Report: Portugal’s drug decriminalization running into trouble

PORTLAND, Ore. (KGW) — In the run-up to the November 2020 election, proponents of Measure 110 cited the European nation of Portugal as a positive example of what can be accomplished by decriminalizing drugs for users. But now there are signs that the country’s once-promising program has run into trouble.

KGW’s The Story has reported before on how Oregon’s Measure 110 perhaps didn’t mirror Portugal’s model near enough. The consequences for drug users, which Portugal has used as a method of directing people into treatment, are much weaker in Oregon. Portugal also has universal health care, which helps ensure that anyone can seek help when they need it without being turned away.

So if Portugal is struggling, what does that mean for Oregon?

The Washington Post’s reporting

For progressives in the Pacific Northwest, Portugal stood as a shining example of how much good can be done through drug decriminalization. The argument was that addiction is a health issue, not a criminal one. Instead of dealing with police and courts, most people caught using drugs in public were given counseling and a quick path into treatment facilities if that’s what they wanted.

And Portugal did report dramatic results soon after passing its new law back in 2001. But the Washington Post recently reported that 22 years later, Portugal now struggles with drug users who openly flout the law and police who are losing motivation to issue tickets.

The Post story quotes the mayor of Porto, a large city on Portugal’s Atlantic coast, who questions whether the country should rethink its plan for drugs.

“These days in Portugal, it is forbidden to smoke tobacco outside a school or a hospital. It is forbidden to advertise ice cream and sugar candies. And yet, it is allowed for people to be there, injecting drugs,” the mayor told the Post.

According to the article, police claim that urban visibility of the drug problem is at its worst point in decades, and the state-funded non-governmental organizations that have mostly taken over responding to substance users seem less concerned with treatment than affirming that lifetime drug use should be seen as a human right.

The police chief of Porto is quoted as saying: “At the end of the day, the police have their hands tied.” He added that the situation is now comparable to the years before decriminalization began.

The article also cites a newly released national survey showing that the percentage of adults using illicit drugs is on the rise. Back in 2001 it was 7.8% — now it’s 12.8%, and overdose rates have hit a 12-year high.

Admissions of a backslide

Last November, The Story’s Pat Dooris spoke to the architect of Portugal’s drug decriminalization, Dr. João Goulão. Back then, he painted a fairly rosy picture of success for the country since 2001.

“We estimate that when our strategy that included decriminalization was approved, we estimate that we could have 100,000 people using only heroin,” Dr. Goulão told Dooris. “That means 1% of our population. Nowadays we estimate that we can have around 33,000 using any kind of drug in a problematic way.”

But since that Washington Post article, Goulão has changed his tune. He’s publicly admitting that things are not going all that well in Portugal.

Last week, he spoke at Georgetown University, at the O’Neill Institute for National and Global Health Law, acknowledging some of the problems that have been cropping up in his country.

“It is true that we are having some difficulties nowadays in supplying treatment, timely treatment without a waiting list, for instance,” Goulão said. “We have the visibility of disorganized users on the streets in Lisbon and Porto, mostly in the big cities. And we are concerned about it.”

The Washington Post article also points out that Portugal slashed funding for its drug oversight operation back in 2012. It dropped from roughly $83 million per year down to $17 million. That’s why most of the drug outreach is now done by nonprofit groups.

Goulão said that the cuts were a big mistake, although he suggested that the numbers were not entirely correct.

“We have people on the street. And I would say that at the given moment our political responsibles were convinced that such problems in Portugal were solved. Right?” he said. “So there was a stagnation or even a decrease. It’s not exactly the same decrease that is said in the Washington Post article. But it’s not his fault. Probably we explained it wrong. There was a misunderstanding about the cuts. But in fact we are not investing as much as we should.”

When Portugal launched its decriminalization back in 2001, it had plenty of beds for anyone who needed intensive treatment. There was no wait. But that is not the case today, the Washington Post reported — sometimes the wait now can last up to a year.

The Oregon comparison

In some ways, what Portugal is experiencing now can be compared to what Oregon has been going through since Measure 110 passed. Oregon has never had the kind of access to care that Portugal did when it decriminalized drugs, and waitlists at inpatient treatment facilities were common even before Oregon decriminalized drugs.

But there are signs for hope. If funding cuts are indeed a major driver behind Portugal’s backslide, Oregon could eventually be in an even better position that its European forebear.

Portugal has a population of about 10.33 million people. Oregon’s population is less than half that, closer to 4.25 million. Yet thanks to Measure 110, Oregon allocated about $300 million for drug treatment programs in the current biennium alone, compared to Portugal’s $17 million per year as reported by the Post.

It isn’t a one-to-one comparison — Portugal still has the benefit of a publicly-funded health care system, which is not summed up in the funding it puts toward oversight. Oregon already handles most of its addiction outreach through nonprofits, because the state and local governments never had the infrastructure to take it on. And even among U.S. states, Oregon is starting from a historic deficit in access to drug treatment and mental health care. But at the very least, Oregon is working to expand that access now instead of diminishing it.

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