Our study will contribute to the evidence about effects of drug decriminalization policy, by assessing implementation and outcomes from Oregon?s November 2020 ballot initiative Measure 110: Drug Addiction Treatment and Recovery Act (M-110). This measure decriminalizes possession of small amounts of drugs and reduces criminal penalties for greater offenses. Possession of small amounts of drugs would no longer be a crime, but instead result in a civil penalty, with a $100 fine that can be waived by participating in a health assessment provided through M-110-established regional Addiction Recovery Centers (ARCs). This is the first such policy to be passed in the United States.
The aims of this proposed administrative supplement would build on the parent study?s data and approaches to assess implementation of substance use policies and associated outcomes, and how variability in local policies is associated with different outcomes, including in rural and urban community settings and among different population groups.
The first aim will provide a systematic description of trends in behavioral health system capacity following implementation of M-110 provisions, including time-varying local-level funding for behavioral health, availability of treatment services, and health assessments delivered.
The second aim will assess trends in delivery of public-paid substance use dependence treatment services.
The third aim will assess trends in drug- related hospitalizations and emergency department (ED) visits.
Aims 2 and 3 will describe Oregon trends, assess whether there are differences in trends for different community types (e.g., urban/rural) or for different groups of individuals (e.g., by race/ethnicity, age, gender, and income), and whether variability is explained by differences in community-level behavioral health capacity. We will address these aims using quasi-experimental methods developed in our parent study, which exploit within-state and across-time variation in local policies. Public health surveillance data for the study are in-hand from the parent grant, including hospitalization and ED data and public-paid treatment (Medicaid charge) data. Findings from this study will be critical for understanding the effects of drug decriminalization policy, and potential contribution to health equity.

Public Health Relevance

Our study will contribute to the evidence about drug decriminalization, by assessing effects of Oregon?s November 2020 ballot initiative Measure 110: Drug Addiction Treatment and Recovery Act (M-110)? the first such policy to be passed in the United States. We will provide a systematic description of 1) changes in behavioral health system capacity, following implementation of M-110 provisions; 2) detailed information on general trends in substance use dependence treatment, and whether trends are equitable among different communities and among groups of people; and 3) detailed information on general trends in drug-related hospitalizations and emergency department (ED) visits, and whether trends are equitable among different communities and among groups of people. Findings from this study will inform understanding about the effects of drug decriminalization, and potential contribution to health equity.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
3R01DA039293-05S1
Application #
10312833
Study Section
Program Officer
Kimmel, Heather L
Project Start
2015-09-15
Project End
2024-07-31
Budget Start
2020-08-01
Budget End
2021-07-31
Support Year
5
Fiscal Year
2021
Total Cost
Indirect Cost
Name
Multnomah County Health Department
Department
Type
DUNS #
030784888
City
Portland
State
OR
Country
United States
Zip Code
97204
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Dilley, Julia A; Hitchcock, Laura; McGroder, Nancy et al. (2017) Community-level policy responses to state marijuana legalization in Washington State. Int J Drug Policy 42:102-108
Smart, Rosanna; Caulkins, Jonathan P; Kilmer, Beau et al. (2017) Variation in cannabis potency and prices in a newly legal market: evidence from 30 million cannabis sales in Washington state. Addiction 112:2167-2177
Smart, Rosanna; Caulkins, Jonathan P; Kilmer, Beau et al. (2017) Response to Commentaries: new data sources for understanding cannabis markets. Addiction 112:2180-2181