PORTLAND, Ore. (AP) — Oregon’s first-in-the-nation law that decriminalized the possession of small amounts of heroin, cocaine and other illicit drugs in favor of an emphasis on addiction treatment is facing strong headwinds in the progressive state after an explosion of public drug use fueled by the proliferation of fentanyl and a surge in deaths from opioids, including those of children.

John Horvick, vice president of polling firm DHM Research, stated that the prevalence of open-air drug use in daily life is a major concern for urban residents. This has significantly influenced their views on Measure 110.

Three years ago, when 58% of Oregon voters approved the law, Measure 110 was praised by its supporters as a groundbreaking strategy that would revolutionize the treatment of addiction. This was achieved by reducing penalties for drug use and redirecting resources towards recovery.

However, even prominent Democratic legislators who supported the legislation, which is expected to be a major focus in the upcoming legislative session, acknowledge that they are willing to reconsider it following the significant rise in deaths from synthetic opioids in states that have released their data.

The pattern of dependency and lack of permanent housing caused by fentanyl is most evident in Portland, where it’s common to witness individuals injecting the drug in public during peak hours on crowded urban roads.

“I am open to all options,” stated Senator Kate Lieber, co-chair of a recently formed bipartisan committee aimed at addressing addiction. “We must take action to ensure safer communities and preserve lives.”

Measure 110 directed the state’s cannabis tax revenue toward drug addiction treatment services while decriminalizing the possession of so-called “personal use” amounts of illicit drugs. Possession of under a gram of heroin, for example, is only subject to a ticket and a maximum fine of $100.

Individuals found with small quantities of drugs have the option to have their citation dismissed if they contact a 24-hour hotline to undergo an addiction screening within 45 days. However, those who do not complete the screening will not face any penalties for not paying the fine. According to state auditors, during the first year after the implementation of the law in February 2021, only 1% of individuals who received citations for drug possession sought assistance through the hotline.

Opponents of the legislation argue that it fails to encourage individuals to seek medical care.

GOP legislators are pressuring Gov. Kotek (D) to convene a special session before the February legislative session to tackle the problem. Their suggestions include tougher penalties for drug possession and other related crimes, compulsory rehabilitation, and loosening restrictions on detaining individuals who are under the influence in places like hospitals if they are a threat to themselves or others.

A letter to Kotek from a group of Republican state representatives stated that treatment should be mandatory, not merely recommended.

Law enforcement officials who have testified before the new legislative committee on addiction have proposed reestablishing drug possession as a class A misdemeanor, which is punishable by up to a year in jail or a $6,250 fine.

Hermiston police chief Jason Edmiston expressed that the solution does not lie in reincarceration, but rather in reintroducing a (class A) misdemeanor for possession with the option for diversion. This is deemed crucially important for the small, rural city of Hermiston in northeast Oregon.

According to the National Survey on Drug Use and Health, nearly 25 million Americans, which accounts for approximately 8% of the population, reported using illegal drugs (excluding marijuana) in the past year. Despite decades of laws criminalizing drug possession, this data suggests that it has not deterred people from using drugs.

Certain legislators have proposed prioritizing the criminalization of public drug usage rather than possession. According to Alex Kreit, a law professor at Northern Kentucky University and head of its Center on Addiction Law and Policy, this strategy may reduce the prevalence of drug use in public spaces, but it fails to address the underlying issue of homelessness.

He mentioned California as an instance, stating that there are states without decriminalization that face similar challenges with public health, public order, and quality-of-life concerns due to a high number of homeless individuals in downtown areas.

Supporters of Oregon’s strategy argue that decriminalization may not be the sole cause, as there have been reports of rising fentanyl-related deaths in other states with stricter drug regulations.

However, according to data reported by the U.S. Centers for Disease Control and Prevention, Oregon had the largest rise in synthetic opioid overdose deaths compared to other states. This increase was 13 times higher, with a surge from 84 deaths in 2019 to over 1,100 in the 12-month period ending on June 30.

According to CDC data, Washington state, which is adjacent, experienced a seven-fold rise in estimated deaths from synthetic opioid overdoses during the same time periods.

The number of overdose deaths caused by synthetic opioids, like fentanyl, has approximately doubled on a national level. Approximately two-thirds of all fatal overdoses in the United States in the 12 months leading up to June 30 were caused by synthetic opioids, according to data from the federal government.

Advocates for the Oregon legislation argue that it faced a combination of significant factors, such as the COVID-19 pandemic, a scarcity of mental health professionals, and the surge of fentanyl-related issues. These issues did not reach their peak until the law had already been implemented in early 2021.

A delegation of legislators from Oregon recently visited Portugal, a country that has decriminalized the possession of drugs since 2001, in order to gain a better understanding of its policy. State Representative Lily Morgan, the sole Republican representative on the trip, expressed interest in Portugal’s approach but acknowledged that it may not be directly applicable to Oregon.

According to her, the most significant contrast is that they have yet to address fentanyl and meth, despite having universal health care in the country.

Contrary to popular belief, the law has shown improvement by allocating $265 million from cannabis tax earnings to establish the state’s new addiction treatment system.

The law also created what are known as Behavioral Health Resource Networks in every county, which provide care regardless of the ability to pay. The networks have ensured about 7,000 people entered treatment from January to March of this year, doubling from nearly 3,500 people from July through September 2022, state data shows.

According to Heather Jefferis, executive director of Oregon Council for Behavioral Health, the funding provided by the law has been crucial for mental health and addiction service providers. It has established a stable and reliable source of funding for services that previously lacked proper financial support.

According to Horvick, the pollster, despite resistance towards the legislation, there is still strong public support for the expansion of treatment.

Lieber, a Democratic state senator, believes that it would be counterproductive to revoke 110 at this time as it would hinder our progress. Simply getting rid of it will not resolve the issue at hand. Even without 110, we would still face major challenges.

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Geoff Mulvihill, a journalist for the Associated Press, provided additional information from Philadelphia.

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Claire Rush works as a member of the Associated Press/Report for America Statehouse News Initiative. Report for America is an organization that provides national service opportunities to journalists, placing them in local newsrooms to cover overlooked topics.