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Notes -
I had originally posted this in the Friday fun thread but it turns out that it was killing the vibe in there. Not sure what I was thinking. Anyway...
Note: I will completely qualify Portugal Europe and Portland Oregon in this article because they're easy to mix up.
Is liberalism peaking in Oregon?
In 2020, the state of Oregon passed a referendum, ballot Measure 110, which decriminalized all drugs(!) with a vote of 58% in favor.
Voters in Oregon (such as myself) believed this was the path to enlightened drug policy, being informed by the revered Portugal Europe model. Tacked onto the referendum was a bit of social justice theory as well: the police would be required to document in detail the race of anyone they stopped from now on for any reason. To ensure the police weren't disproportionately harassing the 2.3% of the population that's black.
As an occasional drug enjoyer, I do find it a relief to wander the streets of Portland Oregon squirting ketamine up my nostrils like I'm a visionary tech CEO without fear of police. But in broad strokes it appears to be a disaster.
Indeed, the ensuing data was an almost perfect A/B test, the kind you'd run with no shame over which kind of font improved e-commerce site checkout conversions.
By 2023, Oregon's drug overdose rate was well outpacing the rest of the country, so much so that the police officers regularly Narcan with them and revive people splayed out in public parks. Sometimes the same person from week to week. It's true this coincides with the fentanyl epidemic, which could confound the data and have bumped up overdoses everywhere but that wouldn't explain alone why deaths have especially increased in Oregon. The timing fits M110.
https://www.axios.com/local/portland/2024/02/21/fentanyl-overdose-rate-oregon-spikes
At some point someone decided to compare notes with Portugal Europe's system. Some stark differences!
https://gooddrugpolicy.org/wp-content/uploads/2024/02/PortugalvOregon1.pdf
Briefly, Portugal Europe uses a carrot and stick model with a lot of negative incentive, whereas Oregon just kinda writes a $100 ticket and suggests calling a hotline for your raging drug problem maybe.
In the first 15 months after Measure 110 took effect, state auditors found, only 119 people called the state’s 24-hour hotline. That meant the cost of operating the hotline amounted to roughly $7,000 per call. The total number of callers as of early December of last year had only amounted to 943.
The absence of stick appears to not be very effective in encouraging users to seek treatment.
Are the kids having fun at least? https://www.nytimes.com/2023/07/31/health/portland-oregon-drugs.html (paywall bypass: https://archive.ph/fHxWk)
That's the brightest part of the article. The rest is pretty depressing and sad and sickening and worrisome.
After a few years of this, the Oregon legislature yesterday finished voting to re-criminalize drugs.
The NYT again https://www.nytimes.com/2024/03/01/us/oregon-drug-decriminalization-rollback-measure-110.html (paywall bypass: https://archive.ph/3zksH)
The governor has indicated that she would sign.
Critics are out in force, arguing that the legislature overrode the will of voters (remember it was passed by referendum) and that the state sabotaged the program by not efficiently distributing treatment resources to addicts. This poster believes the low uptake and missing negative incentives prove that drug harm reduction is not primarily about access to treatment, but about incentive not to use. I do sympathize that better public services and addiction resources that people actually trusted would help, but fentanyl complicates the situation substantially. People need to hit bottom before they seek help (or so goes the popular saying) but fentanyl is so potent and unpredictable that they're dying of an unexpected OD before they find themselves at bottom, ready to seek change.
Frankly, I'm surprised Oregon repealed this so quickly. Has liberalism peaked in Oregon?
As someone who voted for the referendum back in 2020, I'm a little sad that some of the overdose deaths are on my hands. Kind of. Like 1 millionth of the overdose deaths perhaps. It's good to run experiments though, right? This was a pretty good experiment. We at least have an upper bound on how liberal a drug policy we should pursue.
I believe this shows Oregon is not quite as ideologically liberal as previously led to believe. Or, at least, not anymore.
Object level conversation already lengthy below, but want to take this in a tangent... about this reverse moral proscriptive perspective of government. It's not quite horseshoe theory because it inverts around pure liberalism.
On the one side, you have this idea that the government can prohibit or regulate certain behaviors. Rules against drugs, prostitution, gambling, buying alcohol on Sundays, etc. have traditionally existed within a concept of appropriate government power. These things may be associated with social conservatism, but more broadly the whole range of government's regulatory power is not broadly understoods as allowed only narrowly through a liberal perspective but as a (varyingly constrained) right of the democratic government to govern.
In the middle you've got a liberal ethos, where we should be maximizing personal freedom, only intervening where it threaten's another's freedom. Here most government regulation would be understood as only justified through protecting freedoms.
But then you get to the other side where you allow behaviors but demand socialized payments for the costs of those behaviors. Here the idea is flipped from the right to regulate to the obligation to provide additional services. Instead of saying, 'hey you can't gamble" to the gambler, we say, "hey, you have to subsidize the externalities of his gambling" to his neighbor. The druggy has the right to drugulate, but I don't have a right to not pay for the addict's access to hotlines, resources, etc (let alone the costs I have to pay for the infrastructural externalities).
I'm struggling to find the right words to describe this framework, but it's definitely a phenomenon.
And I want to add that very rarely would any individual be maximally inside one of these three frameworks across their political beliefs, but rather it's about the proportion and scope. All forms of general welfare do exist inside of this third frame, but it's traditionally seen as something to be limited and something that ideally comes from true disadvantage and need, not as a ballooning response to greasing self-destructive 'freedoms'.
To go full circle:
I completely disagree, and this is a runaway bad idea. If you want to make something legal / unregulated, then it stops being the government's job to prop it up against it's bad effects. Leave that to charity and NGOs.
If drugs are illegal, then I'm all for also pouring tons of money into helping people who use them. I'm all for a flexible justice system that can substitute help and supervised second chances for punishment and imprisonment. But if drugs are legal, then suck it up and use your freedoms responsibly. Don't demand the rest of the public to pay for the government to be the 'cool parent' who bails you out for the rest of your life.
That is a brilliant analysis. Trying to put it in my own words so that I can steal it, I realise that there is a British NHS way of framing it.
The three founding principles of the NHS are that: one, it is funded out of general taxation; two, free at the point of use; three, treatment is based on clinical need, regardless of the ability to pay. The fourth principle was silent; one didn't say out loud. The NHS didn't ask why the patient needed treatment. No-one was refused treatment because their illness was their own stupid fault.
There have always been worrywart who feared that the silence wouldn't hold. Treating liver disease and type II diabetes is expensive. Why is the tax payer on the hook for peoples' drunkenness and gluttony? The question gets asked and used to justify the government intervening in peoples lives, making alcohol harder to get to spare peoples livers, and making fatty food harder to get in the hope of shrinking their waist lines. Both to save the NHS money. Both current UK public policy.
The previous paragraph is very British. An alternative response to the very same question, uses the issue to justify cutting the funding to the NHS. Fund treatment for illnesses that strike at random, but stop subsidizing bad lifestyle choices.
Me too. Here is my attempt:
tight budget paternalism The government has the obligation to raise taxes to pay for rescuing people from the bad consequences of unwise choices AND the power to limit peoples choices by punishing expensively bad choices, with the aim of discouraging them.
no budget freedom The government protects people from others who would tell them: No! Bansturbators tolerate this in return for not having to pay for rescuing people from the consequences of their own bad choices.
budget busting freedom The government has the obligation to raise taxes to pay for rescuing people from the bad consequences of unwise choices. Bad choices multiply and get worse until the money runs out.
Another attempt:
When there are potentially bad choices that can be made, do you
Limit the ability to make such choices
Allow them to make such choices (and to suffer the consequences)
Support them in making such choices
I'm keen to get some mention of budget or money into the short name.
Why? I reckon that the way that Support fails is that the proponents come up with a plan. The plan is good in itself, but costs ten times what is politically feasible. The plan goes ahead anyway, with 10% of the funding that it really needs. Fails badly :-(
A good comment reminds us of Scott's epic critique of addiction research. Perhaps we don't have affordable answers to addiction, and Suport has a good plan that requires 100 times the politically feasible funding. Gets 1% of the funding it needs; fails very badly.
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