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Oregon launches into expanded addiction treatment - with little evidence of what works

Oregon spent more than $200 million to treat substance abuse last year. An investigation by the Salem Reporter finds officials aren't sure of the results.

Rachel Alexander, Saphara Harrell

Amanda Loman/Salem Reporter

Oregon is poised to dramatically expand an addiction treatment system that already consumes millions of dollars each year with no clear results.

Oregonians passed Measure 110 last fall to take drug users out of jails and put them into clinics. That could move thousands of people into a system already clogged and lacking evidence it’s effective, an investigation by Salem Reporter found.

For years, Oregon has had among the highest rates of substance abuse in the country. Federal estimates indicate more than 332,000 Oregonians are substance abusers, based on surveys about drug and alcohol consumption. 

Alcohol abuse accounts for the bulk of that, but Oregon ranks first among states in painkiller abuse and second in methamphetamine use. 

State government spends about $236 million per year to prevent or treat substance abuse. About 63% of that is for addiction-related care through the Oregon Health Plan.

Last year, that meant some type of drug treatment for about 48,000 Oregonians. It doesn’t include the total spent by individuals or private insurers.

Yet treatment providers, state policymakers and the ballot measure’s supporters agree too many Oregonians currently battle addiction on their own and too often die before they receive the treatment they need. 

Local treatment providers and state policymakers say there’s little data gauging whether the programs work. There is virtually no tracking to see if the Oregonians who get treatment reduce or stop their drug use, improve their health or achieve other goals.

“It’s really a black mark on Oregon,” said John Fitzgerald, a licensed counselor and addiction specialist. He authored a 2019 state Criminal Justice Commission report for the Legislature about the state’s treatment system.

Of state spending on addictions, just 3% goes to preventing alcohol and drug abuse.

“Oregon has one of the worst prevention systems in the country measured by dollars spent,” said Mike Marshall, executive director of Oregon Recovers, which advocates for improving addiction treatment.