One important observation is that drug use is largely downstream of homelessness. Being homeless is awful, and drives people to self-medication/-numbing. (Of course some homelessness is caused by prior drug addiction but I’ve seen compelling analysis suggesting it’s mostly the other way around.) SF primarily has a cost-of-living problem, which produces a homelessness problem, which produces a drug problem.

Programs that address homelessness (like housing-first, or work training) will also reduce drug abuse/deaths. And upstream stuff like really buying into building housing stock will also help with homelessness.

Part of the whole package of drug legalization is that if you actually dismantle the war on drugs machinery, you will have a huge budget to direct to social programs that can reduce the upstream causes of drug abuse, not just providing treatment after the fact. It sounds like Oregon didn’t get those programs in place yet.