How Portugal successfully addressed substance abuse

Our world, and all of us, are interconnected. And this is very true in the case of substance abuse. The interests of the producers and the consumers are intertwined.

I had been planning to write about Portugal’s approach to dealing with drug users. Then after events in Afghanistan, I started to wonder if, given the Taliban role in opium cultivation, decriminalizing the use of heroin and meth in western societies might reduce their sources of income. Then I discovered that this is not a new idea. Some well-informed and influential people have suggested it over the past two decades.

100510-F-7713A-171: A Por Chaman resident helps other local villagers with destroying a poppy field in the district of Por Chaman in Farah Province, Afghanistan, May 10, 2010. The destruction of the poppy field occurred in the presence of Farah Provincial Governor Rahool Amin, as an effort to promote positive agricultural solutions such as wheat cultivation. (ISAF photo by U.S. Air Force Senior Airman Rylan K. Albright)
Afghans destroying a poppy field. By ISAF Headquarters Public Affairs Office from Kabul, Afghanistan – 100510-F-7713A-171, Public Domain, https://commons.wikimedia.org/w/index.php?curid=10395200

“Before going to Afghanistan, my own instincts told me that it could not be right to decriminalise drugs,” said William Patey, who served as British ambassador to Afghanistan from 2010-2012. “But my experience there has convinced me that all political parties need to engage seriously, without trying to score points off each other.”

Writing in the Guardian In 2015, he noted that the war on drugs had failed in Afghanistan and that “if we cannot deal effectively with supply, then the only alternative would seem to be to try to limit the demand for illicit drugs by making a supply of them available from a legally regulated market.” 

While the Taliban is saying that it will not turn into a narco-state and that “from now on, nobody’s going to get involved (in the heroin trade), nobody can be involved in drug smuggling,” this doesn’t seem likely given the importance of the opium crop to local farmers – although to be fair, the Taliban did ban opium cultivation for a year in 2000 – and the lack of a way to incorporate the opium into the legal market. Reuters just reported that “three of the last four years have seen some of Afghanistan’s highest levels of opium production”.

In 2019, opium was by far Afghanistan’s biggest cash crop, accounting for around a third of Afghanistan’s GDP and generating almost 600,000 full-time jobs, despite long-running military-led attempts to end it. The US military spent $1.5m a day on countering narcotics since October 2001, or almost $9 billion in total. Many agencies tried to move farmers into cultivating other crops, with limited success.

The one notable halt was the Taliban ban in 2000-2001. “By harvest time in spring 2001, the effectiveness of the ban was already confirmed beyond any doubt, and astonished the international community at the time.” However, this drug control success was a major humanitarian disaster that ignited a huge political storm against the Taliban.

The informal credit system based on opium collapsed and hundreds of thousands of Afghan refugees were displaced internally or moved towards Pakistan and Iran, including indebted former poppy farmers defaulting on their seasonal loans, according to TNI. Farmers were forced to reschedule their payments – leading to the full rebound of poppy cultivation the following year – and sell land, livestock, and even their daughters to settle their debts.

The Taliban had thought that in exchange for the ban, they would get compensation of up to US $250 million, but this did not happen. In 2001, the Taliban apparently had proposed that western countries buy remaining stocks of opium for processing in the pharmaceutical industry for medicinal purposes. (In 2004, at the UN Commission on Narcotic Drugs, Afghanistan raised questions about the possibility of obtaining permission to regulate part of its opium production, placing it under state control supervised by the INCB. India and Australia strongly opposed the idea.)

The International Narcotics Control Board (INCB), established after the 1961 UN Single Convention on Narcotic Drugs entered into force, ensures that drugs are available for medical and scientific uses, and that leakages from licit sources to illicit traffic do not occur. The legal opiates market is “comparable in size or even bigger than the illicit one.” In 2002, legal production was 583 tons on 115,500 hectares, vs 449 tons of illicit production on 180,000 hectares. Australia is by far the largest licit producer, followed by India, France, Spain, Turkey and Hungary.

U.N. officials say the Taliban likely earned more than $400 million between 2018 and 2019 from the drug trade, although one expert estimates it at only $40 million annually from levies on opium production, heroin labs and drug shipments. Whichever figure is correct, it is a lot of money. And it’s all clear evidence that the war on the Afghani drug supply did not work.

So while decriminalization of drugs is often an extremely charged topic, it also offers another way to intervene in the supply chain – by addressing the consumers. Afghanistan produces between 80% and 90% of the global supply of illicit opium and is also a source of hashish, synthetic drugs such as methamphetamines, and ephedra, a wild herb with speed-like effects used in crystal meth, Sky News reported, and its heroin is trafficked to every region of the world except Latin America. 

The Portuguese Approach

It’s not like decriminalization is a theoretical discussion. We have an example of what happens when a whole country decriminalizes the personal use of drugs and treats substance addiction as a health issue.

Lisbon. By Ввласенко – Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=23425982

In 2001, after having first tried to address its heroin addiction epidemic through harsh policies and imprisoning addicts, Portugal took a radical step – it decriminalized personal possession of drugs as part of a citizen-focused, health-led approach that focuses on harm reduction and treatment. 

Only one section of the tough 1993 law was changed – the article that deals with possession for use, explains João Goulão, Portugal’s national drug coordinator and the man who played a key role in creating the policy. “We established a limit for possession of drugs and that limit is calculated on the basis of personal use for 10 days. If someone is intercepted by the police, in possession of drugs, he is still taken to the police station. The drug is weighed and if he has more than a 10 day amount, he is sent to the criminal justice system as before. Then it is up to the trial, up to the judge, up to the lawyers to discuss and to decide if he is dealing drugs or not. If he’s actually dealing drugs, he may end up in prison as before.”

Before 2001, “it was almost impossible to find a family in Portugal that did not have drug-related problems,” he says. Drug addiction was the top social concern for the public. “It made much more sense for us to treat drug addicts as patients who needed help, not as criminals.” That meant police could focus on traffickers and dealers, freeing up resources the government could put into treatment and harm reduction practices. New HIV infections, drug deaths and the prison population all fell sharply within the first decade after the new approach was adopted.

“A 2015 study found that since Portugal approved the new national strategy in 1999 … the per capita social cost of drug misuse decreased by 18%,” Time reported. “And according to a report by the Drug Policy Alliance, a New York-based nonprofit with the goal of ending America’s “War on Drugs,” the percentage of people in prison in Portugal for drug law violations has decreased dramatically, from 44% in 1999 to 24% in 2013.”

While drug dealers still go to prison, anyone caught with less than a 10-day supply of any drug—including heroin—is sent to a local commission, consisting of a doctor, lawyer and social worker, where they learn about treatment and available medical services. Portugal has more than 40 rehabilitation centres across the country.

In 2020, invited to address the Rhode Island State House, he said: “Nowadays we have the lowest rates of overdose deaths in Europe. We had 38 deaths in 2017, a country of 10 million inhabitants. If you had the same rate of overdoses [here in Rhode Island], you should have three or four a year, and you are having 300.”

While politically, decriminalizing was difficult at the time, he said, “nobody even thinks about going back, because the results speak for themselves. And that’s the case with overdoses, that’s the case with the efficiency of law enforcement combating drug traffic, that’s the case with HIV infections, that’s the case with stigma. That’s the case with the total number of addicted people, with problematic drug users. We started from 100,000 people using heroin. Nowadays we have less than 50,000 people depending on any drug and from those, 30,000 are following treatment programs.”

The Portuguese experience inspired Oregon to vote in 2020 to decriminalize possession of all drugs, including cocaine and heroin. Measure 110 reclassified possession of controlled substances from a misdemeanor to a violation with a $100 fine, and shifted over $100 million a year of marijuana tax revenue to support addiction recovery. Addiction recovery centers will be tasked with “triaging the acute needs of people who use drugs and assessing and addressing any on-going needs thorough intensive case management and linkage to care and services,” the Associated Press reported.

Sources:

Want to Win the War on Drugs? Portugal Might Have the Answer. Time, Aug. 1, 2018

Drug decriminalisation in Portugal: setting the record straight. Transform Drug Policy Foundation, May 13, 2021

Learning Lessons from the Taliban Opium Ban. Transnational Institute, Mar. 1, 2005

Oregon 1st state to decriminalize possession of drugs. Associated Press, Feb. 1, 2021

Updates:

Green Energy Complicates the Taliban’s New Battle Against Opium. New York Times, May 29, 2022

1 thought on “How Portugal successfully addressed substance abuse

  1. Pingback: How Portugal successfully addressed substance abuse – MAD Production. Company.

Comments are closed.