Community supervision during Oregon's partial decriminalization Measure 110: Criminal legal system involvement, overdose, and naloxone access.

Background: In 2020, the U.S. state of Oregon passed Measure 110 (M110), which aimed to address substance use disorder as a public health issue and reduce disparities in the criminal legal system by decriminalizing personal drug possession and increasing services. The impact of partial drug decriminalization on individuals under community supervision-whose release conditions often prohibit drug use and who M110 excluded-is understudied. Methods: We used targeted sampling to recruit and survey people who use drugs (PWUD; N = 468) in eight Oregon counties in 2023. We compared PWUD under community supervision to those who were not to assess opioid-related overdose, naloxone access, and law enforcement engagement. Results: Compared to PWUD who were not under community supervision, those under supervision had higher prevalence of past year opioid-related overdose. There were no differences by naloxone access. Eighty-two percent (82%) of PWUD on community supervision were stopped by law enforcement in the past year. PWUD on community supervision were more likely than those not on community supervision to report in the past year being searched by law enforcement at least once (adjusted prevalence differences [APD]=0.33; 95% CI: 0.23, 0.43), spent time in jail at least once (APD=0.33; 95% CI: 0.23, 0.43), and to have concerns about getting into trouble if they called 911 for a drug-related health issue (APD=0.12; 95% CI: 0.00, 0.18). Conclusion: Under M110, Oregon PWUD under community supervision experienced more police engagement and overdoses. Findings have implications for less police presence at overdose scenes, greater access to naloxone and support services, and protections under future decriminalization laws.