Introduction- This research evaluates whether the January, 2021 decriminalization of drug possession in Oregon was associated with changes in fatal drug overdose rates after accounting for the timing and spread of fentanyl through Oregon’s unregulated drug market, a substance known to drive fatal overdose rates.
Methods- The association between fatal drug overdose and enactment of M110 in Oregon was analyzed using a matrix completion synthetic control method imputed from 48 US states and Washington DC. The rapid escalation 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 analogs. A changepoint analysis was used to determine when each state experienced a rapid escalation of fentanyl in its unregulated drug market. Mortality data were obtained from the Centers for Disease Control and Prevention from 2008-2022.
Results- Analysis indicated a rapid escalation of fentanyl in Oregon’s unregulated drug supply occurred in the first half of 2021, contemporaneous with the enactment of M110. The crude association between decriminalization and fatal overdose rate per 100,000 per half-year was significant (Tau = 1.83; SE = 0.39; p < 0.001); however, adjusting for the rapid escalation of fentanyl as a confounder, the effect of drug decriminalization on overdose mortality in Oregon was null (Tau = -0.51; SE = 0.36).
Conclusions- Future evaluations of drug policies should account for confounding changes in the composition and potency of unregulated drug markets.
Brandon del Pozo, PhD, MPA, MA conducts NIH-funded research at the intersection of public health, public safety, and justice, focusing on substance use, the overdose crisis, and violence.
Prior to research, Dr. del Pozo served as a police officer for 23 years. Nineteen were spent in the New York City Police Department, where he started on patrol in East Flatbush, Brooklyn, went on to command two patrol precincts, deploy to Amman, Jordan as an intelligence liaison, and serve in the police commissioner's office. He also spent four years as Chief of Police of Burlington, Vermont, where he directed the city's interdisciplinary response to the opioid crisis. His efforts were associated with a substantial and sustained reduction in opioid overdose deaths.
An elected member of the national Council on Criminal Justice, and a Law Enforcement Advancing Data and Science academic fellow at the National Institute of Justice, Dr. del Pozo was the 2016 recipient of the Police Executive Research Forum's Gary Hayes Award for excellence in police leadership and innovation.
His popular writing has been featured in The New York Times, Washington Post, Boston Globe, Philadelphia Inquirer, Chicago Tribune, Vital City, CNN, and the New York Daily News. Dr. del Pozo's book, The Police and the State: Security, Social Cooperation, and the Public Good, was published in December, 2022 by Cambridge University Press.
Interested in substance use epidemiology