In 2001, Portugal became the only EU state to decriminalise personal possession of all drugs in attempt to boost public health. Use, possession and purchase of these drugs (as long as the among remains below the average quantity for ten days of consumption in order to prevent trafficking) is now only an administrative offence. Since the introduction of this law, Portugal has seen a sharp decline in drug related offences, deaths and to a lesser extent overall use, but is this enough to justify applying the policy elsewhere? And if so, why has the rest of the world been so slow at catching on?
Arguably one of the most important aspects of the policy is it involves coordinated efforts to treat addiction as a health issue, rather than a regular crime. Under current law, drug dissuasion panels can order treatment for addicts. Those who refuse treatment are required to check in regularly with a family doctor, and if they refuse to show up the police personally hand them a notification to ensure they know when and where they have to attend the check-ups. Coordination between the police and healthcare professionals is key, as it helps ensure the system can provide aid for people who may have mental health issues or other conditions leading them to repeated drug use, rather than simply punishing them for the sake of ‘justice.’
Non-profit groups also work in parallel with government efforts, providing clean needles to help reduce HIV levels, and occasionally even crack pipes to encourage users to stay within the system of state service providers rather than turning to potentially more dangerous routes. Needle provision, as well as providing substances for substitution which aren’t taken in risky ways, have helped the rate of HIV infections to fall rapidly since decriminalisation, with there being 1,016 cases of new infection in 2001, compared to just 56 in 2012.
In terms of preventing overdoses, the policy has had unprecedented success, undoubtedly saving many lives. In 2001, there were 80 Portuguese cases of deaths through overdose, a number that had declined to 16 in 2012. In 2016, Portugal’s drug induced death rate of three per million was more than five times lower than the EU’s average of 17.3 per million. Estimations also suggest that, following implementation of decriminalisation, there was a sharp decrease in levels of seizures from both cocaine and heroin use compared to predicted levels. This is likely due to a higher proportion of people being encouraged to seek help before drug use reaches a stage where overdose is more common and to more people sourcing drugs through safer routes such as NGOs.
The positive impacts decriminalisation has seen aren’t limited to users; the policy has had significant economic benefits for the country too. The cost of the programme amounts to under $10 per citizen per year, while in contrast the US has spent over $1 trillion in tackling drug use over the same period. Furthermore between 2001 and 2011, societal cost savings from the programme came to 12%, then 18%. This may be partially to do with prisons not having to deal with so many drug users – the proportion of prisoners sentenced for drug use from 2001 to 2021 fell from 40% to 15%. Thus, it seems the policy has not only helped vulnerable users, but in turn the rest of society too – surely it’s surprising very few other countries have adopted similar approaches.
With the recent ban on Nitrous Oxide, perhaps the UK is headed towards becoming stricter on drug use. However, it could be argued that ban of Nitrous Oxide was more of a political move only able to be voted through to stop the Conservatives accusing Labour of condoning antisocial behaviour, and may not reflect public or scientific opinion. The move itself was not without controversy – earlier this year the UK’s drug advisory panel rejected calls to ban the sale and possession of Nitrous Oxide, arguing that social harms were not proportional to justify the ban. They also stressed the move for a health based approach, with comprehensive warnings on packets of Nitrous Oxide and an educational campaign on its harms. Professor David Nutt, director of neuropharmacology at Imperial College London, contrasted Nitrous Oxide with alcohol, pointing out that it is, ‘way less damaging in the long term than alcohol, much less likely to cause aggression, much less impairing of people’s driving performance.’ However, while drug use policies are influenced heavily by partisan politics, there is no sure way to predict whether more drugs will be decriminalised in the future, regardless of academic or scientific opinion.
Despite this, Doctor Joao Goulao, architect of the Portuguese decriminalisation programme and Director-General of The General-Directorate for Intervention on Addictive Behaviours and Dependencies (SICAD) in Lisbon believes we are ‘already watching’ a shift in drug policy away from a prohibitionist model and towards a public health model. He stated, ‘our main task in the international context should be to produce further evidence that the humanistic approach is far more efficient than policies based on prosecution, which are sometimes in complete disregard of human rights.’
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