Amid the worst fatal opioid overdose crisis in US history, many jurisdictions have explored alternatives to traditional models of arrest and incarceration for drug possession. Some states have decriminalized the personal possession of certain federally scheduled substances (e.g., cannabis, psilocybin, and buprenorphine), enacted Good Samaritan laws to shield people from arrest at the scene of an overdose when they seek help, created police programs that link people to treatment and harm reduction services, and taken de facto approaches to decriminalizing drug possession. In the most sweeping response to date, Oregon voters passed Measure 110 (M110) in November 2020, making it the first state to decriminalize the possession of all nonprescribed drugs for personal use while reallocating millions of dollars toward addiction treatment, recovery programs, housing, and harm reduction services. The measure was intended to reduce overdoses by expanding and promoting linkages to health care systems for people who use drugs while reducing entrenched racial and ethnic disparities in the enforcement of drug possession laws.