Oregon — A December 2025 audit by the Oregon Secretary of State concludes that Measure 110 has not consistently delivered on its goal of replacing criminal penalties for drug possession with a coordinated public health approach to addiction.
Auditors identified four core weaknesses undermining the program’s effectiveness: unstable governance, poor integration with Oregon’s broader behavioral health system, major data limitations, and inconsistent use of deflection programs across counties. Together, these issues prevent the state from clearly determining whether Measure 110 funding has reduced overdoses, expanded treatment access, or improved long-term recovery outcomes.
Since voter approval in 2020, Measure 110 has undergone repeated legislative changes, including recriminalization of drug possession in 2024 and a restructuring of grant authority beginning in 2026. The audit found that frequent leadership turnover and shifting statutory direction contributed to unclear accountability and inconsistent grant oversight within the Oregon Health Authority.
The report also found that Measure 110 services operate largely parallel to, rather than integrated with, Medicaid and other state-funded behavioral health systems. This fragmentation weakens continuity of care and increases risk to people with substance use disorders, particularly as Oregon faces potential reductions in federal Medicaid funding.
Data shortcomings remain a central concern. Auditors concluded the state lacks reliable, complete data needed to determine whether overdose deaths declined, whether access to treatment and housing improved, or whether services reached communities most impacted by the war on drugs. Without consistent data collection and outcome tracking, the effectiveness of hundreds of millions of dollars in program investments cannot be verified.
County-level variation in deflection programs further limits equity and access. Some counties offer pathways that connect people to treatment instead of jail, while others lack deflection options entirely. The audit found this patchwork approach results in unequal outcomes for Oregonians based on where they live.
The Secretary of State issued six recommendations aimed at stabilizing and strengthening the program, including establishing a clear implementation roadmap, standardizing data reporting, setting baseline performance measures, and publishing annual outcome reports. State officials agreed with some recommendations but raised concerns about scope, budget, and technical barriers to full implementation.
The audit concludes that without sustained improvements in governance, integration, accountability, and data quality, Measure 110 is unlikely to fulfill the public-health-centered addiction response envisioned by Oregon voters.
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