Want to know how Portugal won its War on Drugs? It ended it

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Every two years, on the shores of Idanha-a-Nova in southern Portugal, ravers of all nationalities dance to trance music at the Boom Festival, many of them under the kaleidoscopic influence of psychedelic drugs. But unlike at other festivals around the world, these drug users are not committing a crime.

Instead, they have access to free containers to sniff cocaine, needles to inject heroin and a laboratory to get their substances tested. People can find out exactly what they’re about to take and what effects the drug will have on them.

“This is part of the country’s approach of harm reduction and risk minimisation, a strategy which is possible in the country due to the country’s decriminalisation of drugs,” says Maria Carmo Carvalho, a lecturer at the Faculty of Education and Psychology at the Catholic University of Portugal and coordinator of Kosmicare, a government-supported centre which helps people who may be experiencing a “psychedelic emergency” at the festival.

Portugal decriminalised drugs in 2001, meaning that anyone caught with less than 10 days worth of drugs is not sent to court but to a CDT, a Commission for the Dissuasion of Drug Addiction, of which there are 18 centres across mainland Portugal.

Located next to a furniture shop and with no visible sign on the door, so as to respect the privacy of attendees, Lisbon’s CDT waiting room is busy with visitors. Most are in their 20s and 30s, most are male and most have been caught with hashish.

Clinical psychologist Raquel Lopes, who works at centre alongside a lawyer and social worker, says this service only exists because of the decriminialisation laws.

“Before, people who abused drugs didn’t have access to this kind of support,” she tells Equal Times. “Here, a technical team carries out an interview to understand what type of consumption we are faced with, and to see if it is necessary to refer the person to a service related to employment or treatment.”

During the interview, the person’s level of risk is categorised as low, moderate or high. They can expect to be referred for treatment if they wish so, a small penalty fine, or nothing at all.

“We also take other factors into account, like if the person is in school or at work or if he or she has a family structure. Even if consumption is just occasional, the life of that person might be unstructured,” Lopes explains.


Declining drug usage

Since the law was introduced in 2001, the latest study by the European Monitoring Centre for Drugs and Addiction (EMCCDA), which is headquartered in Lisbon, suggests that the use of most illicit substances in Portugal might be declining.

Cannabis is the most frequently used illicit substance followed by ecstasy and cocaine, according to the report, with lifetime prevalence of any illicit substance amongst adults falling from 12 per cent in 2007 to 9.5 per cent in 2012, and from 17.4 per cent in 2012 to 14.5 per cent amongst young adults.

The country saw 16 cases of drug-related deaths in 2012 – higher than the number of deaths reported in 2011 but below the number of deaths registered annually between 2008 and 2010.

The institution also notes a decreasing trend in the total number of people with HIV and Aids cases since the early 2000s.

However, for Manuel Pinto Coelho, former President of the now-defunt Association for a Drug Free Portugal, a private body founded by Coelho, decriminalisation is in fact a step backwards.

“There has to be a paradigm shift,” he tells Equal Times. “Drug addicts are now socially protected. Most of them are unemployed. The worst idea is to give them another drug (methadone) which will create more addiction,” he says adding that, “the current system just victimises them. They have a choice to quit. It’s not a chronic illness like diabetes.”

But Dr Joao Goulao, Director-General of Portugal’s Centre for Intervention on Addictive Behaviors and Dependencies (SICAD), who was involved in drafting the current law, points out: “The punitive posture is today challenged by scientific evidence that the legal regime of drugs and penalties do not influence levels of consumption.”

Dr Goulao, who is also chairperson of the EMCDDA, adds that criminalising drug addicts puts a burden on the criminal justice system, rather than focusing on treating people.

While he admits that the country’s drug situation hasn’t improved solely due to decriminalisation, he says it has facilitated important changes in Portugal’s health and social policy enforcement.


Back from the brink of catastrophe

Portugal has come a long way from the drug boom it experienced after the end of António de Oliveira Salazar’s dictatorship in 1974.

“Portuguese society saw a big impact on health, crime and public nuisance caused by the use of drugs. We reached around 100,000 consumers of heroin by 1999, almost 1 per cent of the population, and HIV soared. It led to a catastrophic situation,” Goulao recalls.

In 1998, the government convened a group of experts to draw up a report on Portugal’s drug crisis and to come up with strategies to confront the problem. As a result, Dr Goulao and his colleagues reached the conclusion that drug addicts were not criminals – they were chronically mentally ill.

From that point, Portugal went from criminally punishing users to treating them, moving responsibility from the criminal justice system to the health system.

“It was inconsistent to assume that we are dealing with a health problem and then to criminalise the sick,” says Dr Goulao.

Casal Ventoso is a neighborhood in Lisbon which used to be known as Europe’s ‘drug supermarket’, where everyday around 5,000 people went to buy narcotics.

Elsa Belo, coordinator of the association Ares do Pinhal, which implements a low threshold methadone program in Lisbon, was one of those first social workers to intervene in Casal Ventoso.

“Drug addicts would consume (heroin) and end up staying there in shacks made from cardboard boxes and plastic sheets. They wouldn’t leave. They’d all be together consuming and sharing the same syringes,” she recalls.

“We didn’t have methadone and there were around 1,000 homeless people with their clothes so filthy they had to go in the bin, and parts of their body had haematoma and bugs that had to be covered with sanitary towels,” she says, adding that all they had to offer was a bath and hot food.

The shacks were eventually destroyed overnight, and Belo now works in another neighborhood in Lisbon, Quinta do Lavrado, at a state-funded centre for the recovery of drug addicts, situated above a nursery school. Nearby, a woman appears to be taking drugs inside a battered car.

Here at the centre, a technical team deals with around 1,300 patients daily, all of whom take methadone from one of their mobile units, which drives around a number of neighborhoods around Lisbon.

Elsa greets the users with the same concern and friendliness as a family doctor. The van stops for an hour and a half, with dozens of people arriving to take their daily dose of methadone, some of whom are surprisingly neatly dressed. One man arrives in a 4x4 with his relatives, including his son who appears to be no more than five. Another woman turns up with apparent breathing problems.

Marco, 42, has already taken his medication but is hanging around the van. He began smoking hashish when he was 16 years old, and started cocaine and heroin when he was 18. He has been taking methadone for two years as well as medication to treat hepatitis.

While he managed to complete a degree in hotel management and secured several jobs, he suffered several relapses, especially after breaking up with a long-term girlfriend.

“I hit the very bottom,” he says, “and I realised everything was at risk. I found out about this program by word of mouth, a colleague told me that I could take methadone and I’d forget about taking drugs.”

Tania Barbas, 39, started taking heroin when she was 14 with her older sister. She says it turned into a problem for her when she was 17 and began to take it more frequently.

She was prescribed methadone when she was 25 and pregnant with her oldest son. But after having managed to wean herself off heroin, she had a relapse.

“I have never been able to quit cold turkey. But now I have a normal life, I have quit drugs, Now I feel happy and calm and slowly am leading a normal life, except for having to come here.”