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Why Oregon's groundbreaking drug decriminalization experiment is coming to an end


This is FRESH AIR. I'm Dave Davies. In 2020, voters in Oregon overwhelmingly approved a ballot measure to decriminalize the possession of small amounts of hard drugs, including fentanyl, heroin, cocaine and methamphetamine. The initiative was accompanied by new investments in addiction treatment and support services. The move was hailed by national drug reform advocates, who've long condemned the so-called war on drugs as a self-defeating policy that filled prisons, disproportionately harmed the poor and communities of color, and failed to deter drug use. But 3 1/2 years later, public opinion has turned against the groundbreaking approach, and the state legislature has acted to restore criminal penalties for hard drugs. The state experienced rising overdose deaths and high rates of drug use, and open air drug use in streets, parks and camping areas unnerved many residents.

Our guest, journalist E. Tammy Kim, wrote about the Oregon experience in The New Yorker, speaking with activists, treatment providers, police, lawmakers and drug users, among others. Kim is a contributing writer for The New Yorker, covering labor and the workplace, arts and culture, poverty and politics, and the Koreas. She previously worked as a contributing opinion writer for The New York Times and a staff writer for Al-Jazeera America. Kim is an attorney who worked in New York for low-wage workers and families facing medical debt before entering journalism. Her January story in The New Yorker is titled, "A Drug-Decriminalization Fight Erupts In Oregon." Well, E. Tammy Kim, welcome to FRESH AIR.

E TAMMY KIM: Thank you so much. It's a pleasure.

DAVIES: So let's set the stage for this story. November 2020 - Oregon embarks on this dramatic decriminalization of hard drugs in small amounts. This was approved in a state-wide voter referendum. So it wasn't just legislature. The voters had their say. You wrote that this was inspired by a sense of desperation. Meaning what?

KIM: This came at a time, obviously, during the pandemic, but also right after the reckoning over the summer with Black Lives Matter's protests being the largest in our nation's history. People were thinking about drug use and the addiction crisis, the opioid crisis, in a new and different way. I think in Oregon, the way that played out was people were seeing rising rates of overdose deaths. Fentanyl was coming into the market. And the previous program, which was really sort of law enforcement-based program, as it has historically been in this country, wasn't working. And I think in combination with the sort of sense of the Black Lives Matter movement saying, let's reevaluate our relationship to law enforcement more generally, people were wanting to try something new. And the form that that took was Measure 110, which was a ballot initiative that was developed both by national harm reduction and sort of criminal justice advocates, but also local activists and organizations who were interested in a new approach to the war on drugs.

DAVIES: Right. Now, this didn't legalize hard drugs, per se, right? What exactly did it provide?

KIM: It didn't. It decriminalized, which essentially meant that it took away the sort of usual policing power around use, so public use of drugs, and possession of small amounts of illicit drugs. In Oregon, meth has always been sort of the most popular illicit drug on the street. But of course, like the rest of the country, opioids have come in very strong over the past decade or so. And then kind of in distinction to the Midwest and the Northeast, where fentanyl already a decade ago was sort of overtaking oxycodone and heroin, we saw this happening sort of right before the pandemic in Oregon. And so what Measure 110 did on the policing side was to say to the police, we're not going to arrest people anymore for possession. You're going to give them an option where they can pay a fine, or they can call a hotline and sort of submit to an encounter to get counseling around treatment.

DAVIES: Right. So you'd get a ticket and then you'd either pay $100 fine or make this call and get sort of an on-the-phone evaluation, so not a heavy burden.

KIM: That's correct.

DAVIES: Right. But there was more about - more to this than the enforcement change, right? There was also supposed to be additional funding - for what?

KIM: Exactly. So Measure 110, sort of taking a sort of bird's-eye view of it, has two big prongs. So one is this change in law enforcement, so the decriminalization prong. And the other prong was a massive infusion of money from recreational marijuana tax dollars, primarily, to fund a treatment and harm reduction infrastructure across the state. A curious thing about Oregon is, I think nationally, we really think of it as a very progressive place with really advanced social services, a welfare state that's quite developed. And yet Oregon has ranked towards the bottom - by some rankings, 49th in the country - in terms of access to behavioral and mental health services. So it was sort of starting from a place of being very behind in the ability of people who wanted to get out of addiction to seek that treatment. And this was going to cure that, was the plan.

DAVIES: Right. Anybody who knows folks who've suffered with this knows that it's not easy to find treatment when you need it, and sometimes you need it right away.

KIM: Absolutely.

DAVIES: When someone's ready, you want to be able to respond.

KIM: And you need it multiple times, usually, also.

DAVIES: Right, right. Now, in addition to traditional, you know, outpatient and inpatient treatment, you know, there was this new notion of what is called harm reduction. It's a different kind of activity to deal with this issue. You want to just explain what it means?

KIM: Yeah. So what we wanted - what I was doing in this story was sort of looking at what does it mean to get treatment? And on the treatment prong of Measure 110, what was the kind of evolution in the thinking and the science around what the money would fund? And as you just said, you know, I think there's this TV version of sort of what it looks like to get out of alcohol or drug use, and it's kind of a Betty Ford clinic - right? - where you check in to a residential center, and you're kind of separated from your family and friends. You do a 90-day, you know, session, let's say, and then you kind of get out and go on your way. That's representing actually quite a limited part of the treatment infrastructure.

And what we actually have and has developed over the past few decades is this kind of continuum of care, which looks at people who aren't yet ready to give up drug and alcohol use. They need instead a safe place to perhaps do those drugs. They need supplies so that they don't get sick. You know, I think the key example for this is the free needles or needle exchange programs, which came about really in the AIDS crisis to combat the transmission of AIDS, HIV and Hep C and you know, so - but in addition to that, now people are using different kinds of drugs, consuming drugs in different ways. And so harm reduction might be, for example, giving out cookers or pipes that are safe and have been sanitized for people. So this is all to say, like on the side of people who aren't yet ready to go into a recovery or treatment program, you want to reduce the harm to themselves and to others, and then also infuse services that are more along the kind of traditional path of treatment.

DAVIES: Right. And it's a less judgmental way to deal with people who have this issue, and it also connects them to treatment if they're ready, right? The idea is that you're talking to somebody, and somebody who knows how to get you somewhere if you really want to get into a rehab or something. You know, a lot of people know that Portland is a place where politics are progressive, and there's a lot of tolerance for unhoused people and people dealing with addiction. Things changed there. But the law was statewide, and you looked at a community called Medford in southwest Oregon. You want to just talk about what some of the developments were that were troubling to some folks, and we'll get into some of the reasons for them. So what was the experience, what arose there that created issues for citizens of Medford and Jackson County?

KIM: I think on the policing side, the police had always played a very important role in the treatment infrastructure, if we can call it that. So before Measure 110, police would make arrests for misdemeanors and felonies related to drugs, obviously, and some of those were for possession - simple possession by users. The way the police saw themselves was they would make those arrests, they would bring people to the county jail and at the jail as a kind of interface point for social services and at the courthouse, they saw themselves as funneling people into treatment. You know, I think on the other side, obviously, the critics of that would say, well, you were creating harm by - just by arresting people and putting them in jail. And the jail and the court system was never really a good place for people to get treatment. There's an old adage in recovery and addiction, which is, you know, you can't get better until you're ready and that, you know, you really need to do this voluntarily. And so there's always been in that kind of dynamic.

Another thing that was going on in Southern Oregon was a steep rise in homelessness. Obviously, we've seen this across the country through the hardship of the pandemic, the mental health strains, all sorts of different reasons why people were more visibly homeless, and then, of course, the arrival of fentanyl. So we had, you know, sort of this strained system, fentanyl coming in, which is incredibly addictive and incredibly cheap and incredibly deadly, and this, you know, rise of homelessness and a backlash against homelessness. And so, I think the way that Southern Oregon was then experiencing this huge policy change under Measure 110 was, hey, Measure 110 happened when all of these bad things were happening. Therefore, it seems like Measure 110 might have caused these bad things.

DAVIES: Right. Measure 110 being the referendum which provided for the decriminalization of hard drugs. We're going to take a break here. Let me reintroduce you.

We're speaking with E. Tammy Kim. She's a contributing writer for The New Yorker. Her January story is titled, "A Drug Decriminalization Fight Erupts In Oregon." We'll continue our conversation in just a moment. This is FRESH AIR.


DAVIES: This is FRESH AIR, and we're speaking with New Yorker contributing writer E. Tammy Kim about the end of Oregon's three-and-a-half year experiment with the decriminalization of the possession of hard drugs. She wrote a piece in January titled, "A Drug Decriminalization Fight Erupts In Oregon."

You mentioned that there was increasing encampments of unhoused people at a greenway there in the area, and police now, under the new rules, could not apprehend people for using drugs. And so people could do it openly. What did local citizens see that they found so troubling here?

KIM: That's correct. I think there was a kind of twinning in people's minds of homelessness and the sort of physical, you know, messiness of homelessness and drug use. And under the decriminalization of drugs in Oregon, people were then essentially not able to be arrested for using drugs in public. You know, it wasn't just that they couldn't possess drugs, but that they couldn't - it wasn't just that they were able to possess drugs in public and not be arrested, it was that they could essentially use drugs in public and not be arrested. And so that did lead to more encounters by sort of, you know, your average people, your average families who were experiencing public places with drugs and drug use.

You know, we know that drug use occurs in every socioeconomic stratum. And if you have a home, if you have a place to use drugs, you're not as vulnerable, obviously, to law enforcement. But if you're using drugs in public, you know, you can be policed, but you can also have really uncomfortable interactions with people who don't like to see it. And it's not surprising that, you know, parents who were walking by, say, a homeless encampment on the greenway in Medford, Ore., and saw people smoking fentanyl or smelled something strange or saw people who were really amped up on uppers like meth would then have a really strong feeling about, hey, I don't think decriminalization is working, and this is actually making me and my community feel less safe.

DAVIES: One point I believe you wrote that the government of Medford, I guess the City Council enacted a tough anti-camping ordinance, right? What happened there?

KIM: So yeah, the Medford City Council and the Jackson County commissioners in this area, they wanted to crack down on what they called basically unauthorized camping. And what this was was a sort of combination of people who were gathering in public because they had lost housing or people who had already been homeless but were gathering in new areas because of displacement from wildfires. There were - there was a number of reasons why people were sort of moving around but that their homelessness was becoming more visible to people. And so at the same time that the police felt that they couldn't really interact with people in terms of their drug use, they were interacting with people much more in terms of their homelessness and basically prohibiting them from sleeping outside, from gathering in large groups. And this did, in a couple of instances, lead to observed harms. Activists in the area attribute the death of a man who was sleeping outside to this kind of policing.

DAVIES: Who froze to death, right?

KIM: Who froze to death. Yeah.

DAVIES: Tough weather. Yeah.

KIM: He was found in the morning.

DAVIES: There were complaints about crime. Any way to evaluate that? Was there more crime with the growth of these encampments and, you know, the open-air drug use?

KIM: One of the reasons it was hard to evaluate the asserted rise in crime rates was because before the decriminalization of drugs, a lot of drug arrests weren't simply drug arrests, per se. They were drug arrests that were made in connection with other sorts of crimes like, you know, theft or, you know, other sorts of, like, small, petty, kind of usually economic crimes. And I think one of the things that people were saying after the passage of Measure 110 was that there were kind of more people on the street who felt comfortable doing drugs and who also felt comfortable committing acts of petty theft and violence. It was difficult for me to sort of disaggregate, at least in the data that I was looking at, about, you know, whether that was true or whether that was a perception or whether the police were being sort of more vigilant about documenting those crimes as opposed to drug crimes now that they weren't working on those cases anymore.

DAVIES: You know, you just used the phrase petty theft and violence. Some might wonder, what is petty violence?

KIM: I guess I would group some of this under perceptions of disorder. So a thing that I heard repeatedly, like in Medford and Portland, Bend, Eugene, Salem, these different cities across the state was there all these people on meth who are kind of running around naked, or they are waving knives around, so this sort of thing where it wasn't necessarily that people were being assaulted, but they felt threatened by really disturbing things they were seeing on the streets. And I don't mean to say that that isn't disturbing. I think that there was a lot of harm caused by what people saw, you know, with this increased use in public.

DAVIES: You know, one of the things I liked about your story was its exploration of a debate among various folks who, in good faith, want to help drug users get clean and want to help deal with this problem in a constructive way. But there are different beliefs about what works and what doesn't. Maybe we should just start with an organization called Stabbin Wagon - its director, Melissa Jones, who sounded like she was a pretty compelling figure. Tell us what the organization and she were up to.

KIM: Melissa Jones and Stabbin Wagon are on - if we have a sort of gradient of services, are on kind of the more radical and political edge of harm reduction. And it's a group that basically owes its - all of its funding to Measure 110, to this experiment in Oregon. So for me, it was interesting to look at because it was part of the promise of Measure 110, which was that we're going to try new things. And Melissa Jones and Stabbin Wagon were trying new things in this community.

Most of what people saw of Stabbin Wagon's work was the distribution of safe use supplies and safe sex supplies and in-person outreach, delivery of meals through a white cargo van that Melissa and her staff kind of drive around town and park near where people are unhoused. And so, you know, I think for people who benefited from these services, it was a real godsend. And they felt very seen and heard by these people who weren't there to judge their drug use. But for more conservative people in town, they saw this as a representation of a very misguided social program, which is, hey, you're enabling drug use. Why are these state dollars that we voted for to fund treatment going to essentially helping people stay in their use?

DAVIES: Now, there's another point of view that you're right about, some who are more traditional treatment providers who think that addicts need some pressure to enter treatment. I mean, that pressure can come from, obviously, circumstances in their own lives, from loved ones and relatives, but also the threat of jail, where the - where there are alternatives to going to jail, particularly treatment alternatives - can be effective. Give us a sense of how that debate played out here.

KIM: Another provider that I talk about in my story is Sommer Wolcott, who is the director of OnTrack, which is a sort of large social services agency in southern Oregon. And Sommer is not at all an opponent of harm reduction. There is harm reduction sort of built into the treatment and recovery services that her organization provides. However, in some ways, her approach is quite traditional. I mean, the end goal for her interaction with their clients is recovery, to come out of addiction, to come out of drug use. They also partner with the local police in outreach to homeless people and to people who are using on the streets.

So, for example, OnTrack employees, who themselves are usually recovered people who are using drugs, will go out with Medford police officers and approach people who are using and say, hey, do you want to get into treatment? What are your needs? You know, do you need housing, this sort of thing? And, you know, again, the supply of social services is very limited, but they would sort of make that offer and try to do counseling.

And so - but there - you know, there was this contrast between what OnTrack was doing and what groups like Stabbin Wagon were doing. And I think from the OnTrack perspective, they have seen thousands of clients go through treatment and recovery. They believe it can be done. And they just felt that they needed more resources to do that. And they, too, were sort of confused about, well, where is the Measure 110 money going, and is it over-privileging the distribution, for example, of safe use supplies when really we should be having more sober homes, more recovery housing, more inpatient treatment and outpatient treatment?

DAVIES: We're going to take another break here. Let me reintroduce you. We're speaking with E. Tammy Kim. She is a contributing writer for The New Yorker. Her January story is titled, "A Drug Decriminalization Fight Erupts In Oregon." She'll be back to talk more after this short break. I'm Dave Davies, and this is FRESH AIR.


DAVIES: This is FRESH AIR. I'm Dave Davies. We're speaking with New Yorker contributing writer E. Tammy Kim about the end of Oregon's 3-1/2-year experiment with decriminalizing the possession of hard drugs, including fentanyl, heroin and methamphetamine. The move to decriminalize was overwhelmingly approved by Oregon voters in November 2020, but high rates of overdose deaths and open-air drug use in streets, parks and makeshift camping areas soured public opinion, resulting in legislative action to restore criminal penalties. Other aspects of the initiative, including new investments in drug treatment and related social services, are preserved.

Tammy Kim's January article in The New Yorker is titled "A Drug Decriminalization Fight Erupts In Oregon." It seems that although this - you know, this measure which decriminalized hard drugs and provided for investments in treatment, it took quite a while for that funding to get going for reasons that are actually pretty understandable, I guess, right?

KIM: Right. That is perhaps the poison pill of this experiment in Oregon, which is that decriminalization went into effect right away. And the amped-up treatment infrastructure took about a year and a half to get going, essentially. So it took more than a year for the promised funding to begin rolling out to organizations across Oregon.

Part of that was this sort of bureaucratic issue that the organization responsible for doling out that money was also responsible for dealing with COVID. It was the Oregon Health Authority, and they were incredibly overwhelmed. There was under - it was very difficult to hire also for drug and alcohol counselors. So many things that we kind of know about because of the pandemic economy were undermining the ability of this agency to implement this program.

I think another thing that is sort of telling, just kind of thinking about this as a public policy experiment, is this is a program that came to be because of voters in our most sort of direct democratic process of a ballot initiative. However, what that meant also was that there wasn't necessarily institutional buy-in or a kind of institutional advocate for the program. So, you know, many government officials, including at the Oregon Health Authority, would sort of explain this to me as, hey, we didn't, you know, want this. We didn't ask for this. It was foisted upon us by the voters. And now we're kind of rushing to implement this. And it's not fast. It goes slow.

DAVIES: Oh, that's so interesting. So, yeah, like, if it's the governor's pet project, then he gears it up. In this case, she gears it up. But if it's the voters telling you to do it, then it's a slow start. I mean, I will say, having covered government for a long time, even if there is funding and will, it just takes a while for government programs to get up 'cause there are all of these rules that are established to prevent, you know, self-dealing and cronyism and waste. And it just - and, you know, you got to give everybody their chance to have their say. And there's competitive bidding. And it just - it all takes a while under the best of circumstances. And with COVID, it was going to be slow.

KIM: Absolutely.

DAVIES: You write that the money distributed through this measure was both a lot and not very much. What did you mean?

KIM: About $300 million over a period of time was allocated from the marijuana taxes towards treatment and recovery. Sounds like a huge amount of money, but obviously that needs to be distributed statewide. There were also allocations to tribes. So, you know, just kind of jurisdictional, like, everybody gets a piece, but it's very spread out.

Then on top of that, if you're thinking about inpatient or outpatient treatment, these are very expensive programs. And Medicaid will often cover parts of that, but the sort of health parts of that. In addition, you also need to figure out where people are going to live and what they're going to eat while they're going through these programs. And so if you're thinking about kind of a holistic response and kind of taking person who is trying to get out of addiction from, you know, zero to 10, this is very costly. And so I think, you know, there were huge expectations placed on this experiment. And yet it was an experiment that kind of wasn't funded to address all of those hopes and dreams.

DAVIES: You refer to a December 2023 marathon hearing in the legislature, which essentially became a debate over the merits of the decriminalization measure. What complaints did lawmakers hear about it? And then let's talk about what was offered in its defense. First of all, those who favored reversing this move, what did they tell them?

KIM: Most of the people who were speaking to lawmakers against Measure 110 talked about public use and about perceived increases in dangerous drugs. Certainly, business owners also were talking about, you know, people sleeping in front of their properties and getting rowdy in front of those properties, harassing, you know, patrons of their businesses.

And so what was interesting is, I think especially listening to the people testify from Portland - was that part of that is also just the fact that Portland's downtown has been vacated since the pandemic. You know, there are no office workers there anymore. And so it has this sort of vacant quality. And that is going to be - you know, those empty spaces then have been filled by people without homes. And so, again, we're just seeing kind of like this lab experiment be infiltrated by all of the factors that weren't sort of anticipated at the time.

DAVIES: And those who wanted to defend the decriminalization initiative, what did they say in its defense?

KIM: The defenders had generally two arguments. One is that the treatment and recovery and harm reduction infrastructure is expanding and working and that they were seeing it every day. And there are countless examples of people in new detox facilities, recovery homes, in new treatment programs and new family counseling programs where those - you know, they had great stories of their clients.

And then I think the second prong is the racial justice element. Oregon is a fairly white state. However, the disproportionality statistics around drug enforcement arrests, incarceration, to some extent, those are, you know, very skewed against Black, Latino, Native people in particular. And there was a call, like, from a man named Larry Turner, who I quote, who has been doing racial justice work in Portland for a very long time in the African American community, saying, why have we given the drug war decades to do its thing? And now two, three years into this great experiment, we're going to already cut the cord. You know, we need more time to see this out. It is working for our community. And if we reverse it, we're going to go back to the kinds of racial disproportionality that we saw before.

DAVIES: So legislative leaders said, you know, we have to have some change, and a package of legislation was passed. Let's talk about what it does. I mean, what does it do in terms of, you know, rules for possession of these hard drugs?

KIM: The bills - there are two bills that were just passed by the Oregon Legislature. And one of them essentially recriminalizes. And so we're going back to the pre-Measure 110 status quo, where it is a misdemeanor to possess small amounts of illicit drugs. This sets a jail term of about six months. But there is a kind of opt-in program that counties can decide on that's called, like, deflection or diversion, where if somebody says, I'm going to go into treatment and kind of follows through with a treatment and recovery regimen, then the misdemeanor can be wiped out and they don't do jail time. And so that is the kind of, you know, harm reduction promise built into it. However, again, that part of this law is not mandatory. And so it's kind of customizable county by county.

The other bill in this package derives $211 million additional dollars, which is quite a lot to - again, to beef up the treatment infrastructure. This re-criminalization doesn't do away with the treatment and recovery part of Measure 110. Exactly. And so the funding that was going to providers will stay in place in the $211 million newly allocated will support that. And so, you know of course, always, like, devil in the details, we have to see how this is going to be implemented. I think advocates of the 2020 experiment are devastated and feel like this is just going back to the traditional drug war. But lawmakers have been taking pains to say, no, this is not exactly the same. We're just trying to do this in a more efficient way that, you know, lets law enforcement in again to help people on their way to treatment.

DAVIES: We're going to take another break here. Let me reintroduce you.

We are speaking with E. Tammy Kim. She is a contributing writer for The New Yorker. Her January story is titled, "A Drug Decriminalization Fight Erupts In Oregon." We'll continue our conversation in just a moment. This is FRESH AIR.


DAVIES: This is FRESH AIR, and we're speaking with New Yorker contributing writer E. Tammy Kim about the end of Oregon's three-and-a-half year experiment with decriminalizing the possession of hard drugs, including fentanyl, heroin and methamphetamine, that was approved by voters in a 2020 referendum. It's now being reversed due to action by state lawmakers.

You know, the Drug Policy Alliance, which is a national organization which heavily supported the decriminalization initiative in 2020 and has criticized this, has advocated changes in a lot of different states. And I think the idea was that success in Oregon would inspire more change in other states across the country. What do you think the impact will be in other states now that we're considering changes?

KIM: This is a huge setback for the harm reduction and sort of drug reform movements. Yes, Oregon was supposed to sort of pave the way for similar changes in other places. You know, we were - the movement was eyeing California and Maine and Vermont. I think most of those efforts now are going to have a very hard time getting off the ground because of the negative press coverage and the sort of general perception that what was tried in Oregon did not work. The Oregon model also is often referred to as kind of being based on the Portugal model. You know, Portugal being a country where there has been a long history of pretty positive experiment with decriminalization and infusion of services. And so, you know, I think now that people think, well, decriminalizing just, you know, sort of isn't going to work anywhere, we probably won't see as many proposals in other states.

DAVIES: You know, police officers have been frustrated for many years with arresting people for minor drug offenses and spending a lot of time going to court and then nothing really seems to change. You talked to some police officers and prosecutors. What sense did you get of how they feel about criminal penalties for possession?

KIM: The police officers I spoke to were not enthusiastic about policing for a minor possession. You know, they obviously want to be engaged with more significant crimes. And that is the kind of demand from the community that, you know, obviously, they're responding to calls for major robberies and physical assaults, etc. However, they felt offended that they no longer had much of a role to play after decriminalization went into effect. Because, again, I think they have, in many cases, seen instances where they apprehended people, took them to jail and those people got clean and then later sort of thanked the police and the law enforcement infrastructure for that help.

DAVIES: You know, these debates about these harm reduction strategies, which, you know, try to meet drug users where they are as opposed to other methods occurring in all kinds of communities. I'm in Philadelphia, where there's a big battle here over one neighborhood that has a lot of open-air drug markets.

And one of the things that struck me as I've observed the debate is that sometimes I would see harm reduction advocates make a very persuasive case that what they're doing, which is, you know, providing, you know, clean needles and safe injection, is going to keep users alive. It's going to help them get more of them into treatment. But it's definitely going to reduce harm to the users, but they don't really address the community that feels besieged, whose kids have to, you know, walk through needles on the sidewalk and step over people, you know, shooting up and these kinds of things. And sometimes, community advocates, you know, talk about what they're seeing, but they don't really address what - you know, what will be good for these folks who are afflicted with addiction. I don't know what the question here is, but it's just - it seems a really difficult debate.

KIM: Yeah. I think you've honed in on such a key - kind of the emotional key to this whole question. And for my reporting, I went to Vancouver, British Columbia, which is - kind of has long been a sort of beacon of harm reduction. But - and so there's all sorts of practices there that are backed by science and public health researchers, like having safe injection sites, like having drug users who are involved in policy-making, decriminalizing drugs. They did that in 2022. But that doesn't mean that the streets are, you know, sunny, and everybody has a good middle-class job, and there's no, you know, problems. I mean, there's going to be a collision on the street because people are poor, because people are living in desperate circumstances, because people have mental health issues, all sorts of things. And when you throw drugs into that mix, it's a very difficult encounter.

I think your question highlights the need for strong institutional leadership, whether that comes from provincial or state, county or national leaders, to say, yes, we need to respect the human rights of drug users, and harm reduction is science and policy and so - and, you know, so are these sorts of treatment mechanisms. At the same time, we need to figure out how to respect people's desired quality of life on the streets where they live and walk. And, you know, I think a lot of this actually boils down to the question of homelessness policy and housing policy, because, again, it's this question of where are people who use drugs supposed to use drugs 'cause they are going to continue to use drugs?

DAVIES: Well, E. Tammy Kim, thank you so much for speaking with us.

KIM: Thank you. Really appreciate your time.

DAVIES: E. Tammy Kim is a contributing writer for The New Yorker. Her January story is titled "A Drug-Decriminalization Fight Erupts In Oregon." Coming up, Kevin Whitehead remembers jazz and classical and pop singer Sarah Vaughan on the 100th anniversary of her birth. This is FRESH AIR.

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