Portugal’s War on Drugs: Part II

Lisbon at sunset (All images belong to Sophie De Sousa McMeakin, unless otherwise stated)

So how effective has the Portuguese Drug Strategy been? This is difficult to assess because it is likely that decriminalisation alone has not been solely responsible for the promising figures: the expansion of health and social investment in Portugal in the last two decades has almost certainly played a crucial role.

However, statistics reveal that levels of drug use have decreased to below the European average, drug use has declined among the highest-risk group (those aged 15-24) and the rates of continuation of drug use have decreased. Significantly, since 2001 the rates of HIV/AIDS infection from needle use have sharply fallen as well as drug-induced deaths, a key indicator of the policy’s success. This is largely thanks to the harm reduction measures implemented alongside decriminalisation. State-funded and NGO outreach teams consisting of nurses, social workers and psychologists (for example, Crescer) visit areas known to addicts and provide psychological support and drug paraphernalia such as clean needles and citric acid for diluting heroin or crack cocaine. There are also government-funded drug consumption centres where individuals can receive health checks and use them in a sanitary, supervised environment. Rather than viewing this as enabling addiction, supplying addicts with safe ways to use presents a realistic approach that acknowledges that drug abuse in society cannot be eradicated overnight, if at all. The reasons for consumption can be greatly ameliorated, but it would be a utopian fantasy to believe that a drug-free society is attainable. It is better that users consume safely, reducing the threat to their health and others, than increasing pressure on the national health service and risking transmission of diseases. Drug dependency treatments such as methadone (for heroin addiction) are also essential to rehabilitation and are available on prescription and at designated centres.

Naturally, Portugal’s Drug Strategy has not been infallible; despite a 60% increase in users seeking treatment from 1998 to 2011, public hard drug use is still visible and drug-related stigma is has proven difficult to shake. Critics suggest that the ten-day personal limit on drug possession is too lenient, enabling small dealers to operate with impunity. Additionally, in contrast to illicit drug abuse, prescribed anti-depressant usage in the country is one of the highest in Europe, attesting to an ongoing battle with chronic depression rates in Portugal. The nation’s mental health has a key stake in the policy's success, and is largely pivoted on consistent funding for public services and the maintenance of decent living standards. The pandemic and the economic difficulties it triggered have likely been responsible for the sharp increase in drug use in Lisbon between 2019 to 2023, and the 24% rise in drug paraphernalia being collected from streets in Porto, demonstrating the Drug Strategy’s vulnerability to times of socioeconomic instability. There is always the concern that with the challenges of a recession, the government may slash its spending on the treatment network, leading to another rise in HIV cases and overdoses. This would be a great error, as with more HIV cases, the government would be forced to spend more on treatment, offsetting the initial savings.

Indeed, there is little evidence that a punitive approach reduces substance abuse or crime associated with it. However, there is evidence that a systematic approach towards decriminalisation reduces overdose deaths, drug-related crime and prison populations. Since 2000, other countries have also partially or totally decriminalised drugs: Estonia, Switzerland, Netherlands, Germany and the Czech Republic, to name a few. The efficacy of the policy in Portugal and other nations is under constant review, and the introduction of drugs such as fentanyl (a powerful synthetic opiate), which has already created an acute overdose crisis in the US and Canada, will form a tough test for decriminalisation policy.

Lastly, despite the numerous positive outcomes of decriminalisation, it is vital to stress the damage inflicted by the drug crisis of the ‘80s and ‘90s in Portugal; nearly everyone knows someone who struggles with addiction, heroin in particular. Many families in Portugal have battled with the destructive consequences of substance abuse. There is the emotional toll of concern about a family member addicted to heroin, the financial repercussions as they over-spend on drugs, fail to attend to their basic needs or hold down a job. There are medical emergencies: HIV and hepatitis C infection from reusing or sharing needles, overdose and suicide attempts. In some respects, Portugal’s innovative approach can be understood as a desperate stand against a domestic emergency, which was severe enough to force the hands of even the more conservative figures in government. It highlights that the most powerful show of force in the “War on Drugs” is also the most compassionate one: treating drug users humanely and implementing harm reduction measures. Indeed, it should be a war on drugs, not people.