Measure 110 on thin ice

The backlash against Multnomah County's fentanyl smoking kit giveaway highlights the vulnerability of Oregon's hard drug decriminalization and "harm reduction" measure.

Fentanyl and smoking paraphernalia

Multnomah County’s now-paused plan to distribute aluminum foil, pipes and other smoking and snorting paraphernalia to fentanyl addicts elicited, when announced, massive and immediate pushback from Portland-area elected officials, including county commissioners and city councilors, all of whom are Democrats. The pushback was generated by intense, and intensely skeptical, media coverage of the plan.

The skepticism and pushback arose from the inescapable absurdity of Portland’s public health authority giving addicts stuff they need to use the drug that is killing them at a rapid clip. Multnomah County Commissioner Sharon Meieran, a medical doctor, summarized the insanity:

“The idea of handing out foil and straws, essentially while Rome is burning, is ludicrous.”

Meieran’s fellow commissioner, Julia Brim-Edwards, supported pausing the plan. Portland Mayor Ted Wheeler blasted the county plan: “I adamantly oppose distributing paraphernalia to encourage using a drug that is the leading cause of death for Americans under 50 and responsible for 190 fatal overdoses a day in the US.”

Portland City Commissioner Rene Gonzalez tweeted, “Thoughtful harm reduction may have a place in addressing substance use disorder, but handing out tinfoil/straws in a community ravaged by fentanyl is reckless.”

“Harm reduction” describes policies intended to, well, reduce the harm drugs do to the people addicted to them, under the assumption they will continue to use the drugs. Accordingly, Multnomah County bought rubber mouthpieces designed to inhibit the transmission of germs when people share pipes and chap stick for the same purpose. It also purchased a pamphlet extolling the virtues of “boofing,” a harm reduction measure in which the user introduces drugs into the body through an, um, alternate route.

Harm reduction measures are not new in Portland. They have been a favored approach throughout Portland’s slide into the drug capital of the United States. What is new is the public and a critical mass of elected officials saying publicly, and loudly, that harm reduction measures are, at the very least, ill-suited for the current drug crisis.

Portlanders and others who were outraged by Multnomah County’s smoking kit plan should really hate Measure 110. The voter-approved 2020 law that decriminalized fentanyl and other hard drugs also siphoned lots of money into a whole new state drug scheme focused on, you guessed it, harm reduction. So long as Measure 110 remains on the books in its current form, Oregon is in the harm reduction business in a very big way.

Measure 110, in the form passed by the voters, provided grant funding for the creation of Addiction Recovery Centers throughout the state “for the purposes of immediately triaging the acute needs of people who use drugs and assessing and addressing any on-going [sic] needs through intensive case management and linkage to care and services.”

The Centers were limited to providing only those services “centered on principles of harm reduction”:

(That language was altered slightly in 2021 by Senate Bill 755, the law implementing Measure 110, removing the specific reference to harm reduction in the paragraph quoted above).

Funding authorized by Measure 110 is overseen by a body called the Oversight and Accountability Council, the members of which are appointed by the Director of the Oregon Health Authority. One such member must be a “harm reduction service provider.” In practice, many of the members of the OAC, drawn disproportionately from the non-profit and vendor communities - what one might call the Measure 110 industrial complex - are harm reduction service providers and advocates.

So, while Multnomah County is sheepishly backing away from its foil-and-straw give-away, Measure 110 ensures there is plenty of state funding to fill the gap, and then some. Willamette Week reports that Portland-based Nonprofit Outside is giving fentanyl addicts paraphernalia at a rapid clip, using Measure 110 funds:

Indeed, the centrality of harm reduction practices to Measure 110 is demonstrated in the Oregon Health Authority data dashboard for Measure 110 funding through December 31, 2022. Measure 110-funded entities provide harm reduction services to more clients than any other service, dwarfing employment and housing-related services.

(BHRN is “Behavioral Health Resource Network,” the term SB 755, the implementing law, used instead of Addiction Recover Centers).

The blowback against Multnomah County’s paraphernalia plan shows that formerly sympathetic media, elected officials and voters understand the insanity of a harm reduction focused response to Portland’s fentanyl crisis. Many, if not most, of those folks supported Measure 110 in 2020, before fentanyl really sank its fangs into Oregon.

Public opinion moves fast in a crisis. Many liberal Oregonians are now strongly, angrily opposed to the central and animating treatment philosophy of Measure 110. Voter opposition to the measure’s other main feature, de-criminalization, is well-established.

Oregon’s most liberal county just rejected a harm reduction measure out of step with voters who are fed up with the addiction crisis. Measure 110 is on very, very thin ice.