflection programs are administered by the counties that opt into it.
The audit is the last of three Measure 110 program audits required by the state Legislature.
Not all of the audit’s findings are new. Measure 110’s critics, for example, have been warning since before its initial passage that a provision in the bill, which stood up a new Behavioral Health Resource Network, was unnecessarily duplicating existing efforts by state, county and private health systems to treat addiction and support people living with it.
The audit echoes that concern, finding that services funded through Measure 110 are isolated from other state-funded programs and the rest of Oregon’s behavioral health system.
FILE - A syringe is seen in a tent near the intersection of SW 12th Avenue and SW Columbia Street in downtown Portland, June 25, 2021. Measure 110, a drug treatment and recovery act, aimed to connect drug users to treatment and recovery services, including housing assistance instead of serving time in jail for possessing small amounts of drugs.
Kristyna Wentz-Graff / OPB
It also found weak governance and frequent restructuring at OHA contributing to a chaotic rollout of the program, especially in the early years.
“This resulted in a lopsided implementation, where law enforcement had few tools to engage with people possessing small amounts of drugs, and no established treatment system to support people who needed help,” auditors wrote. “As a result, there were fewer interventions for people suffering from addiction and using drugs in public spaces,”
Lack of data
Auditors also found that gaps in data have limited the state’s ability to evaluate whether Measure 110’s ongoing spending on services is achieving goals that are codified in state law.
Among the issues auditors flagged is that OHA doesn’t have baseline data from before Measure 110’s passage to determine if the spending increased the number of treatment providers and services.
While OHA has shared recent data suggesting that many more people have started accessing services, some of that data may double-count individuals, the auditors wrote.
“For example, one provider may report 23 clients in harm reduction, 20 in peer support, and 15 in housing services, but there’s no way to tell whether these are separate groups for a total of 58 individuals served, or if there is overlap among them,” the audit reads.
“What seems to be missing is some sort of accountable person or organization,” said John McConnell, the director of the Center for Health Systems Effectiveness at OHSU. He has been independently studying Oregon’s behavioral health and mental health system. “I like data, obviously. But lots of data, fragmented across different groups where nobody is accountable for things, isn’t really going to get us where we want.”
The auditors made six recommendations. The Oregon Health Authority agreed with three of them and disputed parts of the others.
The most significant disagreement between the agency and the auditors is over a recommendation that OHA complete a baseline analysis to attempt to answer questions about how effective the law has been.
That analysis — which legislators directed the audit division to evaluate — would include whether overdose rates have declined since the law first passed in 2020 and whether the number of services, providers and people getting treatment for substance use has increased.
In its response, OHA said the Legislature had waived the requirement that it attempt to evaluate whether Measure 110 had any impact on overdoses.
The rollout of the law coincided with the arrival of fentanyl in Oregon, making it impossible to make any valid comparison, the agency said.
“Overdose rates cannot be attributed to any single grantee or program, as they are influenced by a complex array of environmental and systemic factors,” OHA Director Sejal Hathi wrote in the agency’s response.
OHSU’s McConnell agreed with that assessment. “Whatever fentanyl did made it impossible to pull out any signal,” he said.
The number of overdose deaths in Oregon started to drop last year, after climbing between 2020 and 2024 - mirroring a national drop in overdose deaths.
OHA said it is implementing two new data systems that will integrate with electronic health records and collect more complete data on clients served by the Behavioral Health Resource Network. All Measure 110 grantees will be required to submit their data through those systems by November 2026.
