Second in a series on the Decriminalization of Drugs in Portugal
By Joe Chivers
In the last installment of this series on the Portuguese approach to the drug war, we covered the massive addiction problems plaguing Portugal in the 1980s and 1990s. In this article, we will examine how Portugal’s various efforts to tackle this public health crisis ultimately led to decriminalization.
We begin in the late 1980s. Hepatitis, HIV and heroin addiction were spreading like wildfire across the nation, and through all levels of society. What was to be done?
In 1987, the government began to take the issue more seriously. An initiative aimed at combating the epidemic in a unified manner, across all governmental ministries, was put into place, and an innovative new clinic for those suffering from addiction was established. The Centro das Taipas in Lisbon was aimed squarely at the victims of Portugal’s addiction crisis, featuring an outpatient clinic, emergency unit, and detox facilities. As noted in this paper from the country’s General Directorate for Intervention on Addictive Behaviours and Dependencies, numerous other cities soon followed suit. The clinic’s treatment model, allowing for patients to be treated using multiple techniques simultaneously, was distributed to other clinics across the nation. This allowed patients to move around Portugal without jeopardizing their treatment plan. The clinics were soon swamped with patients, which, while putting a strain on the services, led to increased attention being drawn to the scope of the problem. To cope with this, a new government agency, the SPTT (Service for Prevention and Treatment of Drug Addiction) was created.
Another important tool that the Portuguese government used in the fight against addiction was substitution treatment. Methadone, a drug used to lessen the symptoms of heroin withdrawal, had been available in the city of Porto since 1977, and was the sole municipality to offer it until 1992. In that year, the program spread to numerous other areas. The program continues to this day, with paper cups of methadone distributed by van daily. This was paired, the following year, with a national needle exchange program. Across the country, 2500 pharmacies participated in the “Say No! To A Used Syringe” program. Drug users could exchange dirty needles for a kit that included new needles, a condom, rubbing alcohol, and a pamphlet advertising addiction treatment centers and information on preventing the spread of AIDS. In the following years, the programs provided three million syringes per annum. The needle exchange itself was also widely advertised, with the government running commercials on TV, radio, the press, and distributing posters.
In 1999, the government approved a new strategy based around the quality of service available to drug users, for the first time, as this paper states, “as a main concern and a fundamental right of the drug user as a citizen.” The plan saw significant investment towards enlargement of health services, both public and private; the growth of opiate substitution and needle exchange programs, and the enlargement of the infectious diseases notification systems for hepatitis, HIV, and tuberculosis. The nation as a whole was also at least somewhat supportive of decriminalization, with even right-wing political parties supporting a referendum on the issue. Between 1999 and 2000, investment across the government aimed at resolving drug addiction increased by over €21 million. It was clear then, that the government knew their earlier approaches were not enough.
Despite the most popular drug amongst the general population being hash, users with drug-related health problems or legal issues, tended to use heroin.
In July 2001, drug use was decriminalized, with possession of drugs changed from a criminal to an administrative issue. As noted by The Guardian, social views on drug users also began to change. Rather than referring to those suffering from addiction as “drogados,” a word meaning junkie, as had been common, Portuguese society began to see drug addiction for the illness that it is, rather than an issue for the weak-willed of society. In the years since, problematic use of drugs has fallen dramatically and HIV infection rates have plummeted. There were just 4.2 new cases per million in 2015, compared to 104.2 per million in 2000.
As mentioned earlier, the possession of drugs is now classed as a civil offense under Portuguese law, as opposed to a criminal one. There are no hefty prison sentences handed out to drug users. Instead, they are brought before a “Commission for the Dissuasion of Drug Addiction.” As noted by a BBC journalist, their approach is fairly relaxed, with the commission being composed of a social worker and a psychologist. They are able to sentence people to community service, confiscate their driving license, ban a person from carrying a gun, or strip them of their right to practice their job if it is thought they would harm others due to their drug problem (i.e., if they are a doctor.) Their main aim, however, is to have a frank discussion and see if the person they are assessing would benefit from specialised treatment. As you would expect, most of the cases just involve pot, but the law has made one tremendous difference. Now, those with addiction problems can go to hospitals and doctor’s offices across the country without fear of facing prison time for their illnesses. Instead of asking doctors to unplug their intercoms for fear of someone listening in, they can simply talk frankly about their problems and get the treatment they need. Said treatment extends beyond simply getting the person off drugs, however. Following their treatment, the government works to support recovering addicts through training schemes, housing, and employment opportunities.
It is important to realize that this is not some fairy story. Nor is it a Sweden-style social democracy that others can point at and admonish simply by saying “that wouldn’t work here.” Portugal went from being a country ruled by a fascist dictatorship to one with perhaps the world’s most progressive approach to drugs in fewer than 30 years. It is also a country where such a policy survived right-wing governments. The system works, has helped countless people, and has changed the culture of the country with it. In the next and final installment of this series, we will examine recent developments in the Portuguese system, and what could be in store in the future.
Joe is a print and online journalist, based in Europe, who specializes in writing on war and social issues.