"Portugal’s radical drugs policy is working. Why hasn’t the world copied it?"

The title of this post is the title of this lengthy recent Guardian article taking an in-depth look at how Portugal achieved and operationalizes its distinctive approach to drug use and abuse.  The extended article takes a deep dive into a lot of particular, but here are excerpts from the more general discussion:

In 2001, ... Portugal became the first country to decriminalise the possession and consumption of all illicit substances.  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 commission — a doctor, a lawyer and a social worker — about treatment, harm reduction, and the support services that were available to them.

The opioid crisis soon stabilised, and the ensuing years saw dramatic drops in problematic drug use, HIV and hepatitis infection rates, overdose deaths, drug-related crime and incarceration rates.  HIV infection plummeted from an all-time high in 2000 of 104.2 new cases per million to 4.2 cases per million in 2015.  The data behind these changes has been studied and cited as evidence by harm-reduction movements around the globe.  It’s misleading, however, to credit these positive results entirely to a change in law.

Portugal’s remarkable recovery, and the fact that it has held steady through several changes in government — including conservative leaders who would have preferred to return to the US-style war on drugs — could not have happened without an enormous cultural shift, and a change in how the country viewed drugs, addiction — and itself.  In many ways, the law was merely a reflection of transformations that were already happening in clinics, in pharmacies and around kitchen tables across the country.  The official policy of decriminalisation made it far easier for a broad range of services (health, psychiatry, employment, housing etc) that had been struggling to pool their resources and expertise, to work together more effectively to serve their communities....

In spite of Portugal’s tangible results, other countries have been reluctant to follow.  The Portuguese began seriously considering decriminalisation in 1998, immediately following the first UN General Assembly Special Session on the Global Drug Problem (UNgass).  High-level UNgass meetings are convened every 10 years to set drug policy for all member states, addressing trends in addiction, infection, money laundering, trafficking and cartel violence.  At the first session — for which the slogan was “A drug-free world: we can do it” — Latin American member states pressed for a radical rethinking of the war on drugs, but every effort to examine alternative models (such as decriminalisation) was blocked. By the time of the next session, in 2008, worldwide drug use and violence related to the drug trade had vastly increased.  An extraordinary session was held last year, but it was largely a disappointment — the outcome document didn’t mention “harm reduction” once.

Despite that letdown, 2016 produced a number of promising other developments: Chile and Australia opened their first medical cannabis clubs; following the lead of several others, four more US states introduced medical cannabis, and four more legalised recreational cannabis; Denmark opened the world’s largest drug consumption facility, and France opened its first; South Africa proposed legalising medical cannabis; Canada outlined a plan to legalise recreational cannabis nationally and to open more supervised injection sites; and Ghana announced it would decriminalise all personal drug use.

The biggest change in global attitudes and policy has been the momentum behind cannabis legalisation.  Local activists have pressed Goulão to take a stance on regulating cannabis and legalising its sale in Portugal; for years, he has responded that the time wasn’t right.  Legalising a single substance would call into question the foundation of Portugal’s drug and harm-reduction philosophy.  If the drugs aren’t the problem, if the problem is the relationship with drugs, if there’s no such thing as a hard or a soft drug, and if all illicit substances are to be treated equally, he argued, then shouldn’t all drugs be legalised and regulated?

Massive international cultural shifts in thinking about drugs and addiction are needed to make way for decriminalisation and legalisation globally.  In the US, the White House has remained reluctant to address what drug policy reform advocates have termed an “addiction to punishment”.  But if conservative, isolationist, Catholic Portugal could transform into a country where same-sex marriage and abortion are legal, and where drug use is decriminalised, a broader shift in attitudes seems possible elsewhere.  But, as the harm-reduction adage goes: one has to want the change in order to make it.