Portugal had an even higher heroin addiction rate than America does at the height of our own addiction crisis. Drastic measures saved Portugal.
There’s no question America is reeling from an addiction crisis stemming from heroin and opioid-based painkillers like fentanyl. Police in Lowell, Massachusetts, for example, have had to respond to 20 different opioid-related overdoses in just three days. The American Society of Addiction Medicine (ASAM) estimates that in 2015 alone, there were 20,101 overdose deaths as a result of prescription painkillers, and 12,990 deaths resulting from heroin overdose.
However, there’s good news amidst all of the bad: Another country has had it worse than we have it right now, and they found a way out of it.
According to the Canadian Broadcasting Corporation, Portugal once had Europe’s highest addiction rate, with as much as one percent of the population addicted to hard drugs like heroin and cocaine in 1999. To compare, the Substance Abuse and Mental Health Services Administration counted approximately 2.5 million Americans addicted to either prescription painkillers (2 million) or heroin (591,000) in 2015, which is roughly 0.8 percent of the U.S. population.
By 2001, Portugal’s government was ready to try different solutions. The government began by decriminalizing all drugs across the board and treating drug addiction as a public health issue rather than a criminal offense. By 2015, Portugal’s addiction rate was halved, and now there are only 3 overdose deaths per million citizens. To compare, the EU’s average overdose rate was 17.3 per million citizens in 2015.
Public health physician Dr.João Goulão, who is credited as the architect of Portugal’s drug policy, told CBC that in Portugal, 90 percent of tax dollars allocated toward fighting drug addiction in Portugal now goes to public health programs, rather than law enforcement. In a 2017 interview with NPR, Goulão said the prevalence of drug addiction finally forced citizens to take a more compassionate approach focused on helping drug addicts recover instead of punishing them.
“Every family had its own drug addict. It was so, so present in everyday life, that it turned public opinion,” Goulão said. “We are dealing with a chronic relapsing disease, and this is a disease like any other. I do not put a diabetic in jail, for instance.”
Today, when someone in Portugal is caught with drugs, they are given an appointment with a health department official, rather than a court date.
There are no gowns or gavels in the commission’s bare-bones office and police and prosecutors aren’t involved.
Instead, the commission’s function is to identify potential problem drug users early on and either provide them with information about treatment or quickly get them access to the health-care system.
In the case of a 25-year-old man named Bruno, his penalty for possessing a small amount of hashish was a meeting … followed by the offer of some information about addiction services.
“If it were not for the commission, we would be obliged to go to the court and court expenses are far more expensive,” the young man told CBC News.
Comparatively, a 2009 report from Columbia University’s National Center on Addiction and Substance Abuse (CASA) found that in 2005 alone, more than 95 percent of the $373.9 billion tax dollars state and federal governments allocated toward drug abuse, addiction, and its consequences went toward law enforcement, with just 1.9 percent going to prevention and treatment. In 2016, the Drug Policy Alliance counted 1.57 million drug-related arrests amounting to one arrest every 20 seconds, which is more than a 5 percent increase from 2015.
CASA’s October 2017 report on state expenditures for the consequences of drug addiction wasn’t much better, with just 15.7 percent of state tax dollars funding addiction treatment:
States pay the enormous expenses of untreated addiction (in costs related to criminal justice, health care, education, social welfare, public safety, and lost productivity). Our Center’s analysis found that approximately 15.7 percent of total state spending goes toward substance use and addiction; 94 percent of that amount is spent on addressing the consequences of substance use and addiction rather than on prevention, treatment, or research.
Despite its success, Portugal’s case study doesn’t appear to be something that President Trump’s administration is prioritizing in national drug policy. During a recent speech in Cincinnati, Ohio, Trump said his approach to the addiction crisis sweeping American cities was to “get really, really tough, really mean with the drug pushers and the drug dealers.” Trump’s proposed budget also cuts the Office of National Drug Control Policy by 95 percent.
Watch this video from The Economist to see Portugal’s revamped drug policy in action:
Carl Gibson is a politics contributor for Grit Post. His work has previously been published in The Guardian, The Washington Post, The Houston Chronicle, Al-Jazeera America, and NPR, among others. Follow him on Twitter @crgibs or send him an email at carl at gritpost dot com.