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From Dirty Needles to Decriminalized Drugs

Updated: Nov 1, 2020

Lessons from Portugal’s Drug Policy of Decriminalization

By Aisha Mahal

Portugal decriminalized drugs 19 years ago in a move which carved a path for a new, radical understanding for drug policy. Understanding and learning from Portugal’s approach is crucial for other countries. Prior to decriminalization, Portugal was in the midst of a drug-driven crisis. More than 1% of the population was addicted to heroin - everyone from students to bankers to teachers. Portugal had the highest rate of HIV infections in Europe, with people shooting up in broad daylight, dirty-needles becoming the norm.

The initial response to the crisis was one which many Americans will recognize. A ‘War on Drugs’ was declared. Drug use was demonized and harshly punished. By the late 1990s, half of Portugal’s prison population was there for drug-related crimes. This led to a huge volume of addicted inmates. It did not, however, solve the crisis. The turning point came in 2001 when the Portuguese government decriminalized the possession of all drugs for personal use.

An important distinction to make here is the difference between the decriminalization and the legalization of drugs. Decriminalization removes the criminal offense from drug use. However, it can still be penalized. Meanwhile, legalization would remove all legal consequences for drug use, placing it on the same level of alcohol use or smoking cigarettes.

How does this work in Portugal? The possession of personal drugs carries no criminal penalty. Instead, it can be penalized through ‘administrative fallbacks’. This includes fines, community service or recommendations for treatment and therapy. These penalties are decided by ‘Commissions for the Dissuasion of Drug Addiction’. It is important to note that these commissions are made up of legal, health and social work professionals. This places the responsibilities in the hands of those with knowledge better suited to drug misuse than that of the police.

This shift appears to have worked. Numerous indicators suggest that Portugal is a country on the road to recovery. Firstly, drug use has declined among 15-24 year-olds. Rates of the continuation of drug use (using drugs repeatedly and regularly) have also decreased. HIV infections have halved over 10 years, falling from 2,167 in 2007 to 1,030 in 2016. Between 2001 and 2012, the number of new cases of AIDS among those who inject drugs decreased from 568 to only 38.

In terms of prison populations, the proportion of drug-related offenders in Portuguese prisons dropped from 44% of the prison population in 1999, to under 21% in 2012. The much-feared dramatic increase in drug use has not materialized despite decriminalization. Nor has Portugal become a ‘narco-state’ as many right-wing opponents of the policy feared.

From most perspectives, it appears that Portugal has achieved the impossible by decriminalizing drugs. It has dramatically reduced HIV cases and drug-related deaths in a move that should be mirrored across the globe. However, this is not a black-and-white case. Decriminalization alone did not create all these improvements. It would not have been possible without a cultural and political shift in how drugs are approached. Decriminalization helped to change the mindset from drugs as a criminal issue to drugs as a health issue. This, arguably, is the most crucial aspect of Portugal’s solution. Decriminalization helped facilitate a move towards ‘health-based’ responses and improved social and health care. It placed doctors, therapists and social workers at the forefront of the crisis (where they always should have been).

It coincided with the creation of Portuguese welfare programs, such as the introduction of a minimum wage. Decriminalization helped a broad range of struggling services (health, psychiatry, employment, housing, etc.) to pool their resources and expertise in order to work more effectively to help their communities.

There was also an important shift in the language around drug use. Prior to decriminalization, drug addicts were dismissed as ‘drogados’. This term with negative connotations was replaced in the public discourse by the phrase ‘people with addiction disorders’. This helped facilitate the cultural shift which changed the view of drug addicts from being seen as criminals, to people who needed support and help.

It is misleading to credit all the positive results completely to a change in law and policy. Decriminalization alone would not have solved Portugal’s crisis. Rather, it took a drastic overhaul of the mindset and the structure of the Portuguese health and social system.

It is also important to remember that Portugal is not alone in decriminalizing drugs. Around 25 countries have removed criminal penalties for the personal possession of some or all drugs. This has helped the growing global shift away from drug policies which focus on punishment.

Portugal still has a long way to go in recovering from the drugs crisis it faced at the end of the last century. The decriminalization policy received widespread praise on the international stage, however grassroots activists have criticized the policy for various reasons. For one, the government has been very slow in creating safe, supervised injection sites and drug consumption facilities. This would further prevent the spread of infections and the misuse of dangerous equipment. Moreover, anti-overdose medication needs to be made more readily available to both paramedics and drug-users. Gatekeeping this type of medication puts the progress Portugal has made at risk.

Coronavirus and related-economic struggles also pose a risk for Portugal’s recovery. With political and economic priorities shifting away from drug policy, there is a possibility that Portugal slips back towards the darker days of the 1990s. It will take bipartisan commitment to the policy of decriminalization to maintain Portugal’s trajectory.

Portugal’s decriminalization policy is far from the perfect solution to high drug-related death and HIV rates. However, it is a better approach than policies which use violent, militarized language to demonize drug users (take the ‘War on Drugs’). Drugs users are not the enemy, nor are drugs. Governments around the world need to follow Portugal’s lead. Health-based approaches to cases of misuse of drugs are the future.

It is time to take the police and criminal justice system out of matters concerning people’s brains and bodies (not just drugs, but also mental health sectioning). The decriminalization of drugs plays into a wider need to defund police forces around the world and redirect that money and resources into our doctors, therapists, social workers and teachers. Portugal took the first step. It is time for other countries to follow suit.

Written by writer Aisha Mahal

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