Harm Reduction And Decriminalisation In Portugal

Portugal's Revolutionary Approach to Drug Addiction Helped Break the Stigma, Drop Crime Rates and Seriously Reduce Drug Related Deaths.

Drug addiction is a complex disease, and to break free of its grasp it usually takes more than good intentions or a strong will. It’s almost always compulsive and difficult to control, despite its harmful consequences. It challenges your self-control and changes your brain in a persistent, long-lasting way, meaning relapse is part of the treatment for many people. No one factor can predict if a person will become addicted to drugs, instead a combination of factors influences risk of addiction. The harm caused to those who suffer from drug addiction, and to their circle of friends and family is, for the most part widely understood. However, different nations have adopted a number of approaches to tackle drug addiction in their communities, with more and more places considering the idea of the decriminalisation of drugs. Most notably, Portugal adopted a harm reduction approach in 2001, which has since led to dramatic drops in overdoses, HIV infection and drug-related crime.

Photograph: Horacio Villalobos/Corbis via Getty Images

Back in the ‘80s, 1 in 10 people in Portugal were using heroin. People were openly and obviously using the drug and crime in the country was a serious problem, with daily robberies and muggings. By the late ‘90s, about half the people in prison were there for drug related reasons. The rate of HIV infection in Portugal became the highest in the European Union. When the country decriminalised illicit substances in 2001, rather than being arrested, those caught with a personal supply might be given a warning, a small fine or told to appear before a local doctor or social worker to discuss treatment, harm reduction and the support services that were available to them. The following years saw dramatic drops in problematic drug use, drug related crime and incarceration rates. However, the remarkable recovery that took place in Portugal must also be accredited to the enormous cultural shift, and how the country renewed their approach to how drugs and addiction were perceived.

Portugal’s policy rests on three pillars; that there’s no such thing as a soft or hard drug, only healthy and unhealthy relationships with drugs. Secondly, that an individual’s unhealthy relationship with drugs often conceals frayed relationships with loved ones, with the world around them and with themselves, and finally, that the eradication of all drugs is an impossible goal. In treatment, they approach each individual differently depending on their needs. When visiting a treatment centre in Portugal, one reporter found that the centre’s responsibility was not to force anyone to stop using, but to help minimise the risks users were exposed to. The visitors to the centre had to want the treatment, and failure was often an inevitable part of it.

Drugs have not been legalised in Portugal, and the manufacture, importation and sale of drugs remain very much illegal. The decriminalisation policies, despite their success have not been entirely welcomed, some arguing that drug users should not be thought of sick people in need of help. For some, thinking of drug addiction in terms of health and disease was too reductive. It’s also heavily debated how easily these policies could be applied to other countries, yet it’s clear that in Portugal, healthcare workers feel better equipped to help those with drug addictions. Perhaps the biggest signal of the success of Portugal’s policy is its ability to protect the next generation, with drug use declining within the 15-24 year old population, which are those most at risk of initiating drug use. Ultimately, it’s understood that drug addiction is something that will always exist, but by eliminating the threat of criminal penalties and the associated stigma, it has become easier for people to seek treatment. That’s not to say that Portugal doesn’t have a way to go to, with some people still continuing to use drugs in terrible conditions, but it has showed that governments can give drug users the tools to put their lives back on track, but to do so they’d have stop treating drug users like criminals.

Featured Photograph: Horacio Villalobos/Corbis via Getty Images