Author: George Kitsaras

Editor-in-chief / Psychologist / Doctoral Researcher

2001 was the year that an unprecedented action took place, an action easily forgotten and rarely promoted. In 2001 Portugal became the first country to decriminalise the possession and consumption of all illicit substances. As the Guardian explains: “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 – a doctor, a lawyer and a social worker – about treatment, harm reduction, and the support services that were available to them” (Ferreira, 2017).

The 2001 legislation was a radical movement by the Portuguese government in response to an escalating substance misuse problem that had engulfed Portugal from the early 1980s. Back then, Portugal experienced rapidly increasing levels of problematic drug use, higher deaths due to drug use, increase in prevalence of STDs amongst intravenous drug users resulting in an uncontrollable spiralling situation for public health, social cohesion and public finances (Domoslawski & Siemaszko 2011; Ferreira, 2017; Kristof, 2017; Van Het Loo et al., 2002).

Contrary today, a decade after implementing this radical and at time controversial approach, Portugal is experiencing numerous benefits in many areas. Dramatic drops in problematic drug use, lower HIV and hepatitis infection rates, decrease in drug-related crime and incarceration rates with subsequent benefits in public finances and ease of burden for the police and the judiciary (Domoslawski & Siemaszko 2011; Ferreira, 2017). Today, among Portuguese adults, there are 3 drug overdose deaths for every 1,000,000 citizens. Comparable numbers in other countries range from 10.2 per million in the Netherlands to 44.6 per million in the UK, all the way up to 126.8 per million in Estonia (Domoslawski & Siemaszko 2011).

Additionally, and perhaps most importantly, language began to shift, too. Those who had been referred to sneeringly as drogados (junkies) became known more broadly, more sympathetically, and more accurately, as “people who use drugs” (Ferreira, 2017). That shift shattered social stigma around substance use and offered users and their families a invaluable platform to openly discuss and share their struggle Finally, changes in official policy made it easier for a broad range of services that had been struggling to pool their resources and expertise, to work together more effectively to serve their communities. Despite its widely accepted positive effects, Portugal’s paradigm is not without its problems. Long-term effects of problematic drug use including STDs, cirrhosis and liver cancer are still a burden on public health and public finances.

Portugal’s experience taught us that decriminalisation is not and should not be treated as either a fearful or a magical solution. In order to achieve and possibly surpass the Portuguese achievements a comprehensive system should be in place one that guarantees on-going support for users and their families while reducing harm, a system that offers a variety of treatment options and finally, provides a clear and supportive path back to society.

Portugal’s example should continue to act as a reminder to politicians and societies that substance use is not a contagious issue that needs to be fought. In most cases, addiction is not a choice; it is the end result of an intricate network of causal factors both societal and individual. It merely is another dimension of our modern societies, one that requires progressive policies, compassion, openness and dialogue.

References

Domoslawski, A., & Siemaszko, H. (2011). Drug policy in Portugal: the benefits of decriminalizing drug use. New York, NY: Open Society Foundations.

Ferreira S. (2017, December 5). The long read. Portugal’s radical drugs policy is working. Why hasn’t the world copied it?. The Guardian. Retrieved from: www.theguardina.com

Kristof N. (2017, September 22). How to win a war on drugs: Portugal treats addiction as a disease, not crime. The New York Times. Retrieved from: www.nytimes.com

Van Het Loo, M., Van Beusekom, I., & Kahan, J. P. (2002). Decriminalization of drug use in Portugal: the development of a policy. The Annals of the American Academy of Political and Social Science, 582(1), 49-63.