{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T15:12:08Z","timestamp":1793718728690,"version":"4.6.1"},"reference-count":38,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Psychiatry"],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:sec id=\"ab-yoi230072-4\"><jats:title>Importance<\/jats:title><jats:p>Two states modified laws to remove or substantially reduce criminal penalties for any drug possession. The hypothesis was that removing criminal penalties for drug possession may reduce fatal drug overdoses due to reduced incarceration and increased calls for help at the scene of an overdose.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi230072-5\"><jats:title>Objective<\/jats:title><jats:p>To evaluate whether decriminalization of drug possession in Oregon and Washington was associated with changes in either direction in fatal drug overdose rates.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi230072-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This cohort study used a synthetic control method approach to examine whether there were changes in drug possession laws and fatal drug overdose rates in Oregon and Washington in the postpolicy period (February 1, 2021, to March 31, 2022, in Oregon and March 1, 2021, to March 31, 2022, in Washington). A counterfactual comparison group (synthetic controls) was created for Oregon and Washington, using 48 states and the District of Columbia, that did not implement similar policies during the study period (January 1, 2018, to March 31, 2022). For 2018-2021, final multiple cause-of-death data from the National Vital Statistics System (NVSS) were used. For 2022, provisional NVSS data were used. Drug overdose deaths were identified using <jats:italic>International Statistical Classification of Diseases and Related Health Problems, 10th Revision<\/jats:italic> underlying cause-of-death codes X40-X44, X60-X64, X85, and Y10-Y14.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi230072-7\"><jats:title>Exposures<\/jats:title><jats:p>In Oregon, Measure 110 went into effect on February 1, 2021. In Washington, the Washington Supreme Court decision in <jats:italic>State v Blake<\/jats:italic> occurred on February 25, 2021.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi230072-8\"><jats:title>Main Outcome<\/jats:title><jats:p>Monthly fatal drug overdose rates.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi230072-9\"><jats:title>Results<\/jats:title><jats:p>Following the implementation of Measure 110, absolute monthly rate differences between Oregon and its synthetic control were not statistically significant (probability\u2009=\u20090.26). The average rate difference post Measure 110 was 0.268 fatal drug overdoses per 100\u202f000 state population. Following the implementation of the policy change in Washington, the absolute monthly rate differences between Washington and synthetic Washington were not statistically significant (probability\u2009=\u20090.06). The average rate difference post <jats:italic>Blake<\/jats:italic> was 0.112 fatal drug overdoses per 100\u202f000 state population.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi230072-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>This study found no evidence of an association between legal changes that removed or substantially reduced criminal penalties for drug possession in Oregon and Washington and fatal drug overdose rates. Additional research could examine potential other outcomes as well as longer-term associations with fatal drug overdose overall and across racial and ethnic groups.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamapsychiatry.2023.3416","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T15:34:44Z","timestamp":1695828884000},"page":"1277","source":"Crossref","is-referenced-by-count":23,"title":["One-Year Association of Drug Possession Law Change With Fatal Drug Overdose in Oregon and Washington"],"prefix":"10.1001","volume":"80","author":[{"given":"Spruha","family":"Joshi","sequence":"first","affiliation":[{"name":"Department of Population Health, New York University Grossman School of Medicine, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca D.","family":"Rivera","sequence":"additional","affiliation":[{"name":"Department of Population Health, New York University Grossman School of Medicine, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Cerd\u00e1","sequence":"additional","affiliation":[{"name":"Department of Population Health, New York University Grossman School of Medicine, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Gery P.","family":"Guy","sequence":"additional","affiliation":[{"name":"Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Strahan","sequence":"additional","affiliation":[{"name":"Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haven","family":"Wheelock","sequence":"additional","affiliation":[{"name":"Outside In, Portland, Oregon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corey S.","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Population Health, New York University Grossman School of Medicine, New York"},{"name":"Network for Public Health Law, Edina, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"key":"yoi230072r3","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2022.109425","article-title":"Legality of drug checking equipment in the United States: a systematic legal analysis.","volume":"234","author":"Davis","year":"2022","journal-title":"Drug Alcohol Depend"},{"issue":"10","key":"yoi230072r4","doi-asserted-by":"publisher","first-page":"1783","DOI":"10.1093\/aje\/kwac122","article-title":"Use of an inverted synthetic control method to estimate effects of recent drug overdose Good Samaritan laws, overall and by Black\/White race\/ethnicity.","volume":"191","author":"Townsend","year":"2022","journal-title":"Am J Epidemiol"},{"issue":"1","key":"yoi230072r5","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1111\/add.v116.1","article-title":"Systematic review of the emerging literature on the effectiveness of naloxone access laws in the United States.","volume":"116","author":"Smart","year":"2021","journal-title":"Addiction"},{"issue":"2","key":"yoi230072r6","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.36687","article-title":"Systematic evaluation of state policy interventions targeting the US opioid epidemic, 2007-2018.","volume":"4","author":"Lee","year":"2021","journal-title":"JAMA Netw Open"},{"key":"yoi230072r7","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2020.102769","article-title":"Tackling the overdose crisis: the role of safe supply.","volume":"80","author":"Ivsins","year":"2020","journal-title":"Int J Drug Policy"},{"issue":"5","key":"yoi230072r8","doi-asserted-by":"publisher","first-page":"556","DOI":"10.15288\/jsad.2020.81.556","article-title":"Addressing the syndemic of HIV, hepatitis C, overdose, and COVID-19 among people who use drugs: the potential roles for decriminalization and safe supply.","volume":"81","author":"Bonn","year":"2020","journal-title":"J Stud Alcohol Drugs"},{"key":"yoi230072r9","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.drugpo.2017.09.010","article-title":"\u201cCaught with a body\u201d yet protected by law? 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Too early to tell: the challenging implementation of Measure 110 has increased risks, but the effectiveness of the program has yet to be determined. January 2023. Accessed July 31, 2023. https:\/\/sos.oregon.gov\/audits\/Documents\/2023-03.pdf"},{"key":"yoi230072r34","unstructured":"Measure 110 Behavioral Health Resource Network (BHRN) dashboard. July 17, 2023. Accessed February 3, 2023. https:\/\/app.powerbigov.us\/view"},{"key":"yoi230072r35","unstructured":"Oregon Health Authority. Drug Addiction Treatment and Recovery Act (Measure 110): behavioral health services: state of Oregon. Accessed February 3, 2023. https:\/\/www.oregon.gov\/oha\/hsd\/amh\/pages\/measure110.aspx"},{"key":"yoi230072r36","unstructured":"Office of the State Public Health Director. Measure 110 (M110) Behavioral Health Resource Network (BHRN) BHRN partner onboarding: frequently asked questions (FAQ). November 29, 2022. 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