By Kevin Sabet, published in the Wall Street Journal March 7, 2024

When Gil Kerlikowske, my then-boss and the Obama administration’s drug czar, announced an end to the war on drugs in May 2009, U.S. drug policy took a more humanitarian, public health-centered approach. Stigmatizing drug users was counterproductive and blocked paths to recovery, we reasoned. At the same time, we were careful not to normalize or legalize drugs. We recognized that making drugs more accessible would be a disaster. It was a balancing act.

Oregon threw that out the window in 2020 when, encouraged by deep-pocketed interest groups, voters approved a ballot measure that decriminalized the possession of small amounts of hard drugs including heroin, fentanyl and cocaine, and removed any incentive for treatment. Now the state is poised to reverse this policy with a vengeance. Oregon’s liberal governor, Tina Kotek, is expected to sign bipartisan legislation repealing Measure 110, the ill-conceived ballot initiative.

Oregon’s experiment was a disaster. The state gave people found in possession of illegal drugs a few choices: appear in court and plead not guilty, pay a fine of $100, ask the court to reduce your fine, or simply call a health-assessment hotline to have the penalty waived. But if someone took none of these actions, there was no consequence. Measure 110 essentially made drug use penalty-free. Open-air drug dealing and use became the norm, frustrating local officials including Portland’s mayor, as there was little anyone could do. Oregon in 2021-22 had the highest rate of residents reporting past-month use of illicit drugs — not including marijuana — of any state in the U.S., behind the District of Columbia.

Though law-enforcement officers have issued more than 6,000 tickets in Oregon since decriminalization took effect in February 2021, drug users have ignored most of the citations. Police say they have largely stopped handing out citations because it is a waste of time. “There are no consequences if you don’t do anything about the ticket,” Dwight Holton told me in an interview. Mr. Holton, a former U.S. attorney for Oregon, is CEO of Lines for Life, a nonprofit that housed the hotline until last year.

Mr. Holton said the tickets don’t even include a phone number to call for help. No wonder that only 1% of people who received citations for possessing illegal drugs sought help via the hotline — only 600 people since its inception. Instead, addiction has persisted. More than 700,000 people in Oregon who needed treatment for substance use disorders in 2022 didn’t receive it, according to the National Survey on Drug Use and Health.

Instead of reducing overdose deaths, Measure 110 appears to have made the crisis worse. Between 2020 and 2022, overdose deaths in Oregon increased 75%, from 797 to 1,392, compared with an 18% increase nationally, according to the Centers for Disease Control and Prevention.

This critique of Oregon’s policy isn’t a call to criminalize addiction. It’s inappropriate to treat addiction as a moral failing or to view it solely through the prism of enforcement. Addiction is a complex biobehavioral disorder that responds to carrots and sticks. That is why drug-treatment courts — a bipartisan model offering structured treatment with incentives — work. Drug-treatment courts bring in both the public-safety system and public-health system to hold people with substance use disorders accountable, something Measure 110 never did. The state provided no structure or incentive for people to get help.

The bill repealing Measure 110 would recriminalize drugs and create off-ramps from the criminal-justice system, letting people get help to recover from addiction. Measure 110 promised to meet people where they were, but it left them there. We now have the chance to take them to a better place — and we shouldn’t squander it.

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Mr. Sabet is president of the Foundation for Drug Policy Solutions and author of “One Nation Under the Influence,” forthcoming from Polity in 2025.