Opposition to Overdose Prevention Centers and Decriminalization of Personal Possession of Illicit Drugs in a Conservative Great Plains State

The opening of sanctioned overdose prevention centers (OPCs) in New York City and the decriminalization of personal possession of all illicit drugs in Oregon marked significant changes to drug policy in the United States. Both changes came as the national yearly overdose deaths approached and then surpassed 100,000 deaths annually (CDC 2025a). Rising overdose deaths have been declared a state of emergency in the US and more Americans likely know someone who has died of an overdose than at any time in US history. In such an environment, new drug policies may have more support than they typically would. However, without sufficient public support, policy measures such as OPCs or decriminalization may be short-lived or reversed. In Oregon, the change in public support for decriminalization eroded enough from the passing of a law by ballot measure in 2020 to being revoked in 2024 by the legislature. Similarly, the current downturn in overdose deaths may cut support for sanctioned OPCs and other overdose prevention measures. Public support is therefore a critical component for sustained drug policy changes such as OPCs and decriminalization, even when these policies are introduced in times of emergency. In this paper, we studied the level of public support for OPCs and decriminalization measures as viewed by the general public in Nebraska. Nebraska is a state with little history of drug policy reform, a low rate of overdose deaths, and its residents are predominantly Republican. We estimated that 64.5% and 56.4% of adult Nebraskans support OPCs and 69.2% to 65.3% supported decriminalization in 2022 and 2023, respectively. This support was related to political party with Democrats overwhelmingly supporting both policies. However, 38% to 52% of Republicans also supported these two policies depending on the year. Although focused on Nebraska, these findings show what may be expected from similar states such as those in the Great Plains and Midwest areas of the US.