Want Drug Policies That Actually Work? Look at Portugal

This week the government launched a ten-year strategy “to combat illegal drug use”. While allocating a much-needed £780m fund for drug treatment and recovery, it also announced a string of reactionary measures including £300m for the further policing and punishment of both dealers and users. Sanctions will include bigger fines, the loss of personal identification documents, and ultimately incarceration. The new plan will also further increase police use of stop and search powers, which have long been used to target and harass Black and minority ethnic people. 

I grew up in Portugal in the 1990s and witnessed first-hand how a change in political will was able to curb the country’s drug problem. To solve it, all it took was looking at drug addiction as a health rather than a moral crisis. 

Portugal’s drug experiment.

When I was little, my grandmother used to tell me to avert my eyes from a certain café we walked past on our way to church. “That’s where the drug addicts are”, she would say – and the words filled me with terror. Portugal in the 1990s seemed irretrievably plagued with ‘drug addicts’. In the collective Portuguese imagination, they populated our cafés, jumped out of the dark asking to park our cars in return for money, broke into our homes for everything but the kitchen sink, and collapsed stupefied in our parks and public squares. The news was filled with stories of citizens robbed at ‘syringe-point’, or threatened with AIDS or hepatitis by delinquents looking to turn our hard-earned cash into another hit. The Boogey Man of my childhood was a drug addict. 

The truth, of course, was that the café my grandmother warned me about was merely a cheap place where young adults congregated for a beer at the end of the day. But by the last 1990s, there were around 130,000 people consuming heroin and other hard drugs in Portugal. In a country of just over 10 million, that number is more than a little scary. Portugal had a severe problem on its hands. 

In 2001, however, the Portuguese government brought in an extensive programme to tackle the crisis. This included significant investment in drug treatment and healthcare infrastructure, but also, notably, the decriminalisation of all drugs. Since then, anyone caught acquiring, consuming or in possession of an illicit substance, within the thresholds defined in law for personal use, now faces a ‘dissuasion programme’ instead of a criminal record. The programme works by referring individuals to their local ‘Commission for the Dissuasion of Drug Addiction’ – a panel made up of health, social care and legal professionals, the primary aim of which is to educate users on the dangers of drug consumption. Repeat offenders might be liable to pay a fine or do community service. Problematic cases are often further referred to counselling and treatment facilities. 

Other less talked about measures included the ‘syringe exchange’ programme in pharmacies, whereby users of injectables can dispose of their old kits and get new, safer ones. The scheme significantly reduced the risk of infection and transmission of life threatening viruses such as HIV. This was no small task in a country that counted over 600 new HIV infections related to drug use every year. But by 2019, the number had fallen to merely 13 new infections a year.

The measures also included the social rehabilitation of many of the neighbourhoods formerly rife with hard drugs. In Portugal, like in many other countries, the distribution and use of hard drugs is often embedded within the poorest and most vulnerable communities. National and local authorities throughout the 2000s targeted these neighbourhoods, demolishing illegal infrastructure and replacing it with social housing. And while many of the social problems in these communities remain, hard drugs is no longer one of them. Now, in Portugal’s biggest cities, the main threat many of these communities face is gentrification. In Porto, the Aleixo neighbourhood was flattened and its residents displaced. The area is now empty and has caught the eye of property speculators. Soon, Aleixo might be associated not with Portugal’s heroin epidemic, but with luxury homes instead.

In the neighbourhood that replaced Casal Ventoso, a one-time slum in central Lisbon, the last of the 2000s promises has finally become a reality. 20 years later, the first fixed, safe consumption space has now opened to the public. It assists up to 120 users a day and currently has 762 enrolled patients. Most are smokers of hard drugs (like heroin or crack cocaine), but 28% also inject in the premises. Patients only bring drugs they will consume there and then to the space, and must adhere to thresholds set by law for “personal use” – 1g in the case of heroin and crack cocaine. Upon entering, users are given kits to meet their needs: from syringes, tourniquets and spoons for heroin users, to pipes for crack smokers. Staff come to know the patients and their consumption habits in order to prevent potential overdoses. Addiction is compared to diabetes or other chronic conditions – an illness that mustn’t be stigmatised, and which needs to be handled safely. 

While experts are quick to note that we can’t draw a simple “causal link between decriminalisation by itself and the positive tendencies we’ve seen”, it’s also true that improvements are visible. The sight of discarded needles in public spaces is now such a distant memory – most Lisboners under the age of 30 I speak to about it look back at me aghast. Both drug use and drug-related deaths are now well below the EU average. And the trend is likely to prevail, as young people in Portugal (most of whom were born after drug decriminalisation) have one of the lowest usage rates in Europe.

Most importantly, however, is how the stigma surrounding drug use has shifted in the last two decades. The drug addict is no longer depicted as the dangerous delinquent my grandmother feared, but as someone with a health condition – serious, but treatable. It is hard to explain what such a shift does to a society and its consumption of narcotics. But one thing is for sure: the removal of shame from the equation has given many addicts the encouragement they’ve needed to seek treatment and rebuild their lives. 

Where’s the opposition?

If the point of drug policies is to alleviate the burden addiction places on the state and on the taxpayer, decriminalisation in Portugal has been a raging success. But it didn’t just happen out of nowhere. 

The Portuguese left campaigned relentlessly for the decriminalisation of drug consumption, and continues to argue for the legalisation of light drugs such as cannabis. It was a Socialist government, led by the now UN general secretary António Guterres, that commissioned a report on the drug crisis in Portugal and subsequently proposed the decriminalisation law. And while the bill passed in parliament primarily with the support of the centre-left and left benches, the positive outcomes have generated such political consensus on the subject that in 20 years few politicians have attempted to touch it. 

So it was truly repugnant that when Britain’s Tory government boldly announced a regressive drug strategy this week, Labour went and supported the initiative. Keir Starmer suggested looking at the plans, as if to beef them up with his legal expertise. And Labour’s new shadow home secretary Yvette Cooper went further, saying the programme was “long, long overdue”. The attitude isn’t new for the Labour leadership, either. When earlier this year Scotland implemented the de facto decriminalisation of personal drug use, Starmer was quick to distance himself from the move. By contrast, Lib Dem leader Ed Davey has signed calls for drug policy reform, as has Green party MP Caroline Lucas and Labour backbencher John McDonnell.

This approach by the opposition raises serious questions over how long it will take to see drug reform in England. In the meantime, how many more lives will be shattered and lost in the Tories’ ‘war on drugs’?