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The success of Portugal’s unconventional drug strategy – in numbers

Graphic: Sean Creighton/The Progress Playbook
Graphic: Sean Creighton/The Progress Playbook

In the 1990s, Portugal was in the grip of an opioid epidemic – much like the US is today.

The ‘war on drugs’, at least in the traditional sense, wasn’t working. So, policymakers decided to ditch the archaic playbook that had been in place for several decades, and swapped it for a more science-based approach.

In 2001, the government decriminalised drug use and treated the problem as a public health crisis, rather than a criminal one (drug use isn’t legalised today, but it’s no longer a crime).

Users are now regarded as patients, not felons. Those who are ‘caught’ are sent to doctors, social workers and drug experts, who in turn can refer them to treatment and harm reduction programmes. As a result, those with drug problems get the treatment they need, unlike in most other countries, where use is inevitably driven underground.

The results have been remarkable:

     

      • According to the Portuguese health ministry, via the New York Timesthe number of heroin users in the country dropped from about 100,000 before the law to just 25,000 in 2017.

      • As part of the policy to treat addiction as a health crisis, drug users can exchange used syringes for new ones at pharmacies. This has sharply reduced needle sharing, which, in turn, has allowed Portugal to get on top of its HIV epidemic. There are now no new HIV cases linked to the injection of drugsaccording to the EU agency that monitors such things. Back in 2000, half of the country’s HIV cases stemmed from drug use. A similar trend has been observed with hepatitis.

      • Total drug-related deaths have fallen from an average of more than one a day before the law took effect, to one every five days now, separate data from the agency shows. According to the New York Times analysis, Portugal’s drug mortality rate is now the lowest in Western Europe, and much lower than America’s.

    The war on drugs, which US president Richard Nixon launched in 1971, has been an incredibly expensive waste of time, many activists say. It doesn’t address the root causes of drug abuse – focusing merely on the symptoms – and has only made things less safe for users, who don’t get the professional help they require.

    Portugal’s approach, on the other hand, has reduced stigmatisation, promoted social reintegration, and delivered positive public health benefits for society at large.

    Yes, but: Oregon hasn’t had much success since adopting a similar strategy two and a half years ago.

    In the midst of the Covid-19 pandemic, the state experimented with a new policy whereby people caught with small amounts of drugs are fined $100 – a sanction that can be waived if they seek treatment.

    It’s not gone well. Open-air drug use is now in full view, and overdose rates have increased, the New York Times reports.

    The policy is now under scrutiny, although some groups are begging for it to be given more time.

    Why has Oregon’s approach failed so far? According to Solara Salazar, director at Cielo Treatment Center, there’s not nearly enough capacity in rehabilitation facilities, meaning patients can wait months to be seen.

    “You just can’t skip a step and expect people to be successful,” she said, per the New York Times report.

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