Incentives vs Consequences: The debate continues over altering aspects of Measure 110

PORTLAND, Ore. (KOIN) -- Measure 110, Oregon's controversial law that decriminalized hard drugs, has been the cause of great debate over the last few years. While there has been wide support for all of the funding that it provides to increase access to free addiction treatment, there is disagreement on what will motivate people to get sober.

On Monday, one group filed a ballot initiative to change aspects of Measure 110. However, the initiative still has a way to go before gathering signatures or making it to the ballot.

Overall, those who support the measure and those who oppose it have a shared goal of getting people with addiction into treatment and minimizing harm along the way. However, they have competing ideas of what that should look like and what will drive results.

As fentanyl has become the leading drug causing overdoses, people suffering from their active addiction can be seen throughout Portland.

The creators of the initiative to change aspects of Measure 110 say their policy is focused on getting people into treatment quicker, using misdemeanors and diversion to require mandatory treatment.

"That's really our focus and we think that the current model doesn't provide the necessary incentives or balance the public harm issues against the individual harm issues in a way that is actually working effectively," said Max Williams from the Coalition to Fix and Improve Measure 110.

Out of thousands of police citations for drug possession, 75% of people failed to show up for court and only 50 people completed the full substance use assessment.

Studies from Portland State University researchers suggest that the Measure 110 citation system and recovery hotline are ineffective in their current form.

"Maybe over time, we might see it increase, but I think we are leaning in the direction of where is that Measure 110 money going? If it's going into treatment centers and assessment centers and treatment providers, they also need to be funding outreach workers," said Brian Renauer, director of the Criminal Justice Policy Research Institute at Portland State.

These researchers also think it will take an army of outreach workers to connect people to treatment, and some Measure 110 fund recipients tend to agree.

"The citation in and of itself to me is ineffective," said Monta Knudson, the executive director at Bridges to Change. "Sending out peers to the streets to meet folks that could use services. I see that as possibly the most effective way to get that person into care, rather than relying on them to pick up a phone after the police leave to call a number to get care."

Currently, there is discussion about starting a pilot program to pair case workers with police for street outreach.

"We're deployed to go out and meet with the people who need face-to-face contact. That's where our peers really come into play with their lived experience. They're able to use motivational interviewing," Knudson said.

Last year, Measure 110 outreach workers made nearly 70,000 encounters with people in addiction, according to OHA.

Supporters of the measure say while the police citation system doesn’t appear to be working, data from 2022 shows 8,400 people connected to substance use disorder treatment via Measure 110 providers directly.

Supporters expect those numbers to grow as more resources have opened in recent months. (Data on outreach and treatment is not available yet for 2023).

"What we do know is that coerced and mandated treatment doesn't work and that what people need when they go in voluntarily to access recovery and services, they're much more likely to stay in recovery. Ultimately, that's all what we want," said Tera Hurst from the Health Justice Recovery Alliance.

The group who wants to change Measure 110 agrees those voluntary numbers are promising, yet are still highly concerned about the people visibly and actively using in public, who may lack the capacity to seek treatment and require an extra push to get proper help.

"When you compare voluntary treatment to mandatory treatment, voluntary treatment is always going to perform a little bit better. But that's the wrong comparison. The comparison ought to be mandatory treatment versus untreated individuals on the street because they are the ones who aren't voluntarily moving into treatment," Williams said.

PSU researchers suggest there is no one-size-fits-all approach to what motivates someone with a substance use disorder to get clean -- but they say it's usually a combination of both incentives and consequences.