In 2001, Portugal became the first country in the world to decriminalize the use and possession of personal amounts of all illegal drugs. Decriminalization is different than legalization. The drugs are still illegal but getting caught with a small amount for personal use won’t lead to arrest or jail time. Instead, a person will get a fine or a warning or be made to go before a social commission. That commission is usually made up of a doctor, lawyer, and a social worker and treatment options are discussed and recommendations made. Decriminalization is a harm-reduction approach that sits somewhere between prohibition and full legalization. Addiction is looked at more from a public health issue rather than a criminal one.
In the late ’80s and ’90s, Portugal was in the midst of a drug epidemic. It’s estimated that around one percent of the population was addicted to heroin. In two years, drug-related deaths increased by 56% and HIV resulting from drug use was the highest in the European Union. A neighborhood in the capital of Lisbon called Casal Ventoso became known as “the biggest supermarket of drugs in Europe”. People openly injected heroin in the streets and dirty syringes were everywhere. It’s said that addicts from other countries were even moving there to live just for the easy access to drugs. The epidemic didn’t just affect the poorer lower class, it was felt throughout the whole society.
From 1933 until 1974, Portugal was under authoritarian rule and in many ways, closed off from the rest of the world. The government was trying to censor individual thought and freedom and was not funding education and services. When a military coup ended the authoritarian government in the ’70s, the population and infrastructure of the country were not prepared for this sudden freedom and drugs flooded in, leading to the drug epidemic. In response, rather than taking a prohibition stance, the Portuguese government decided to decriminalize.
The decriminalization policy stuck through several different administrations, including conservative ones, and is still in place today. The Portuguese drug czar, João Goulão, who oversaw the implementation of the policy is also still in place. He travels extensively and speaks to leaders in other countries about drug policy. Goulão says that what has been making Portugal’s drug decriminalization successful is the availability and quality of treatment and healthcare options. The policy doesn’t work by itself, there has to be a support infrastructure in place to help addicts and give them alternative options to drug abuse. The government has made a long-term commitment to Portugal’s drug policy and the treatment options and funding have remained even through an economic crash in 2008.
Statistics in Portugal seem to show that decriminalization has been successful in many areas. In 2015, it was reported that since 1999, the social cost of drug abuse has been reduced by 18%. That includes the costs of drug-related healthcare, law enforcement, and incarceration. Overdose deaths and drug-related diseases like HIV and hepatitis have fallen dramatically. There are about 3 overdose deaths per 1 million people. That’s the lowest in the EU, where the average is about 17 per million and that’s about 1/50th the rate here in the U.S. By 2011 it was reported that there had been a 63% increase of addicts in treatment and a 500% increase in the number of drugs seized from traffickers.
Numbers on the other side of the coin show that individual drug use and experimentation in Portugal have risen but only slightly compared with the positive numbers above. Despite the easy access and wide options for treatment, some local health care and harm reduction workers in Portugal say there still isn’t enough naloxone available and that more needle exchange and supervised injection sites are needed. In 2018, the first 3 injection sites were opened.
Portugal’s drug czar, Gaulão, seems to have a realistic view of the decriminalization policy. He’s stated that it isn’t a magical “silver bullet” that has eradicated the problem of drug addiction. He says that the policy alone wouldn’t have worked and that the nationwide cultural shift of viewing addiction as a disease is a huge part of the progress. Gaulão points to the fact that the epidemic affected people from all levels and areas of Portuguese society. Because heroin use was so widespread, almost every person had an addicted loved one in the family and in turn, became more open-minded regarding the problem.
Fears that decriminalization would create a drug-crazed populace have not materialized. A few of the authors of the articles I read have been to Portugal themselves and said they saw even less evidence of drug use than in their home countries of the U.S. and Canada. There were not loads of people from other countries coming to Portugal just to get high, “drug tourism” as they called it.
Many other countries have taken notice and Gaulão stays busy speaking with representatives from these nations all over the world. Other countries like Norway and the Netherlands, who are suffering from their own drug problems, are taking steps in the decriminalization direction.
The drug czar says that there are three pillars that underpin Portugal’s drug policy:
I think Portugal’s drug policy is something to be studied and considered. I don’t think it’s a blanket policy that should be adopted worldwide. Cultures vary widely and what works in Portugal may not work in other places. In regards to the U.S., we’re a much larger country with a more heterogeneous population than Portugal. Opioids are prescribed on a much larger scale and are as much of a problem as illegal drugs.
For me, there are two important aspects to deal with. I’m a firm believer in point 3 above. The eradication of all drugs is an impossible goal. We will never be able to accomplish that. Punitive and prohibitive approaches to drug policy have not worked and may even have made things worse. It’s time to reconsider the war on drugs.
Lastly, there does need to be a major cultural shift here in the U.S. like in Portugal in how we see the problem of addiction. That does seem to be happening and if we carefully consider what seems to be working in Portugal, maybe we too can make some progress.