What We Learned from Oregon’s New Audit of Measure 110

In 2020, Oregon voters put a lot of stock in Measure 110 — the groundbreaking citizen initiative that made the state the first in the nation to decriminalize user amounts of drugs. The decriminalization portion of Measure 110 was rolled back by the legislature in 2024 — but the part of Measure 110 that took cannabis revenue and turned it into drug treatment dollars remained.

Since then, the Oregon Secretary of State’s Audits Division has done three audits of the program, with some of the same problems emerging each time. Among other issues, auditors allege that frequent tinkering by the legislature and the Oregon Health Authority are making success hard to achieve.

“For a problem that is decades in the making, it will likely take decades of intentional effort to correct,” auditors wrote. “Instead, the pattern of annual revisions has undermined confidence in the program’s direction and hindered the development of long-term strategies.”

Each audit has uncovered challenges at OHA around a lack of overall strategy, inadequate data around the effectiveness of treatment programs, and — an issue since resolved — around an ineffective hotline that wasted taxpayers’ money. The most recent audit, released in December, also criticized frequently changing laws at the legislative level and inconsistent rules among counties’ deflection programs — the program put in place in 2024 to direct people into treatment rather than jail for drug offenses.

OHA agreed with three of the audit’s recommendations, saying it has already put a project management structure in place, as well as new data collection programs. It disagreed with three other recommendations, mostly around retrospective data collection. While it’s fair for auditors to want numbers that show whether a program is working, this particular program went into effect during the pandemic, OHA reminded auditors, which makes them impossible years to use to compare trends.

In its quest to end its reputation as one of the worst-performing states when it comes to drug treatment, Oregon leaders are rightly evaluating the process and tinkering with the recipe. Too much money is on the line — and too many lives, especially in the age of fentanyl — to do anything else. But it’s a complicated process, involves a massive state agency, legislators, behavioral health professionals, and law enforcement officials from every corner of the state, among others.

The audit is a deep read about the state of state-sponsored drug treatment — but here are some key takeaways.

-The pandemic years messed up data. We don’t have good baseline data about overdoses, drug treatment and more for the years 2019-2023, and that means we can’t adequately assess how the state did on its goals for those years. If auditors want to be able to compare treatment rates over time to assess the efficacy of the program, for better or worse, they’ll have to start with the year 2024, OHA said. Not helpful, but that seems like it’s the reality.

Measure 110 was more than just legalizing drugs. A big part of it was ensuring access to treatment for a state that experiences among the highest rates of substance use disorders in the nation.

-A patchwork of enforcement and participation on deflection programs across Oregon counties offers the opposite of justice — especially when cops and district attorneys have discretion about who to send to deflection. When legislators in 2024 changed the laws so that people could “deflect” into a treatment program rather than the courts after a drug possession charge, they gave counties “local control” about whether (and how) to implement deflection. That sounded like a way to appease more conservative counties — but with some counties not doing deflection at all, it’s resulting in an uneven form of justice. People aren’t getting equal treatment in one county compared to another, and given that a major thrust of Measure 110 was to address racial disparities in policing, that’s not OK.

-Frequent changes in leadership and legislation can be difficult for a large agency – that works in two-year budget cycles – to adapt to… but change in the program is still needed. While the Secretary of State’s audit warned that frequent changes in legislation or programs could lead to failure, there’s no getting around the fact that things need tinkering. Specifically, changes need to happen to better align the various counties around the notion of deflection — and cops need more training about how to handle deflection cases.

Measure 110 was more than just legalizing drugs. A big part of it was ensuring access to treatment for a state that experiences among the highest rates of substance use disorders in the nation.

While the recent audit doesn’t paint a rosy picture of how we’re doing, it does point to the fact that Oregon’s leadership isn’t giving up on the effort. Asking hard questions and demanding better results is the only way out of this mess.

This article appears in the Source January 1, 2026.