by Tony Newman

from The Leaf Online

How did Portugal go from having the highest rate of overdose fatalities in the E.U. to the second lowest? Or from having the highest rate of injection drug-transmitted HIV infections in the E.U. to the lowest?

It decriminalized all drugs in 2001,followed by a 60 percent decline of people arrested and referred to criminal court for drug offenses.

Much to learn from Portugal’s success

Now a group of Americans from communities who have been hit hardest by the U.S. war on drugs – people who’ve been incarcerated for drug offenses, those who’ve lost loved ones to overdose – are in Portugal to investigate these questions and more in a learning tour organized by the Drug Policy Alliance.

Over 70 participants will come from New York, Chicago, Los Angeles, San Francisco, North Carolina and other cities across the country. Representatives of more than 35 organization sand several media outlets that cover the drug war and mass incarceration will attend the tour March 19 – 21 to learn from Portugal’s success story. The delegation will hear from Portuguese General Director for Intervention on Addictive Behaviors and Dependencies João Goulão, as well as experts from the Ministry of Public Health, NGO leaders, active drug users and formerly incarcerated people.

Decriminalization reducing stigma, normalizing harm reduction

“Portugal’s experiment in decriminalizing all drugs has reduced stigma and normalized harm reduction protocols, which has resulted in exceptional public health outcomes—and the reduction of people incarcerated for low-level drug law offenses,” said asha bandele, Senior Director of Grants, Partnerships and Special Projects at DPA. “It demonstrates that there is another way to approach drug use in a society that is far more successful than the methods that the U.S. has advanced since the Nixon administration.

“Portugal measures success in the saving and quality of a person’s life, not simply by their abstinence or how much we can punish them. If we can understand how to prevent overdose and new HIV infections from intravenous drug use; and if we begin to dismantle some of the architecture that drives prison and jail populations, we can begin to fully realize a nation whose public health and safety protocols are centered on human rights and justice.”

The delegation will also visit the largest drug treatment center in Lisbon; tour methadone maintenance vans located throughout the city offering an opioid substitute; and shadow harm reduction street teams that do direct intervention with active IV drug users, including refugees, chronically homeless people, and sex workers


US Drug War — A failure at every level

In the U.S. there are almost as many drug overdose deaths per year as there are lives lost to guns and car accidents combined.  In addition, the criminalization of drug possession is a major driver of mass incarceration and mass criminalization. Each year, U.S. law enforcement makes more than 1.5 million drug arrests. The overwhelming majority — more than 80 percent — are for possession only. Discriminatory enforcement of drug possession laws has produced profound racial and ethnic disparities at all levels of the criminal justice system.

The Portuguese Health Ministry spends less than $10 per citizen per year on its successful drug policy. Meanwhile the US has spent some $10K per household (more than $1 trillion total) over the decades on a failed drug policy that results in more than 1,000 deaths each week.

More on Portugal’s decriminalization policy and its impacts

In 2001, Portuguese legislators eliminated criminal penalties for low-level possession and consumption of all drugs and reclassified these activities as “administrative violations” (the equivalent of a traffic ticket). The policy also included a major expansion of treatment and harm reduction services, including access to sterile syringes, methadone maintenance, and the elimination of most barriers to such vital services.

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Drug trafficking remains illegal and is still processed through the criminal justice system. The results? According to the DPA report, It’s Time for the U.S. to Decriminalize Drug Use and Possession, which examined the results of Portugal’s drug policy:

  • Between 1998 and 2011, the number of people in drug treatment increased by more than 60 percent (from approximately 23,600 to roughly 38,000). Over 70 percent of those who seek treatment receive opioid-substitution therapy, the most effective treatment for opioid dependence.
  • The number of new HIV diagnoses dropped dramatically – from 1,575 cases in 2000 to 78 cases in 2013 – and the number of new AIDS cases decreased from 626 in 2000 to 74 cases in 2013 (in a country of just over 10 million people).
  • Drug overdose fatalities dropped from about 80 in 2001 to just 16 in 2012.
  • The Health Ministry estimates that only about 25,000 Portuguese use heroin, down from 100,000 when the policy began.
  • The percentage of people behind bars in Portugal for drug law violations has decreased dramatically, from 44 percent in 1999 to 24 percent in 2013.
  • The percentage of people arrested and sent to criminal court for drug possession declined by 60 percent.
  • Perhaps most significantly, by removing the threat of criminal penalties, Portugal took away the fear and stigma associated with seeking treatment. Now those who need treatment come to it voluntarily – and are more likely to succeed as a result.

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