Portugal’s Radical Drugs Policy is Working
On Dec 5, the Guardian published an article reviewing Portugal’s drug decriminalization policy. Facing a crisis in the 1980’s where 1 in 10 people had fallen into heroin use, Portugal became the first country to decriminalize the possession and consumption of all illicit substances as strategy to address the crisis. Portugal’s policy rests on three pillars: one, that there’s no such thing as a soft or hard drug, only healthy and unhealthy relationships with drugs; two, that an individual’s unhealthy relationship with drugs often conceals frayed relationships with loved ones, with the world around them, and with themselves; and three, that the eradication of all drugs is an impossible goal. Rather than being arrested, those caught with a personal supply might be given a warning, a small fine, or told to appear before a local commission (comprised of doctor, social worker) to talk about treatment and support services that were available to them. With the new policy in effect, their opioid crisis soon stabilized, and the ensuing years saw dramatic drops in problematic drug use, HIV and hepatitis infection rates, overdose deaths, drug-related crime and incarceration rates. HIV infection plummeted from an all-time high in 2000 of 104.2 new cases per million to 4.2 cases per million in 2015. Portugal’s remarkable recovery, and the fact that it has held steady through several changes in government – including conservative leaders who would have preferred to return to the US-style war on drugs – could not have happened without an enormous cultural shift, and a change in how the country viewed drugs and addiction. In many ways, the law was merely a reflection of transformations that were already happening in clinics, pharmacies and around kitchen tables across the country. The official policy of decriminalization made it far easier for a broad range of services (health, psychiatry, employment, housing etc) to work together and serve their communities more effectively. Despite enthusiastic international reactions to Portugal’s success, it is important to note drug use didn’t disappear. While drug-related death, incarceration and infection rates plummeted, the country continues to deal with the health complications of long-term problematic drug use such as hepatitis C, cirrhosis and liver cancer which are burdening their health system. Harm-reduction advocates have also been frustrated by what they see as policy stagnation and criticize the state for dragging its feet on establishing supervised injection sites and drug consumption facilities; for failing to make the anti-overdose medication naloxone more readily available; for not implementing needle-exchange programs in prisons. Portugal’s drug czar told the Guardian, “If the heroin epidemic had affected only Portugal’s lower classes or racialized minorities, and not the middle or upper classes, he doubts the conversation around drugs, addiction and harm reduction would have taken shape in the same way.