Portugal Drug Policy

The Fight Against Drugs: Portugal and its Innovative Drug Policy

The war on drugs is an ongoing process around the world. Many countries have been trying to resolve the problem in their own ways, but Portugal has managed to conquer the war on drugs. On July 1, 2001, the “consumption, acquisition, and the possession of the personal use of narcotic drugs and psychotropic substances” was decriminalized. This was a step taken under the new Regime Jurı´dico do Consumo de Estupefacientes. As mentioned before, many countries around the world have been successful in fighting the war on drugs, but a decriminalization policy was a new, much more successful entry to the list.

The concept of addiction

It has been said that the concept of addiction was recognized formally in the seventeenth century. Alcoholism was a term that was then given to people who consumed large amounts of alcohol regularly. However, the negative connotations of the term addiction became more prominent in the nineteenth century with the rise of urbanization and evangelism. Morality and medicine together comprise the meaning behind addiction.

Drug addiction started becoming more prevalent in the nineteenth century with the introduction of heavier drugs such as morphine and later heroine. In the 1840s, the hypodermic syringe was introduced, and these drugs could be administered to patients by doctors. However, the addiction to these drugs removed the idea of medically administered drug usage and drug addiction became a ‘disease of the will.’

A brief history of Europe and drug usage

A line of white powder sits on a silver surface with a rolled Euro note on the side.
Image source: The Guardian

The influence of drugs in Europe has been prominent since the nineteenth century. There are countries such as the Netherlands where the consumption of soft drugs is not completely condemned under law. But how did we get there? The 1976 Act in the Netherlands made the distinction between soft and hard drugs along with treatment programs for the same. Before the act was passed, there were many instances of people being addicted to morphine, cocaine, and psychoactive drugs as they could easily be administered by medical professionals.

The 1950s saw stricter controls on medical professionals’ ability to prescribe drugs. This can be seen in the British policy against drug use, which is predominantly medical-based. In the 1920s, doctors were said to have complete control over the prescription of drugs and treatments involving heavy drug usage. This, however, changed in 1960 when prescribing drugs was only allowed to a specialist model rather than general practitioners. Only licensed doctors in drug clinics were allowed to prescribe heroine and cocaine to patients. Soon there was a shift in the process of drug control from medical to penal systems. This means that obtaining and illegal usage of drugs was now penalized by law. Drug users also became to be seen as ‘sick’ rather than criminals and drug addiction was often recognized as a disease.

History of drug use in Portugal

A pile of used syringes lie in the open.
Image source: Time

The 1980s was the time when Portugal’s descent into drugs began. The southern Algarve region has become the drug capital of Europe with almost every third person being addicted to heroine. Robberies, muggings, and overdoses were common phenomena at the time. The authoritarian rule under Antonio Salazar in 1933 saw some of the worst times for the people in Portugal. Lack of education and weak institutions was Salazar’s way of keeping the public under his control. The fewer people knew the better!

Portugal was literally locked in under Salazar. The people were unaware of what was happening in the world and the technological and commercial boom of the 1960s was never experienced in Portugal. However, this despotic rule suddenly ended in 1974 and the exposure was too much. From being banned for drinking Coca-Cola, the country suddenly was exposed to everything that the world had slowly been experiencing since the 60s. The flow of marijuana and heroine into the Portuguese border was welcomed as nobody knew what they were getting into, and there was no stopping the destruction that it caused.

Drug Usage in Portugal – 1990s

The outstanding drug policy that seems to work today was definitely not Portugal’s first attempt at dealing with drug use. In the 1990s, Portugal was the hub of heroine addiction. The streets were filled with people shooting up in the middle of the day and the gutters piled up with used-up syringes. Américo Nave, a psychologist and President of Crescer, an outreach NGO focused on harm-reduction practices, was working with the people living on the streets and had to witness some truly disgusting sites.

The initial government response was to introduce harsh policies against drug use, which was criticized quite a lot. In fact, the prison cells in Portugal by the late 90s were mostly filled with people involved in some drug-related incidents. Moreover, drug addiction was not just a criminal offense but was affecting the lives and health of the population. At the time, Portugal had the highest rate of HIV cases in the entire European Union. At least 45% of the HIV-positive cases in 1997 were IV drug users. Hence, steps were taken to deal with the drug problem and solve the biggest health risk to the population of Portugal.

The National Strategy of The Fight Against Drugs

Patron holds a kit with fresh syringes, rubbing alcohol, and condoms.
Kits consist of fresh syringes, condoms, rubbing alcohol wipes, and a message about AIDS awareness.
Image source: Time

In 1999, the drug policy took a drastic turn with the introduction of The National Strategy of the Fight Against Drugs. This included a harm reduction program, changes in the legal framework in handling minor drug offenses, and most importantly, more funding for drug prevention and treatment.

The perspective towards drug usage is now seen as a health risk more than crime. Ensuring better health for the population of Portugal was the main agenda and that included the treatment and reduction of HIV cases while solving the drug problem.

The Harm Reduction Program

Harm reduction is a collection of multiple public health policies to reduce the health risks that come with IV drug usage, alcoholism, AIDS, etc. The needle exchange program was one of the biggest steps taken for harm reduction to reduce the spread of HIV or hepatitis C. Reusing syringes became a common thing for IV drug users since heroine would have to be injected into the bloodstream. A used needle is contaminated with the infected blood that had earlier led to a significant rise in HIV cases in Portugal.

In October 1993, the Ministry of Health and the National Association of Pharmacies came together under the Fight Against AIDS program by the National commission and began the “Say NO! to used syringe” program. The program allows drug users to exchange their used syringes at any pharmacy across the country. In return, they are provided with a kit that includes a clean syringe, condoms, rubbing alcohol, and a positive message regarding the prevention of AIDS and rehabilitation programs.

The goal of the program is to spread awareness about drug usage and HIV transmission through needles. Education advertising has been a huge part of this initiative with posters being put up even in discos and bars. There are still some programs running where people are provided with fresh syringes and are educated about safe needle practices on the streets of Portugal.

The 2001 Drug Policy

A nurse handing out methadone to an addict in Lisbon, Portugal.
A nurse handing out methadone to addicts in Lisbon.
Image source: The Guardian

Portugal is the first country to decriminalize drug usage and the effects of this policy have transformed the country’s war against drugs and HIV. While the possession of drugs is still considered illegal, the status changed from a criminal one that resulted in a prison sentence to an administrative one. Instead of imprisonment, addicts now undergo therapy or community service. Again, it is important to note, in Portugal the possession of drugs is still illegal. Also, the growing, dealing and trafficking of drugs is still a criminal offence.

Now a person in possession of drugs is issued a summons and the drugs are confiscated. They can either be fined for possession, suspended from practice (medical, law, etc.), banned from certain locations, and can be given foreign travel bans. Additionally, one can also be banned from associating with specific people, have their personal possessions confiscated, and can be withdrawn from getting any allowances or subsidies. Addicts go to the rehabilitation center or do community service. Drug rehabilitation is not a compulsory thing. However, it is highly recommended for addicts.

The HIV Status

The huge step of decriminalizing drug usage and spreading awareness about needle safety is proving to be the best way to fight the biggest health risk to the population of Portugal – HIV. In 2001, there were approximately 1,287 new HIV diagnoses due to intravenous drug use, which was the highest in the European Union. Even though Portugal’s population took up 2% of the total population of the EU, their HIV rates were the highest among all the EU countries.

Things have definitely been improving with only 16 new HIV diagnoses (by 2019) in the country. The downfall in the number of HIV-positive cases has been dramatic since the year 2000. This is especially true for cases that are caused due to IV drug usage. The harm reduction program and the various initiatives under it helped bring down the number of HIV cases drastically. In fact, the downward trend is bigger than the average of the entire EU.

The Portugal Drug Policy- A welcome success

A nurse searches through the database for a patient's dose at a methadone clinic.
Image source: Time

As mentioned before, the decriminalization of drug usage has been leading to a drastic drop in HIV cases. However, at the same time, there is a noticeable change in drug-related deaths. The number of overdose victims has been decreasing a lot. In fact, the percentage of overdose victims is at an all-time low in Portugal. Surprisingly, the actual consumption and possession of drugs have gone down as well. Since the policy offers practical solutions to dealing with addiction instead of imprisonment, there has been a significant change in public attitude. According to reports, the cost of consumption of drugs reduced, saving quite a bit of money for the government.

There have been several arguments about the legalization of drugs in Portugal instead of decriminalization. However, after years of observation and multiple scientific theories, combating the drug problem through a public health perspective is better than imprisonment. Today the discussion about drugs is more about whether the person requires them for medical purposes or not. Yes, the legal framework still needs improvement. But if you haven’t noticed yet, Portugal is doing an excellent job of dealing with drug usage. Their decriminalization policy is innovative and highly effective.

Soft Drugs and Laws Against Them

Person handles a cannabis plant.
Image source: Portuguese- American Journal

The soft drug that is available abundantly in Portugal is cannabis. Any recreational use of cannabis is legal and is forbidden by law. Cannabis is allowed for medical purposes. However, it can only be obtained with a valid prescription at pharmacies. It is true that one can easily cultivate your own stash of cannabis. But, cultivation is still prohibited even on a small scale.

Having said that, things have become slightly difficult being situated next to Spain. In Spain, small-scale cultivation of cannabis for personal use is legal.  There are a number of shops all over Spain selling cannabis. However, in 2003, another update to the drug policy made the possession of cannabis seeds illegal as well. Furthermore, buying seeds is considered unlawful. Even if you are buying seeds from a legitimate site. The only way a Portuguese citizen can have access to cannabis is within the country with a valid prescription at a pharmacy.

The New Age

One of the biggest reasons why Portugal faced such a serious drug problem was due to the lack of knowledge. People were unaware of what was happening in the world. The vices just took over, when they were suddenly exposed to the world outside. However, the new age of Portuguese citizens has grown up in a democracy. They live in an age where the entire knowledge of the world sits in their hands.

Portugal’s drug policy sits perfectly well with today’s generation. The younger generation is aware of the problems that come along with drug addiction. Moreover, they have the facilities to ensure their own safety if they use them. Furthermore, the world is still talking about Portugal’s drug policy. There have been multiple discussions about why countries have not yet adopted the same policy as Portugal.

Adapting Portugal’s policy around the world

Most countries have a lot to take into consideration before decriminalizing drug use. That is why adopting the same policy is a difficult task. Portugal has managed to make the people happy and make the lives of healthcare workers much easier. Medical professionals now have the right equipment and facilities to deal with drug-related problems. There is still a long way to go towards funding and the final legal framework of the policy. But Portugal is still doing much better from where it was approximately 20 years ago.

Portugal is doing a lot to ensure better health for its people. They treat their citizens with dignity and care. Hats off to their efforts and to 20 years of decriminalizing drugs and changing the world’s perspective of Portugal!

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