Nuggets of Wisdom

Wednesday, April 1, 2015

Libertarian Drug Policy: Portugal

By the nineteen-eighties, drug abuse had become a serious problem in Portugal. The Lisbon government responded in the usual way—increasing sentences for convictions and spending more money on investigations and prosecutions. Matters only grew worse. In 1999, nearly one per cent of the population—a hundred thousand people—were heroin addicts, and Portugal reported the highest rate of drug-related AIDS deaths in the European Union.

In 2001, Portuguese leaders, flailing about and desperate for change, took an unlikely gamble: they passed a law that made Portugal the first country to fully decriminalize personal drug use. (Other nations, such as Italy and the Netherlands, rarely prosecute minor drug offenses, but none have laws that so explicitly declare drugs to be “decriminalized.”) “We were out of options,” João Goulão told me. Goulão is the president of the Institute on Drugs and Drug Addiction, a department of the Ministry of Health that oversees Portuguese drug laws and policy. “We were spending millions and getting nowhere.” For people caught with no more than a ten-day supply of marijuana, heroin, ecstasy, cocaine, or crystal methamphetamine—anything, really—there would be no arrests, no prosecutions, no prison sentences. Dealers are still sent to prison, or fined, or both, but, for the past decade, Portugal has treated drug abuse solely as a public-health issue.

That doesn’t mean drugs are legal in Portugal. When caught, people are summoned before an administrative body called the Commission for the Dissuasion of Drug Addiction. Each panel consists of three members—usually a lawyer or a judge, a doctor, and a psychologist or a social worker. The commissioners have three options: recommend treatment, levy a small fine, or do nothing. Counselling is the most common approach, and that is what Nuno Miranda received when he appeared, in 2002, before the commission in Lisbon. “I was using drugs for five or seven years before that law passed,” he said. “Since then, everything has changed. Everything.”

In most respects, the law seems to have worked: serious drug use is down significantly, particularly among young people; the burden on the criminal-justice system has eased; the number of people seeking treatment has grown; and the rates of drug-related deaths and cases of infectious diseases have fallen. Initial fears that Portugal would become a haven for “drug tourism” have proved groundless. Surprisingly, political opposition has been tepid and there has never been a concerted repeal effort....

It has been exactly fifty years since the United Nations adopted the Single Convention on Narcotic Drugs, the first truly international effort to prohibit the growth, production, and sale of narcotics, cannabis, and other illegal substances. Since 1961, however, Western nations have struggled with rising rates of drug abuse. Law-enforcement officials, politicians, and public-health leaders have debated their alternatives frequently—and frequently disagreed about what to do. That debate has never ended, and there are still essentially two approaches to substance abuse: rehabilitation and incarceration. In Portugal, though, a consensus quickly formed, even among law-enforcement officials, that devoting ever-increasing resources to drug interdiction had little or no effect. And neither did relying on the criminal-justice system to address the problem.

Eventually, the Portuguese government moved responsibility for drug-control issues from the Justice Department to the Ministry of Health. It was a striking decision; in other countries, drug abuse has remained primarily a matter for law-enforcement agencies. In the past forty years, American police officers have arrested millions of nonviolent drug offenders, and hundreds of thousands have been prosecuted. Rather than try to eliminate drug abuse, Portugal’s approach, commonly known as “harm reduction,” attempts to minimize the negative consequences for society. In recent years, those consequences have become both more obvious and more significant.

“The prevailing approach in the rest of the world ignores scientific reality and squanders resources on things that have been shown again and again to fail,” said Miguel Vasconcelos, the chief psychiatrist at the Taipas treatment center, the largest in Lisbon, with eighteen hundred patients. When Vasconcelos began working at the clinic, more than twenty years ago, there was no attempt at harm reduction. “The goal was to get people off drugs,” he said. “And for many patients that is still the goal. But there are people for whom it is hard and some for whom it is not possible. This is an alternative that does get people off the streets, reduces the rates of H.I.V. infection, and lowers crime. It is humanistic but also pragmatic.”

- "Getting a Fix", Michael Specter (New Yorker).