American voters have turned against liberalized drug policy—an understandable reaction to the experience of West Coast states and cities, which recently tried approaching fentanyl use and drug dealing as rights to be respected. Places like Oregon and San Francisco quickly reversed course in the face of rising suffering and public opposition. But what are the lessons to draw from the past half-decade’s radical shifts and reversals in drug and crime policy in the Pacific Northwest?
As I explain in a new Brookings Institute white paper, the experiment began in 2020. Well-funded activists persuaded policymakers and the public that even flagrant drug dealing and open drug use were inappropriate targets for police intervention. Voters also rejected pressuring addicted people to seek treatment in favor of an exclusively harm-reduction approach.
Enforcement plummeted. From 2020 to 2022, arrests for drug possession dropped by 68 percent in Oregon and 90 percent in Washington. Arrests for distribution fell by 42 percent and 30 percent in the same states over that period. San Francisco’s District Attorney Chesa Boudin, a leading proponent of the new policy approach, did not convict a single person of fentanyl dealing in 2021—a year when more than 500 San Franciscans died of drug overdoses.
If you wanted to use or deal hard drugs free of any constraints, there was no better place to be in these years than the Pacific Northwest. And in the eyes of the individualistic libertarian-left activists, this drug-friendliness was a success.
Residents of the region were not so delighted. From 2020 to 2022, property crime rose 10 percent in Oregon, 23 percent in Washington, and 33 percent in San Francisco. It was flat in the rest of country. Violent crime rose 17 percent in Oregon, 28 percent in Washington, and 17 percent in San Francisco, while declining 5 percent nationally. Portland, which slashed its police budget, set records for homicides in 2021 and 2022.
Pacific Northwest drug-policy reformers claimed that decriminalizing and destigmatizing drug use would lead more users to seek treatment, and that drug overdoses would fall. In fact, treatment utilization was flat. And overdose fatalities in Oregon and Washington grew at 40 times the national rate in the year ending October 2023.
As death and disorder mounted throughout the region, leading figures in the reform movement were swiftly ejected from office. Some, like San Francisco’s Boudin, went out unrepentant. Others, like Portland DA Mike Schmidt and San Francisco mayor London Breed, renounced their drug-tolerant, anti-cop views in desperate, unsuccessful efforts at reelection. State legislators in Oregon and Washington reversed their decriminalization policies by huge margins, putting more money into drug treatment and reestablishing the law as a mechanism to encourage its utilization.
Politicians nationwide have noted that even the most left-wing parts of the country could not tolerate laissez faire drug policy for long. But health-oriented approaches to drug problems remain popular where they are not lumbered with extremist politics. Evidence-based tools like distributing naloxone are practiced around the country. Treatment and recovery enjoy broad bipartisan support, not least because tens of millions of Americans love someone who is addicted.
Compassionate drug policy is politically possible—but it will prove successful only if we appreciate the critical lessons of the Northwest’s experience.
First, drug addiction is indeed a health problem, but it is not one like hypertension or migraines, which inflict harm mainly on the person who experiences them. The external consequences of drug addiction—violence, divorce, unemployment, and child abuse—are substantial. Too many activists dismiss such concerns.
Second, drug addiction is also not like cancer, chronic pain, or PTSD—health problems that the sufferer is desperate to get treated. As damaging as drugs like fentanyl and meth are, in the short-term using them feels good. Addicted people are thus often ambivalent about entering recovery and giving up drugs.
Consider: Oregon handed out tickets to people using drugs in public but waived them if the person called a toll-free number to get a possible referral to free addiction treatment. Over 90 percent of the tickets were thrown away; of the few people who called, almost none received addiction treatment, because they felt no pressure to do so. Such urging from family, friends, employers, and the legal system is a social good that we must maintain.
Third, drug-reform activists need to listen more to the poor and working-class communities that experience the bulk of crime and disorder associated with drugs. In the name of racial justice, college-educated, overwhelmingly white progressives pushed drug policies that proved harmful to and unpopular with most residents of these neighborhoods. Listening to communities means taking seriously parents who have to walk their child to school through an open drug scene, shopkeepers whose stores are robbed every day, and elderly couples afraid to walk the streets at night.
Finally, policymakers should not underestimate drug-policy activists’ ideological zeal. To sell voters on Oregon’s Measure 110, which took effect in 2021, proponents claimed that funding would support treatment and recovery. When almost all of the measure’s money went instead to harm-reduction programs, activists endorsed this as the true goal. As recently as last December, Oregon governor Tina Kotek recommended that funds from the huge settlement against opioid manufacturers be 100 percent allocated to harm reduction, with nothing for law enforcement, treatment, or prevention. Similarly, San Francisco spent more than $20 million on a center promised to link people with addiction treatment. Instead, its operator set up a supervised drug-consumption site. Smart policymakers need to be mindful of who staffs drug-related services; payment should be structured such that providers go out of business if they’re not committed to public health and safety.
Sensible drug policy has four pillars: law enforcement, prevention, harm reduction, and treatment and recovery. Much as the War on Drugs exposed the limits of an overly enforcement-focused approach, the experience of the Pacific Northwest illustrated the costs of a solely harm reduction-focused strategy. The best policy recognizes the value of all four pillars, coupled with a hardheaded appraisal of the reality of addiction and the limits of ideologically led, evidence-free policy.
Top Photo by PATRICK T. FALLON/AFP via Getty Images
