
14 Years After Decriminalizing Drugs, Portugal’s Bold Risk Paid Off - cirrus-clouds
https://mic.com/articles/120403/14-years-after-decriminalizing-drugs-one-chart-shows-why-portugal-s-experiment-has-worked
======
lmickh
Find it misleading that almost all of the recent articles on this subject talk
about decriminalization as the cause for the drop in drug related health
issues.

They shifted a significant chunk of money to health services. If it proves
anything, it is only that health services can reduce drug related health
issues. Without a control, there is nothing to point to regarding
criminalization vs decriminalization. People are now paid to go out to drug
dens and offer medical help. You can't simply say "people were scared to get
help before" when instead you start sending help straight to their location.

Even when an article mentions the change in spending/focus, it is framed in
the context of legalizing drugs. No one is making articles titled "After years
of improving health services, Portugal's drug policy paid off".

I get that some folks want to legalize drugs, but make an argument for it that
doesn't involve this twisting of results to match the desired outcome.

~~~
jdmoreira
I'm Portuguese and I grew up watching the heroin epidemic we had in Portugal.
It was horrible, like the article mentions 1% of the population was addicted
to heroin. Curiously I now live in Sweden, but I lived in Portugal for the
first 11 years of the decriminalization. And the solution actually started
years before, in the early 90s. It's a bit like you said, it was an huge
investment in public health - the first success was that you could get a kit
to inject heroin for free in any pharmacy, paid by the state, no questions
asked! It was a huge win against the spread of HIV.

The biggest difference I see comparing the Portuguese reality to the Swedish
one is the lack of social stigma regarding drugs. Drugs are just openly
discussed in Portugal and addicts are well integrated in society. I have
friends whose parents are heroin addicts and for the most part they are a
normal family with jobs and responsabilities. Sometimes they relapse but it's
not a big deal because they have a network and feel safe to get help quickly
and the state sponsors replacement therapies in the meanwhile.

These are people that started doing heroin in the late 80s and for the most
part still raised a family and are good parents and neighbors.

It's just a disease like any other and Portuguese people see addiction that
way.

~~~
rwnspace
It's peculiar how reports of sensible policy make me feel Portugal is adorned
in rubies and roses. Here in the UK the Home Office recently said they have no
plans to look at even the classification of cannabis. Despite most local
police forces not bothering with anything but factories, a majority of
population supporting legalisation/decriminalisation, and global trends. We
are comparatively medieval but for a few smart initiatives. I have heard that
Germany and Norway/Sweden also have some very similar attitudes: I blame
Calvinism.

I could rant for hours on alcohol and tobacco policy in the UK. A little
knowledge of the field of Harm Reduction opens a lot of avenues for criticism.
Particularly increasing taxation, which extracts most from the working class
and is effective in few use-cases. The UK isn't alone: look up the EU's May
2017 'Tobacco Product Directive' regarding E-cigs. Read: lobbying from groups
that are responsible for millions of deaths and public cost are strangling and
monopolising a market and technology that is an incredible source of harm
reduction... I'm struggling to hold my tongue at this point.

We have a large problem with a political class who don't listen to reason or
evidence, simply an innately conservative discourse makes the problem look
smaller than it really is. It's fantastic to read a positive outlook on
Portugal's policy - it has been smeared countless times here.

~~~
wyclif
_I blame Calvinism_

If you blame Calvinism for either medievalism or postmodern bureaucracy, let
alone the drug war, I suggest you don't know what Calvinism is. I'm for drug
legalisation, but if you want the UK to adopt the policies of Portugal (or
something similar) it will not help to blame the problem on the wrong people.
You ought to be directing your anger at the social planners and the nanny
state. That group, I can assure you, is very decidedly anti-Calvinist in
nature.

~~~
rwnspace
I was hoping that because the statement was so glib and so placed, it would be
communicated that I was being tongue-in-cheek; I made it only because the
countries I mentioned happen to be so important to Calvinism, which roughly
connects to recreational drug use being perceived as antithetical to the
Protestant work ethic. Apologies if that's still too far off the mark even for
a jibe.

I admit I probably only know a little more than the average about Calvinism,
but far less than those who 'know' about it, so I didn't understand your point
entirely. You prompted me to do more reading, which was interesting, so thank
you for that.

More seriously, I think the causes are so multi-faceted it's difficult to
interpret precisely where to place the blame. I think 'Reaganism' is a fine
target, but it's a little short-sighted to lay all the blame there. 'Social
planners' triggers associations with Edward Bernays' and his legacy, and what
else I know from Manufacturing Consent, if that's your gist. Would you mind
expanding on your view?

------
shawnee_
_Portugal 's performance in perspective: Only three people for every million
die of a drug overdose in Portugal, which puts one of the eurozone's poorest
countries in a different league than rich international powerhouse Germany
(17.6 per million) and in a different universe than social democratic utopia
Sweden (69.7 per million)._

There's a fascinating documentary called _American Addict_ on what nearly
happened before this happened:

"In 1971 President Richard Nixon declared war on drugs. He proclaimed,
“America’s public enemy number one in the United States is drug abuse. In
order to fight and defeat this enemy, it is necessary to wage a new, all-out
offensive(Sharp, 1994, p.1).” Nixon fought drug abuse on both the supply and
demand fronts." [source]

Before criminalization, the trend in society was to start treating people who
are afflicted with addictions like the _sick people_ they are, rather than
like criminals. There was an entire movement toward recovery as a necessary
way of life for some people who cannot moderate alcohol intake (or drugs or
whatever), just like insulin is a way of life for diabetics whose pancreases
can't moderate insulin.

Addiction is not a moral issue; it should not be criminalized. It is a medical
issue. It is a mental health issue. When it's caught early enough, and treated
with the proper mental health regimen, it does not have to be debilitating.

Instead, what happened with war on drugs was mass-market criminalization...
essentially forcing alcoholics and addicts forced into debilitation (hiding /
shame)... leading to further desire for escapism through the addiction. It's a
terrible cycle, and the worst part of it is that some counties have made
things like DUIs into their bread-and-butter mainstream source of revenue.

It's hard to say what the trend today is going toward. The privatization of
jails is especially disconcerting; like society wants to trick itself into
thinking that the more people it has locked up the "safer" it is.

[source][http://web.stanford.edu/class/e297c/poverty_prejudice/parado...](http://web.stanford.edu/class/e297c/poverty_prejudice/paradox/htele.html)

~~~
mythrwy
While I generally agree with most of what you state I'd like to offer the
unpopular opinion that the personal decision to use hard or addicting drugs is
something of a moral failing.

Not that there aren't extenuating circumstances, not that it's a "terrible
crime", but, it is a vice in which people for the most part, at least
initially, have some choice.

Again, I'm in favor of most everything you suggest, particularly
decriminalization (which just makes sense). Still, in my view people need to
take a little more personal responsibility. There are always excuses if we
look for them.

The best way to encourage people to take a little more responsibility?
Probably most of what you suggest as well as giving people healthy
environments and opportunity and something to be optimistic about.

But traditionally shaming works a little as well. As unpleasant as this may
sound. We appear to have come to a spot we think people shouldn't be shamed
for anything. Well, except for being a racist or using PHP maybe. Shame was an
effective social control for a long time and if we are going to do away with
it we need to find a replacement.

~~~
ausvisaissues
You are wrong: it is a big moral failing. Why is it impossible for Westerners
not to use drugs, while the Japanese manage not to use it fairly well?

Should we set the bar for behaviour so low?

Even if drugs were legalized, the cost for treatment would be high (and
presumably be bourne by the tax payer).

~~~
3131s
The moral failure is on your part for desiring to restrict the freedom of
others. It's people like you who don't really care that millions have been
imprisoned over a personal choice. You are an authoritarian, which is fine,
but some of us don't take that kind of thing laying down.

~~~
ausvisaissues
> It's people like you who don't really care that millions have been
> imprisoned over a personal choice.

Japan imprisons a very small percentage of people compared to the USA.

Furthermore,it is a personal choice only if the other individual's choice does
not have negative externalities.

Yet, a casual stroll through San Francisco 's mission district would tell you
that this is not the case.

Who would have thought that drug use by the mentally unstable would result in
a bad outcome...

> You are an authoritarian,

Perhaps. But when I compare the outcomes of Japan/ Singapore to that of the
US, it is simple to see which model is the best.

~~~
3131s
> _Furthermore,it is a personal choice only if the other individual 's choice
> does not have negative externalities._

So we should ban every personal choice with negative externalities? There goes
alcohol, twinkies, contact sports, driving, etc. It's a personal choice as
much as anything else, so just estimate the cost of any negative externalities
and cover that through taxation.

> _Yet, a casual stroll through San Francisco 's mission district would tell
> you that this is not the case._

Of course you don't know any of those people and can't say for sure whether
drug abuse is what lead them to the behavior that you disapprove of.

> But when I compare the outcomes of Japan/ Singapore to that of the US, it is
> simple to see which model is the best.

The model of inhumane prisons and death sentences? Actually the US has a
pretty similar model to that already, so I'm not sure what your point is.

~~~
ausvisaissues
> whether drug abuse is what lead them to the behavior that you disapprove of.

I am pretty sure the needles on the sidewalk is just there because everyone
suffers from diabetes, right?

I think that, fortunately for most IT people like us, we can live in nice
neighborhoods, where none of the social ills of drug-ridden neighbortlhoods
affect us. So, we can support drug legalization, without being affected by the
consequences.

> The model of inhumane prisons and death sentences?

Japan/Singapore imprisons much less people for drug crimes than the US - due
to the USA's lenient laws on drugs (grey line vs. red line). The ill effects
of drug use in japan is virtually non-existent.

You can moralize all you want, but it is a better system with less actual
harm.

------
untangle
The singular focus on "drug deaths due to overdose" tells an important part of
the story, but not the whole story. For example, per Wikipedia, drug use may
have doubled after decriminalization.* If so, that's an acceptable tradeoff to
me but may not be to others.

* [https://en.wikipedia.org/wiki/Drug_policy_of_Portugal](https://en.wikipedia.org/wiki/Drug_policy_of_Portugal)

~~~
icebraining
Read a bit further...

 _The increase in drug use observed among adults in Portugal was not greater
than that seen in nearby countries that did not change their drug laws._

------
drefgert
The critical part missing from portugals policy is that drugs must be legal to
buy and sell (via controlled channels).

Decriminalizing use helps, but legalizing sales take out the crime and ensures
the health of users through clean product.

~~~
cpncrunch
Even with clean heroin, there is still a danger from overdose.

[https://www.drugabuse.gov/related-topics/trends-
statistics/o...](https://www.drugabuse.gov/related-topics/trends-
statistics/overdose-death-rates)

You could perhaps consider it as a Darwin award...sell heroin to anyone who
wants it, and then if they become addicted and overdose, at least it clears
the gene pool of people who are too dumb to use it responsibly. /s

Note, that is not my viewpoint, but I wonder if that's what some of the
proponents of legalization are thinking. Obviously heroin has a huge effect on
the brain and personality, and it's very difficult to get off it once you're
addicted. So there is some rationale to the idea that keeping heroin illegal
is helping prevent people from getting involved with it in the first place.

Right now it's (arguably) mostly thrill-seekers or people self-medicating
psychological problems or chronic pain (which in itself has a large
psychological aspect) using heroin. If you legalize it you potentially open it
up to a much larger group who might not have otherwise considered using it.

~~~
toyg
No proposer of legalization ever thought of it as "a darwin award". If
anything, it's the opposite: treating addiction as a health issue usually
ensures people will survive - both users, who get "clean" drugs in predictable
quantities; and dealers, who can come out of the underworld and not risk their
lives running from the police or from other gangs.

The _current_ criminalization is _extremely_ darwinistic: only the most
violent thugs survive in the supply chain, and only the smartest users.

I don't think legalizing will increase usage of heroin, because its health
problems are huge and extremely well-known. Like putting ferrets up your bum,
people are not going to do it simply "because it's legal".

------
justaaron
I want to point out that this is merely a heroin-inspired "harm reduction" law
that removes the criminal penalties from having some arbitrary few number of
days supply of any particular illegal substance. (10 days)

It does not recognize any distinction between substances and retains a "shame
on you" psy-ops bureau that users caught with minor amounts of said substances
are referred to, in lieu of the criminal justice system. This "toxic-
dependency" panel has sanctions available including monetary fines and
revocation of ones passport or other travel restrictions, to bend one to their
ways.

This set of laws does not treat the SUPPLY chain at all!

If one has an amount of substance greater than the threshold one can expect
charges of traffic/distribution, which then will collapse after the 1 year
investigation results in the non-election to pursue such charges, which has
meanwhile resulted in the de-facto punishment of 1 year of weekly(some
interval) police-station-sign-ins and a form of house arrest.

It's not a complete set of laws, and while it did manage to dispatch the
heroin crisis of years past, it doesn't make any distinction, and thus is
impeding efforts towards home cultivation of cannabis being legalized, etc.

De-criminalization, like medical cannabis, has the unfortunate tendency of
providing laurels to rest upon, and thus impeding further progress. (observe
Spains cooperatives, where signed members cooperatively grow and share in the
crop)

Basically, Portugal has a very mature attitude to many things: letting the
golden dreams of empire fade as they should, accepting that some people behave
rashly and putting an emphasis on harm reduction etc. The emergency services
here generally are excellent, professional, and calm in demeanour. I don't
think that in practice one notes any major difference in drug usage in society
with regards to the rest of Europe, I think one simply notes a bit less
paranoia.

By comparison, I find it very odd that more than 15 states in the USA have
medical or legal cannabis, yet harm reduction for heroin seems to be missing,
and hence I'll just say that some people like to learn the hard way :D

------
11thEarlOfMar
It would be illustrative to see a control of some type, perhaps deaths due to
alcoholism. Seeing that trend against the heroin trend would help to
illustrate the impact of decriminalization relative to other efforts or
changes in law or society.

~~~
rwmj
I would want the "drug deaths due to overdose" to _include_ alcohol-related
overdoses (although it's arguable whether that would include deaths due to
alcoholism). Unfortunately I don't think even these enlightened reports do
that :-(

------
petre
Romania is on the last place according to the chart in the article and drug
possesion is a criminal offense in this country. It's punishable by two to
five years in jail. The rehab is _inside_ the penitenciary, so you first go to
jail, then to rehab.

Also it's quite interesting how just about every country that's close to the
Netherlands, save for France which criminalizes posession, is at the top of
the chart.

I've been to Lisbon and was approached countless times on the street by shady
individuals trying to sell drugs, usually mj/hash but also coke, maybe one
time out of ten. This is not a widespread thing in the rest of Portugal, just
in Lisbon's very touristy city centre where.

~~~
galfarragem
> I've been to Lisbon and was approached countless times on the street by
> shady individuals trying to sell drugs, usually mj/hash but also coke

They are mostly groups of gypsies selling fake drugs and sunglasses that will
escalate to coercion if necessary/possible. Police is normally very
permissive.

~~~
ino
This is the truth. Those guys are there to scam tourists.

------
wwwater
There is an amazing TED talk by Johann Hari on that topic
[https://www.ted.com/talks/johann_hari_everything_you_think_y...](https://www.ted.com/talks/johann_hari_everything_you_think_you_know_about_addiction_is_wrong)

------
tompazourek
When I saw the chart I thought, what's wrong with Estonia?

~~~
jacquesm
All the Nordics have large problems with drug addiction. They are also
tracking them quite well so don't compare them to let's say Romania or
Bulgaria where tracking is next to non-existent.

~~~
monksy
Romania did better than Portugal. What are they doing better than Portugal?
Why is Portugal's liberal policy on drugs heralded so great when it's not the
best of the list?

(I'm not saying that it's a bad policy but why is the article focused on
pushing that policy?)

Also what I want to see: What about Portugal makes it work? Could you test
that assertion against a different country if you made the contextual changes
and the change there?

~~~
hn_throwaway_99
I think you missed the point of jacquesm's comment: "They are also tracking
them quite well so don't compare them to let's say Romania or Bulgaria where
tracking is next to non-existent."

In other words, it's highly likely that Romania didn't "do better" than
Portugal, but rather they're doing a very poor job tracking overdoses at all.

~~~
monksy
Oh, if that data was bad, they should have even included it in the graph.

~~~
dmurray
The data points don't even have error bars, unfortunately. They come through
various filters. Leaving out one government's reported numbers and keeping
another's is a political decision in itself, so it's best to just report the
numbers and warn readers of their veracity.

~~~
monksy
The stance I have is more for data quality. If you can't trust the numbers
then they're not good numbers.

------
cpncrunch
In Canada we seem to have de-facto criminalization for possession for personal
use. The problem we have now is that 80% of heroin is laced with fentanyl (at
least in Vancouver), and it's causing a huge overdose problem. Even cocaine
and MDMA is now sometimes cut with fentanyl.

Not sure what the solution is, but perhaps a combination of stronger penalties
for dealers, more resources for treating addiction, and legalising weed.

~~~
wavegeek
> The problem we have now is that 80% of heroin is laced with fentanyl (at
> least in Vancouver), and it's causing a huge overdose problem. Even cocaine
> and MDMA is now sometimes cut with fentanyl.

When you give criminals a monopoly on the supply of recreational drugs, it is
predicable that quality will be a problem. Potencies will vary, purity will
suffer.

The solution is legalization combined with more health measures.

> stronger penalties

How anyone can think that stronger penalties are going to solve the problem
escapes me. We have the evidence of 75 years of unrelieved failure of a
punitive approach. This is an example of "If something fails, do more of it -
That Might Work!".

~~~
cpncrunch
>How anyone can think that stronger penalties are going to solve the problem
escapes me

I was referring to Fentanyl-laced heroin.

[http://www.cbc.ca/news/canada/british-columbia/fentanyl-
traf...](http://www.cbc.ca/news/canada/british-columbia/fentanyl-traffickers-
bc-stiffer-sentences-1.4024080)

It most certainly does make sense to have stronger penalties for dealing drugs
that have a high chance of killing people due to being laced with fentanyl.
Otherwise it's like having the same penalty for a shoplifter as for an armed
robber.

~~~
martinald
How does that work? The whole mess is because of this.

Fentanyl is 100x stronger per gram than heroin. Therefore you can import 100th
the quantity and still make (in theory) make similar money on the street. It
is exactly because you get a worse sentence for higher quantities that drug
dealers have optimised to get the strongest per gram drug. You will get a
lighter sentence for 1g of fent vs 100g of heroin, no doubt.

This is a cycle always seen in prohibition - there was a massive shift from
beer and wine to spirits in the 1920s US when alcohol is prohibited.

Throwing harsher sentences will not help whatsoever and is likely to be
counterproductive.

~~~
cpncrunch
>It is exactly because you get a worse sentence for higher quantities that
drug dealers have optimised to get the strongest per gram drug.

Yeah, that's why there is pressure to increase sentences for the fentanyl
dealers. If you have tougher sentences for the more dangerous drugs, it makes
people more likely to use the less dangerous ones.

~~~
Clubber
How anyone can believe that harsher sentences will curb drug use in this day
and age with 50 years of evidence to the contrary is beyond me.

~~~
cpncrunch
You're probably right. However the other question is whether dealers should be
help criminally liable for fentanyl-related deaths. In essence they are
selling something that they know will likely kill some of their customers.

~~~
Clubber
I mean it depends on how far up the chain you want go. Lets say from the
source to the buyer, it goes through 5 people. Which put fentanyl in it?
Chances are, anyone else in the chain didn't know. Of course the problem with
that is you end up executing some guy who had no idea there was fentanyl in
there while the guy who actually put it in there continues business as usual.

I mean I find it hard to believe dealers want their clients to die off, they
want steady revenue stream just like every other business. If you want to save
lives, the way the US does it obviously isn't working. I don't think it's
their objective. It seems the main objective for the drug war in US is to give
jobs to the FOP and give the government an easier job by eroding liberties,
and to make headlines for politicians trying to get reelected.

------
randyrand
> People caught with less than a 10-day supply of a drug

That's a tiny amount. Punishing people that like to buy in larger quantities
for convenience seems silly. They should have come up with a another or
increased metric to determine who the dealers were.

------
perilunar
> As João Goulão, the architect of Portugal's decriminalization model, told
> Hari, "using drugs is only a symptom of some suffering, and we have to reach
> the reasons."

Not necessarily. Using (harder) drugs is no more an indication of mental
health problems than using alcohol. Many people use drugs recreationally
without becoming addicted.

------
crimsonalucard
What does it mean to have a lower OD rate if legalization caused the entire
population to become addicts? There needs to be a more comprehensive and less
biased examination on what happened to this country. Anyone know the addiction
rate vs other countries?

------
randomstudent
This article is very weak... They cherry pick a single metric (overdose-
related deaths) and use that to prove Portugal's policy is the best thing
ever.

Other metrics that are relevant: Has drug use increased or decreased? What
about the burden of disease associated with drug use? Also, even more
importantly: What has happended to deaths in other countries over time?

~~~
EGO_DEATH
Decreased usage domestically, increased overdose in other countries, Sweden
for instance, by a lot.

------
marze
Is this a correct summary?

USA

150 deaths/million/year

Portugal

3 deaths/million/year

------
Odenwaelder
Has this guy walked the streets of Lisbon? You can't walk 50m without being
offered drugs. It sucks.

------
vivekd
Counterpoint, overdoes deaths increased during some years and drug use has
markedly increased:

Also the chart supporting less overdose deaths seems to be actually a chart
about all drug induced deaths, and not just overdose deaths, which means it
could include HIV/AIDS, once a big killer of heroin users which we can now
treat for much better.

[http://www.huffingtonpost.co.uk/2012/12/10/portugal-
decrimin...](http://www.huffingtonpost.co.uk/2012/12/10/portugal-
decriminalisation-drugs-britain_n_2270789.html)

~~~
pdpi
> it could include HIV/AIDS, once a big killer of heroin users which we can
> now treat for much better.

If it does, that still supports this theory.

My father in law is a leading portuguese HIV expert, and he credits
decreminalisation as a key factor in actually getting those patients into
clinics and on treatment.

~~~
vivekd
I didn't mean we can treat for AIDS better with legalization, I mean we can
treat for AIDS better because of improved and more accessible AIDS treatments
that have emerged in the last decade and a half

~~~
pdpi
I know you didn't. I did.

