Policy Is Public Health

For nearly 20 years, I have worked with people who use injection drugs. People who use drugs like heroin and methamphetamines are often pushed to the outside of society. They lead complicated lives that many would rather just not see. But inside the overdose prevention and syringe services program I run in Portland, Oregon, we get to see the humanity of each person. The artist who brings us paintings. The person who gets supplies for his elderly neighbor. 

I’m committed to advancing policies that can make a safer, healthier world for them. 

As someone who is on the front lines of the addiction crisis, I have seen the devastating effects that criminalization has on people who use drugs. The shame of arrest and the trauma of incarceration stay with people long after they are released from jail. They are also harmful to healing. I have known people who were released from jail only to die days later of an overdose. I have friends who struggle, still, after years of sobriety, to find housing and employment because of drug charges. I have heard countless stories of people who avoid calling 911 during an overdose because of the fear of arrest. 

Criminalizing this health condition perpetuates negative attitudes about people with substance use disorders and makes it harder to implement policies to provide the care they deserve.

This is why I became one of the lead petitioners on Oregon’s Measure 110 last fall. For 20 months leading up to the election, I called on voters, secured endorsements, collected signatures, and answered questions about why Measure 110 was so important.

Measure 110 is a first-in-the-nation ballot initiative that decriminalizes the possession of small amounts of all types of substances. It moves simple possession from a criminal offense to a civil violation. This measure will also use cannabis tax revenue to fund a broad range of services, including housing, peer recovery supports, and harm reduction services for people who use drugs to help them improve their health. It is modeled after the approach taken nearly 20 years ago in Portugal, where they decriminalized possession of substances and invested in health-based interventions that resulted in a reduction in HIV cases, overdose deaths, and crimes related to substance use.  

The people of Oregon brought this measure to the ballot because addiction has touched the lives of so many. Health care organizations, racial justice organizations, labor unions, and even the Oregon Food Bank added their support. 

The way we have historically handled this health condition has proven time and again to not work. Criminalizing this health condition perpetuates negative attitudes about people with substance use disorders and makes it harder to implement policies to provide the care they deserve. Measure 110 is about treating people with dignity and respect. It will allow for people to heal from addictions by providing the supports they need to change their lives—instead of saddling them with a criminal record that can destroy their lives. 

One in 11 Oregonians have a substance use disorder, yet Oregon regularly ranks last in the country for access to addiction services. Measure 110 will help to remedy this by investing in evidence-based services that people can access whenever they need or want care. Every day in the syringe services program where I work, I have conversations with people who are using, who want to stop but can’t. I spend hours on the phone trying to find an open treatment spot or a peer support worker with space on their case load. I think of one client for whom we called different places weekly, trying to get him help. He died from an overdose while on several waitlists for care. 

On November 3, Oregonians took a brave step to try something different. They decided to find a new answer and reduce the stigma associated with substance use disorder.

This measure brings me real hope that we as a society are beginning to embrace a public health approach to substance use. People do not heal through punishment. People heal when they have the tools to be healthier, the resources and supports they need, and the belief that they can change. 

I am hopeful that Oregon can set an example that a health-focused approach is not only possible but the right approach to the disease of addiction.