Pearls and Irritations

Treating personal drug use as an administrative offence along the lines of a parking violation has worked well for Portugal. It has not only been a public health and public policy success but also a political one.

In 2001 Portugal began to treat minor drug possession as an administrative offence. Although the benefits of this approach have been many and far outweighed the minor negatives, few countries have so far sought to emulate Portugal’s policy.

The last couple of decades of the 20^th century were a difficult time for Portugal. Many people from across the social and economic range of the community developed severe problems related to illicit drugs. The rate of drug overdose deaths and crime reached very high levels while the rate of HIV infection among people who injected drugs was the highest in Western Europe and kept rising.

At that stage, Portugal’s drug policy was much the same as other European countries: Portugal relied heavily on drug law enforcement to keep illicit drug problems under control. But it was increasingly difficult to deny that Portugal’s drug policy was not working. Drug policy was discussed vigorously in the nation’s parliament, media and community.

In the late 1990s, the government of Portugal began to consider a different approach relying more on health and social interventions rather than the criminal justice system. António Guterres was the Socialist Party Prime Minister of Portugal from 1995 to 2002 and oversaw the introduction of a drug law reform package. The Portuguese government commissioned an alternative policy. Dr João Goulão, a well-respected Portuguese doctor with considerable experience in providing drug treatment, was influential in devising the reform package. The package of recommendations was adopted much as it had been written and was then implemented from 1 July 2001. Guterres, now Secretary General of the United Nations, has recently encouraged the international community to consider Portugal’s experience.

The main elements of this policy were to: (i) abandon criminal penalties for personal drug use and possession (with threshold quantities defined for each drug type according to an estimated ten days supply); (ii) expand and improve health and social care for people with drug problems; (iii) establish a national network of assessment and referral centres for people using drugs; and (iv) improve the social integration of people with serious drug problems. A small panel of the ‘Commission for the Dissuasion of Drug Addiction’ (CDT) carries out assessments for people found in possession of personal quantities of drugs. The panel can refer people for help if they are struggling with drug problems preventing them from functioning responsibly as citizens. The help provided may include drug treatment, guaranteed minimum income and employment assistance. The CDT system includes ‘carrots and sticks’ to ensure high levels of compliance. Methadone and buprenorphine treatment for heroin dependence is now readily available and reasonable quality. Persons found in possession of quantities of drugs above the specified threshold levels are still managed, as before 2001, by the criminal justice system.

This package of reforms has been a substantial public policy and political success. Positive outcomes have far outweighed the few negative results. In a country of about ten million people, drug induced deaths dropped from over 70 in 2001 to 15 in 2012. HIV infections among people who inject drugs fell from over 1,400 in 2000 to less than a hundred in 2012. Criminal charges fell from almost 14,000 in 2000 to about 6,000 per year. In 2017 the number of drug induced deaths per million was 6 in Portugal, 60 in UK, 100 in Sweden and 185 in USA. Reported drug use in Portugal dropped considerably after 2001 among young people (15-24 years old) but rose slightly in older age groups (35-44 years old, 45-54 years old). Drug use increased to a greater extent in neighbouring Spain and Italy during this period. There is little argument that problematic drug use became less common in Portugal after 2001. The generally encouraging trends in drug consumption in Portugal were in stark contrast to the frequent and confident predictions that illicit drug use would soar after a less punitive approach to drugs was adopted.

Treating personal drug use as an administrative offence along the lines of a parking violation has worked well for Portugal. It has not only been a public health and public policy success but also a political one. The major criticism of the 2001 policy heard in Portugal is that selling of illicit drugs by dealers is now more brazen and sometimes confronting. People dining in outdoor restaurants are now more likely to complain that a drug dealer interrupted their meal. In the scheme of things, it’s perhaps not a major concern.

The drug policy package has survived pretty well intact since being adopted and implemented in 2001. Changes in government after elections and major cuts to government spending after the global financial crisis of 2008/09 have barely affected Portugal’s drug policy.

Many politicians and policy makers from other countries have visited Portugal to see the strengths and weaknesses of Portugal’s approach at first hand. Some official visitors from Norway recently visited Portugal and then announced that Norway would adopt some of Portugal’s drug policy. Australian politicians visiting Portugal have been impressed.

It may seem surprising that more countries have not adopted Portugal’s successful policy if the results have been as favourable as claimed, especially considering the generally dismal results of policy heavily reliant on the criminal justice system. But there is a strong and consistent pattern that governments often adopt with alacrity expensive criminal justice approaches with, at best, mediocre results while rejecting for many years harm reduction and drug law reform approaches that have been shown convincingly to save lives, improve social functioning, reduce crime and save substantial government expenditure.

Another criticism of Portugal’s policy is that the demand for illicit drugs is still met by an unregulated black market. But improvements in drug policy are difficult to achieve, with slow and incremental progress better than nothing.

Australia should consider the very positive experience of Portugal’s drug policy reforms.

Dr Alex Wodak, AM, is an Emeritus Consultant at St. Vincent’s Hospital, Sydney, a Director of Australia21 and is President of the Australian Drug Law Reform Foundation.

Share and Enjoy !

SHARE TWEET SHARE COPY EMAIL PRINT