By Michael J. Zoorob,; Ju Nyeong Park,; Alex H. Kral,; et al

Importance: With the implementation of Measure 110 (M110) in 2021, Oregon became the first US state to decriminalize small amounts of any drug for personal use. To date, no analysis of the association of this law with overdose mortality has fully accounted for the introduction of fentanyl-a substance that is known to drive fatal overdose-to Oregon's unregulated drug market.

Objective: To evaluate whether the decriminalization of drug possession in Oregon was associated with changes in fatal drug overdose rates after accounting for the rapid spread of fentanyl in Oregon's unregulated drug market.

Design, setting, and participants: In this cohort study, the association between fatal overdose and enactment of M110 was analyzed using a matrix completion synthetic control method. The control group consisted of the 48 US states and Washington, DC, all of which did not decriminalize drugs. The rapid spread of fentanyl in unregulated drug markets was determined using the state-level percentage of all samples reported to the National Forensic Laboratory Information System that were identified as fentanyl or its analogues. Mortality data were obtained from the Centers for Disease Control and Prevention for January 1, 2008, to December 31, 2022. Data analysis was performed from fall 2023 through spring 2024.

Exposures: Measure 110 took effect in Oregon on February 1, 2021.

Main outcomes and measures: The primary outcome assessed was fatal drug overdose rates per half-year. A changepoint analysis also determined when each state experienced a rapid escalation of fentanyl in its unregulated drug market.

Results: In this analysis, rapid spread of fentanyl in Oregon's unregulated drug supply occurred in the first half of 2021, contemporaneous with enactment of M110. A positive crude association was found between drug decriminalization and fatal overdose rate per 100 000 per half year (estimate [SE], 1.83 [0.47]; P < .001). After adjusting for the spread of fentanyl as a confounder, the effect size changed signs (estimate [SE], -0.51 [0.61]; P = .41) and there was no longer an association between decriminalization and overdose mortality in Oregon. Sensitivity analyses were consistent with this result.

Conclusions and relevance: In this cohort study of fatal drug overdose and the spread of fentanyl through Oregon's unregulated drug market, no association between M110 and fatal overdose rates was observed. Future evaluations of the health effects of drug policies should account for changes in the composition of unregulated drug markets.  

JAMA Netw Open. 2024;7(9):e2431612. doi:10.1001/jamanetworkopen.2024.31612

By Drug Policy Alliance

In 2020, Oregon voters overwhelmingly approved Ballot Measure 110. This made Oregon the first state in the U.S. to decriminalize possession of small amounts of all drugs, while greatly expanding addiction services and social supports. But in 2024, state leaders recriminalized drug possession after a disinformation campaign led by drug war defenders and backed by corporate interests. Statewide criminal penalties for drug possession returned on September 1, 2024. Promised deflection programs were not ready, meaning people will be arrested and prosecuted because of their addictions. As before, drug use will be used as an excuse to arrest Black and Brown Oregonians at higher rates (they are statistically more likely to face incarceration and harsher sentencing due to targeted policing and enforcement). Oregon’s public defender shortage continues. People who are arrested will likely have their cases dismissed for lack of counsel. In a return to the failed war on drugs, people will cycle through the criminal legal system without connection to services. The successes of Measure 110 should neither be downplayed nor contributed to H.B. 4002. Measure 110 provided over $300 million for addiction services, including a program where police connect people to care without arrest. Policymakers must focus on implementing a thorough public health approach to drugs and real solutions to other pressing issues, not on the false promises of criminalizing drug possession.

New York: Drug Policy Alliance, 2024. 5p.

By Andy Hochstetler1,2, David J. Peters1, Kyle Burgason1, Jeff Bouffard1, Glenn Sterner III3, Shannon Monnat

Introduction: The goal of this project was to identify rural jurisdictions with high drug overdose rates and collaborate with resourced mentors to create law enforcement intelligence responses to local opioid problems. Methods: The first part of the strategy was to control for known contributors to opioid death that are largely beyond the control of law enforcement, and thereby focus on jurisdictions that are outliers in terms of drug problems. (Work products include a Non-Metropolitan County Opioid Overdose Calculator that allows one to examine how demographics and other county conditions affect overdose risk.) Use of maps of drug overdose deaths identified high overdose places by drug type with a classification technique to group places with like drug problems (latent profile analysis) and a multiple regression data analysis to identify outliers. A survey of law enforcement agencies provided an understanding of intelligence resources available in rural areas and agencies. This information informed recruitment of enthusiastic participant agencies. A small scale, intelligence strategy appropriate to resource deprived, rural departments was developed in collaboration with participating agencies, leaving them great flexibility in design. Evaluation of outcomes included a survey, qualitative interviews providing anecdotal feedback, and official data that each department had decided would speak to successful implementation. Conclusions: Variables significantly predicting death rates include population, indicators of ethnic diversity, natural resource amenities, and labor market characteristics. Lagged indicators of drug deaths and prescribing rates are the most consistently significant and convincing block of variables as predictors of current death. The most successful departments implemented efforts based on what they had learned in previous collaborations with better resourced areas, where efforts led to arrests and judges supported use of intelligence in court proceedings, and either information sharing or use of electronic surveillance was supported such as using cell phone opening software. Also, closed network iPads were used in relation to controlled buys, search warrants, pre and post raids, evidence and picture recording during searches, overdose mapping, surveillance photos and messaging to the narcotics officer, confidential informant files and referencing files, and notes from scenes. ODMAP can inform efforts but proved difficult to use on mobile devices, lagging in time, and imprecise to use as daily actionable intelligence. Funds can be well spent in rural places, but investments in departments with little resource slack, lacking in administrative capacity, and where there are few personnel or hours of investment to spare are risky and make for difficult collaborations. Analytics and predictive problem solving are near impossible. Therefore, immediate and accessible intelligence for patrol officers without investment in analytics likely should be the goal.

Ames, IA: Iowa State University, 2023. 71p.

By Yanwen Wang, Jacquelyn Gilbreath , Lynne Mock

While drug crime-related criminal legal system and victim costs reached $113 billion across the United States in 2007, just $14.6 billion was spent on treating substance use disorder (National Institute on Drug Abuse, 2014). Due, in part, to drug crimes, many U.S. citizens are under correctional supervision, with 1 in 66 adults being on probation or parole in 2020 (Bureau of Justice Statistics, 2021). In Illinois, 67,587 individuals were on probation in 2020 (Administrative Offices of the Illinois Courts, 2021) and 26,426 were on parole (Illinois Department of Corrections, 2020). The supervision population rate of substance use is estimated to be two to three times higher than that of the general population, with nearly half of the people under community supervision having a substance use disorder (PEW Charitable Trusts, 2018). The Illinois Criminal Justice Information Authority’s Adult Redeploy Illinois (ARI) program was established by the Crime Reduction Act of 2009 to provide financial incentives to local jurisdictions for programs that divert justice-involved individuals from state prisons by providing community-based supervision and individualized services. While researchers have evaluated ARI, models used in some jurisdictions (DeLong & Reichert, 2016; Kroner, et al., 2021; Mock et al., 2017; Reichert et al., 2016), research on ARI client outcomes related to the impact of drug testing is limited. The research goals for this study included: • Quantitatively examining all local ARI program drug test data, including tested drugs, drug test frequencies, and drug test results. • Systematically examining how ARI drug testing contributes to the possibility of revocation including other factors such as age, sex, and race. • Proposing recommendations for better program practice to reduce the rate of revocation. This study sought to answer the following research questions: 1. How is drug testing being practiced and observed in ARI in terms of its frequency, pass rates, and tested drugs? 2. Does drug testing have a significant impact on ARI participant outcomes when controlling for demographic variables? The study included 53,159 records of 1,055 individuals collected from October 3, 2011, to June 20, 2019. The median number of drug tests per individual was 19, and the median of the average days between drug tests was 10 days. The most frequently tested drugs also had the highest positive results: heroin (32%), marijuana/THC (30%), cocaine/crack (14%), alcohol (10%), and other opiates (8%). Logistic regression analyses were used to determine what demographic, drug testing, and criminal justice variables predicted program outcomes of completion or revocation. Among the demographic variables, only age predicted program outcomes. Neither sex nor race emerged as significant program outcome predictors. Drug test positivity rates predicted revocation, as well as drug test frequency (number of times an individual was tested) and average number of days between the drug tests. i Overall, the average drug positivity rate was 29% and most tests were passed with no drug found. Most successful clients who were older women at medium to medium-high recidivism risk and whom tested monthly with lower test positivity rates. Those most likely to experience program revocation were younger men who tested several times per month with higher test positivity rates during their program tenure. Graphing the programs by test positivity, number of tests, and frequency of tests suggests that individuals enrolled in some programs had higher test positivity rates (>50%) and were subject to less frequent drug tests than other programs. This study focuses on drug test outcomes, however, it also would be worth exploring data on drug testing rewards, sanctions, and requirements for program completion and their impacts on program outcomes.   

Chicago:  Illinois Criminal Justice Information Authority., 2022. 33p 

By Meghan M. O'Neil and Peter Leasure

This study explored, among persons undergoing drug treatment, whether one’s likelihood of possessing any felony charge differed depending upon their primary drug of choice. The results showed that individuals in drug treatment who reported cocaine or heroin/opioids as their primary drug of choice had significantly higher probabilities of having a felony charge than those who reported alcohol as their primary drug of choice.

Ohio State Legal Studies Research Paper No. 878,

By Mark McMullen

Although it is particularly pronounced in Oregon, there is no question that the fentanyl epidemic is imposing severe economic costs across the nation. The current report quantifies some of these costs and describes the state policy environment. Public policy regarding drug use is evolving rapidly in Oregon as we speak. As with all CSI does, the primary goal of this report is to educate and inform Oregonians on policy issues such as this that impact their lives. Key Findings • The economic cost of Oregon’s fentanyl crisis is more than $31 billion annually, up from $5.88 billion in 2017. • Enough fentanyl was seized last year to kill every Oregonian more than 20 times over. • Most western states have seen above-average growth in fentanyl use during recent years. Even so, Oregon’s experience stands out relative to its neighbors. Since the pandemic began, fentanyl-related overdose deaths in Oregon have increased by over 1,000%, more than in any other state. Alaska’s experience is the only one that even comes close. • Although Oregon’s decriminalization experiment cannot be blamed for all the disproportionate local impact of the fentanyl epidemic, it is clearly playing a role. When decriminalization went into effect in February 2021, Oregon ranked 38th out of 48 states with available data in the rate of fentanyl related overdose deaths. By January 2024, Oregon’s rank rose to 13th. • Many voters and policymakers quickly experienced regrets associated with the decriminalization effort and are making some efforts to improve the law. During the 2023 legislative session, legislators enacted House Bill 4002, which created a new misdemeanor for simple drug possession. The new law gives leeway to counties on how to implement it locally, and we are likely to learn much as the different programs evolve.

Greenwood Village, CO: Common  Sense Institute 2024. 

By Michael J. Zoorob, ; Ju Nyeong Park, ; Alex H. Kral,  et alBarrot H. Lambdin, PhD3; Brandon del Pozo, PhD, MPA, MA1,2

IMPORTANCE-  With the implementation of Measure 110 (M110) in 2021, Oregon became the first US state to decriminalize small amounts of any drug for personal use. To date, no analysis of the association of this law with overdose mortality has fully accounted for the introduction of fentanyl—a substance that is known to drive fatal overdose—to Oregon’s unregulated drug market. OBJECTIVE -  To evaluate whether the decriminalization of drug possession in Oregon was associated with changes in fatal drug overdose rates after accounting for the rapid spread of fentanyl in Oregon’s unregulated drug market. DESIGN, SETTING, AND PARTICIPANTS In this cohort study, the association between fatal overdose and enactment of M110 was analyzed using a matrix completion synthetic control method. The control group consisted of the 48 US states and Washington, DC, all of which did not decriminalize drugs. The rapid spread of fentanyl in unregulated drug markets was determined using the state-level percentage of all samples reported to the National Forensic Laboratory Information System that were identified as fentanyl or its analogues. Mortality data were obtained from the Centers for Disease Control and Prevention for January 1, 2008, to December 31, 2022. Data analysis was performed from fall 2023 through spring 2024. EXPOSURES Measure 110 took effect in Oregon on February 1, 2021. MAIN OUTCOMES AND MEASURES The primary outcome assessed was fatal drug overdose rates per half-year. A changepoint analysis also determined when each state experienced a rapid escalation of fentanyl in its unregulated drug market. RESULTS In this analysis, rapid spread of fentanyl in Oregon’s unregulated drug supply occurred in the first half of 2021, contemporaneous with enactment of M110. A positive crude association was found between drug decriminalization and fatal overdose rate per 100 000 per half year (estimate [SE], 1.83 [0.47]; P < .001). After adjusting for the spread of fentanyl as a confounder, the effect size changed signs (estimate [SE], −0.51 [0.61]; P = .41) and there was no longer an association between decriminalization and overdose mortality in Oregon. Sensitivity analyses were consistent with this result. CONCLUSIONS AND RELEVANCE In this cohort study of fatal drug overdose and the spread of fentanyl through Oregon’s unregulated drug market, no association between M110 and fatal overdose rates was observed. Future evaluations of the health effects of drug policies should account for changes in the composition of unregulated drug markets.

  JAMA Netw Open. 2024;7(9):e2431612. doi:10.1001/jamanetworkopen.2024.3161

By Guadalupe Correa-Cabrera, Charles Lewis and William Yaworsky

This article explains some of the mechanisms through which corruption by high-level Mexican politicians and other organized crime members is facilitated in the United States through money laundering operations. The analysis is based on information contained in court records related to key money laundering cases, as well as in news articles and reports from law enforcement agencies. These materials highlight the interrelationships among U.S. drug use, cartel activities in Mexico, human rights abuses, Mexican political corruption, and money laundering in the United States. This work demonstrates the pervasive use of legitimate businesses and fronts in the United States as a disguise for criminal activity. Finally, it provides recommendations for a reformation of policies and penalties directed toward U.S. institutions and persons that facilitate money laundering.

Journal of Illicit Economies and Development, 6(1): pp. 64–78. 2024