Background. In 2020, the state of Oregon, USA, passed two major drug policies: decriminalizing possession of small amounts of illicit drugs while increasing behavioral health resources and legalizing the facilitated use of psilocybin.
Objectives. We examined multiple public health data systems to assess associations between policy changes and drug-related health outcomes for Oregon and other states.
Methods. We assessed monthly counts of Oregon drug-related hospitalizations, emergency department (ED) visits, poison center cases, and deaths over an up to 13-year period, including 2 years after policy changes. Outcomes were defined by drug group (stimulants, depressants, psychedelics, alcohol) and specific drug (e.g., fentanyl, psilocybin). We used Joinpoint software to identify breaks in trend. When possible, we disaggregated data for specific populations (e.g., by gender, age group, race/ethnicity, and region) and compared outcomes for 2 years pre- and post-policy. We compared Oregon Poison Center trends to those of other Western states.
Results. Poison center data indicate significant increases in fentanyl exposures in Oregon during 2021-2023. Although coinciding with the spread of fentanyl to the Western US, these Oregon increases are greater than in most surrounding states. However, hospitalization, ED, and death outcomes for opioids and fentanyl show less extreme increases. Oregon psilocybin cases increased before the start of facilitated use; other states showed increases too.
Implications. Our findings show the importance of examining outcomes from complementary data systems and comparison to other jurisdictions. Longer-term study is needed to understand full policy effects.