This story was originally published by The Lund Report, an independent nonprofit health news organization based in Oregon. It is republished with permission. You can reach Joanne Zuhl at [email protected] and Nick Budnick at [email protected].

Of the $1.5 billion state officials spent in the last two years to combat substance use disorder in Oregon, only $39 million went to community-based prevention programs, and only $13 million was spent outside state agencies.

Meanwhile, despite an Oregon law requiring every public school district to have a research-based plan to equip vulnerable youth with tools to prevent addiction later in life, the majority of reporting districts are not doing so, according to a new legislatively mandated report.

Nor is the state adequately tracking how substance use dollars are spent, what impact they’re having, and whether it’s making any difference in the lives of young Oregonians, a consultant’s assessment found. It added that in Oregon, “the young people at highest risk have the least access to services matched to that risk.”

The consultant’s findings were mandated by lawmakers’ approval of House Bill 3321 last year — and they are “pretty stark,” state Sen. Lisa Reynolds, a pediatrician and a member of the state Alcohol and Drug Policy Commission, told The Lund Report.

She and other advocates called the report’s findings disturbing, but an important step toward addressing the human costs of the state’s substance use disorder problem.

​“We pat ourselves on the back for allocating this money, and then we’re not necessarily following up on what happened … what were the results,” Reynolds told The Lund Report. “We need to really try to prevent Oregonians from becoming newly addicted to substances, and yet we’re not putting resources into that really valuable work.”

Reynolds was among those who called for the state to revamp its youth prevention approach in the wake of a six-month investigation by The Lund Report in 2024 with the University of Oregon Catalyst Journalism Project and Oregon Public Broadcasting. It found most Oregon schools were not using research-based programs to help kids avoid addiction later in life despite state law and rules requiring they do so. The series also detailed how research has improved these programs’ effectiveness, but Oregon does little to promote research-based prevention and other states do far more.

Young people in Oregon use illicit drugs at higher rates than in other states, and in recent years have died of fatal overdoses at among the highest rates in the country, according to federal data — even as prevention efforts have languished.

Jon Epstein, a prevention advocate who lost his 18-year-old son to an accidental fentanyl overdose in 2020, is among the advocates who credited the 2024 investigative series and related coverage with being a catalyst for HB 3321, as well as an accompanying law, House Bill 2029. He said the 246-page report does a good job detailing what the state is doing — and not doing— to address the substance use problem among Oregon’s youth.

“That Oregon is spending only 3 percent of $1.5 billion on primary prevention, of which most of it is actually alcohol age controls … really points to how we are under-serving youth and families by ignoring this part of the continuum of care,” Epstein told The Lund Report.

The report shows “a serious management and accountability problem,” said Pam Pearce, a prevention educator and advocate from West Linn who helped drive the bill to passage last year. “Funding is spread across agencies and purposes, definitions have been inconsistent, and dollars are difficult to trace.”

School-based prevention efforts crippled by lack of support, consultant finds

Analysts with Third Horizon, the Chicago-based consulting firm hired by the state to conduct the assessment, drew on state financial records, statewide surveys and interviews involving school districts and higher education, provider organizations and prevention workers, a school focus group, and more than 500 agency documents and contracts. In addition to their report they offered a one-page summary.

They found that the $1.5 billion Oregon spent between 2023 and 2025 to address substance use disorders was spread among eleven state agencies, the vast majority on treatment or related services after a disorder has taken hold.

Only a small fraction of that money, $39.1 million, or 2.6 percent, went to programs labeled as prevention, although Third Horizon verified only $31.2 million in funding as primary prevention. Of that $31.2 million, $18.2 million stays with the state government, and $15 million of that was spent on enforcing regulations on retail alcohol sales.

Meanwhile, local school districts charged with delivering prevention programs receive no money from the state to do it and little support, the consultant found.

​That blurring of programs is part of the problem, according to the report. Said Pearce, the educator and activist, it “helps explain why we need to distinguish funds that are blended across purposes from funds that are braided together while remaining separately identifiable. We needed this assessment to understand the financing picture before Oregon could make better decisions about it.”

The report faulted the state for not having a dedicated, recurring fund for primary prevention, or even a clear definition of what that means and what’s expected. The report defines primary prevention as “practices, programs, and policies designed to prevent, delay, and reduce the incidence and prevalence of youth substance use.” The report also said the state lacks any regional structure, sufficient workforce, or usable local data.

The Oregon Department of Education, which is supposed to enforce the state’s prevention mandate for school districts, employed a single prevention coordinator and funded a single one-time campaign in the two-year period studied by the consultant, according to the report. Nor do the districts receive state funding to help.

Among the study’s other findings, as summarized by the consultant:

• “The youth at highest risk get the least.” Services designed primarily for young people showing signs of risk are rare — and none of them receive state funding.
• “Schools carry a mandate without money.” Since 1989 state law has required each district to have a prevention plan, but the state provides no financial help to do so. Of the state’s 197 public school districts, only 65 responded to questions for the legislatively mandated report, and only 19 had completed the required plan.
• “The workforce is thin and fragile.” Oregon has very few people delivering prevention services who are credentialed and trained to do so, and most of them don’t work in rural communities, such as in eastern Oregon, which face unique challenges when it comes to substance use disorders. Nearly half of Oregon’s counties had no certified prevention specialist.

Fragmentation of prevention efforts in Oregon further erodes accountability, according to the consultant’s study. “The data systems cannot trace dollars, so advocates cannot show what the money returns, and oversight is inconsistent,” the report said, adding that Oregon has “no standing structure championing prevention funding across agencies, so there is no venue in which these problems are anyone’s responsibility to solve.”

The report highlights one of Oregon’s big obstacles when it comes to prevention: the state’s strong tradition of school-district local control, said Rep. Tawna Sanchez, one of the sponsors of the bill that required the study. She said the state’s strategies need to be updated.

“Oregon is not a one-size-fits-all state and evidence-based practices are not always evidenced on every population,” Sanchez told The Lund Report. “Substances have also changed, and we are in a new world from the one we were in in 1989 when that prevention plan was mandated. The drugs and alcohol we are dealing with now are so much more powerful than they have been in the past.”

Youth prevention efforts key

​Studies indicate that youths who try illicit drugs before age 15 are particularly susceptible to developing a substance use disorder later in life: more than six times more likely than those who wait until age 21 or later. Also, that more than 90% of adults with an addiction problem started taking drugs in their youth.

The report notes that Oregon has a higher rate of substance use disorders than the national average: Nearly 21 percent of residents aged 12 and older met criteria for a substance use disorder in 2023–24, compared to just under 18 percent nationally.

​Given the long-term social and economic costs of addiction, prevention is a financially better investment than treatment, and “returns as much as $63 for every dollar spent.” That’s a better return than for treatment, which returns about $4 to $7 for every dollar, according to the consultant.

Among the consultant’s recommendations:

• Oregon should adopt a clear definition for primary prevention — the same one used by HB 3321  — and require every funded agency, school and organization to use it.
• Increase state spending on prevention to nearly 8 times what it does now or more, using a dedicated revenue stream such as from liquor sales.
• Build a coordinated region-based system with unified staffing, plans, contracts and reporting, similar to how other states do it.
•  Expand services for higher-risk youth, give public awareness a youth focus, and create a well-financed central state prevention office that can be a resource for training, data-tracking and technical assistance.
• Grow the number of certified prevention specialists in Oregon while honing the credential.
• Improve transparency and accountability by making the money flow more visible, with the Alcohol and Drug Prevention Commission reviewing state and federal substance use spending plans while improving youth substance use data so local partners can use it effectively.

Asked about the report and recent efforts by the state education department, a state spokesperson responded that “In recent years, ODE has established dedicated staff capacity for school-based substance use prevention, developed prevention resources and professional learning with one-time legislative funding, strengthened district planning supports, and partnered with the Alcohol and Drug Policy Commission and Oregon Health Authority to bring prevention expertise together through a Substance Use Prevention Advisory Group. These efforts are relatively new, and ODE’s prevention infrastructure is still developing.

“Strengthening youth prevention will require sustained investment and coordination across education, public health, behavioral health, prevention providers, families, and communities.”

Asked for comment on Friday, Oregon Health Authority leadership did not respond to the report as of Tuesday.

A spokesperson for Kotek, who vowed action in response to the 2024 investigation by the Lund Report, said her staff is still reviewing the report, but “The Governor remains committed to enhancing cost-effective prevention programs for Oregon’s youth.”

Pearce, the advocate, praised the report for setting a good starting roadmap, and said that a statewide prevention hub or “center of excellence” could help local communities select and adapt approaches to prevention, access local data and share what works.

Now, she said, the state needs a coherent plan to address the situation. “We need a plan that makes primary prevention a priority and shows whether more children are able to delay or avoid substance use,” she said. “We owe that effort to the people we have lost and to every child who calls Oregon home.”

Epstein said he would like to see lawmakers work to enact some of the report’s recommendations in the upcoming legislative session. And he said Gov. Tina Kotek should give the ADPC greater control over policy and financial decisions.

“Oregon’s governance in many areas seems to measure success by the size of the spend, not what the spend accomplishes,” he said. “So now we know with specificity where the problems are and have good, recommended practical solutions. The question is, will we do anything with them?”

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News Source : https://www.opb.org/article/2026/10/01/report-oregons-efforts-to-combat-youth-addiction-are-sparse-scattered-and-ineffective/