Revisiting Portugal and Drug Decriminalization, 16 Years Later

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Revisiting Portugal and Drug Decriminalization, 16 Years Later

By Paul Gaita 12/08/17

The country adopted a non-punitive, harm reduction driven approach to drug use in 2001.

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drug paraphernalia

An in-depth new feature from the UK's Guardian newspaper has examined the legacy of Portugal's decision to decriminalize all drugs in 2001. The European country took the radical measure in an attempt to combat an epidemic of heroin dependency, overdose deaths, drug-related crime and a host of health problems, including HIV and hepatitis infections that plagued its citizens for much of the 1980s and 1990s.

But after passing legislation to decriminalize all drugs, including cocaine and heroin, Portugal appeared to resume stability, with dramatic drops in drug use, health concerns and crime rates. The country's recovery was held up as a model example of how a non-punitive, harm-reduction-driven approach to drug use can have a positive impact—but as the Guardian feature notes, has it really solved Portugal's drug problem?

The answer is far more complicated than a simple yes or no. The Guardian story details the positive outcome of decriminalization: declines in drug use, overdose deaths, drug-related crime, incarceration rates, and a drop in HIV infection numbers from 104.2 new cases per million in 2000 to 4.2 cases per million in 2015. The policy also allowed for greater collaboration between the country's health and human care services, including psychiatry and housing, which, in turn, provided more assistance to communities struggling under the weight of drug use, crime and related health issues.

But more than 15 years later, Portugal continues to confront challenges that stem from its drug problems. Though the country has methadone distribution centers and allows supervised injection facilities (SIFs), which have proven crucially important for successful treatment in Canada and other European countries, no SIFs currently exist in Portugal.

Advocates say that the government has done little to promote them or needle exchange programs, leaving the distribution of safe needles largely to peer support workers from smaller, non-governmental organizations.

Portugal has also been reluctant to embrace the legalization of any drugs, including marijuana, despite recent scientific exploration into the use of cannabis as addiction therapy and growing global acceptance of marijuana for medical and recreational use.

The Guardian story cites the conundrum faced by a staffer at a center in Lisbon that provides peer support, clean needles and HIV testing to users; having found success with cannabis use to treat his dependency issues with cocaine and opioids after trying methadone and inpatient treatment, the piece notes that his treatment is still subject to the same criminal charge as the drugs that led to his dependency.

Under decriminalization laws, individuals caught with small personal supplies of any substance, including marijuana, still face the possibility of a fine or a request to appear before a local commission, comprised of a doctor, lawyer and social worker, who advise on treatment and support options.

As with any political and cultural issue, the challenges faced by a country and its government include molding policy that will best serve the widest demographic of its citizens.

As Portugal's decriminalization effort illustrates, there are positives and negatives to any arrangement; one size rarely fits all. But as the piece suggests, if a conservative, Catholic country like Portugal can embrace decriminalization—not to mention same-sex marriage and abortion—it's possible that legislation can be enacted to bring all parties to a table where their respective needs in regard to drug dependency and treatment can be met.

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