At a certain point, a problem becomes so common that everyone knows someone who is suffering. So it was with drug addiction in Portugal in 2001. After the collapse of fascism following the bloodless left-wing military coup of 1974, society experienced rapid change and drug use became associated with progressive values – a way of dissociating oneself from past fascist cruelties. Initially a problem only among working class and the workless in Lisbon and other big cities, heroin use increased rapidly and spread across the country. With relatively low levels of education and drug awareness, the proportion of users experiencing problems – addiction, needle-related diseases and overdoses – was far higher than elsewhere in Europe. And by the 1990s, a staggering one percent of the population were heroin users and upwards of 30% of the prison population was HIV positive.
With everyone knowing a heroin user or someone who knew one, the willingness of voters to demonise addicts decreased. And the association between drugs and crime was recognised as more complex than is often portrayed. Middle class decision-makers had new insights on the nature of drug addiction and its harms and public understanding of drug addiction changed. The government also came under pressure from the European Commission to deal with the country’s alarmingly high rate of HIV and AIDS.
When Malcolm Gladwell talked of a ‘tipping point’ his main idea was that at a certain point a behaviour becomes sufficiently normalised for it to prompt mass adoption. But in Portugal what happened was that a behaviour (drug use) became so normalised that the majority of citizens came to understand that behaviour better – and take steps together to reduce that behaviour.
I’ve recently returned from Portugal where I’ve been checking out their “decriminalisation” of drugs. My findings there deserve a longer and more thoughtful piece (which is coming) but for now it is simply worth pointing out that Portuguese drugs policy is a product of the country’s unique history, as well as the determination and political bravery of some radical reformers. One of these reformers, Dr. Joao Goulau (excuse lack of accents) was kind enough to speak to me during my visit. He was one of 9 architects of the 2001 National Drugs Strategy, which I have sitting on my desk, and is the Chairman of both the Institute on Drugs and drug Addiction in Lisbon and the European Monitoring Centre for Drugs and Drug Addiction. I thank him for many of the insights contained in this post and Rúben Serém for arranging this interview at short notice.
A note for those unfamiliar with drug reforms in Portugal: Drugs are not legal in Portugal. Technically even possession of drugs can be treated as a criminal offence. It’s just that laws were liberalised somewhat in 2001 and at the same time treatment options for users were rapidly expanded. After years of a penal approach to drug users, drug use in Portugal effectively came to be considered a health problem. The main changes mean that if police encounter users in possession of small quantities of drugs they are referred to a ‘dissuasion panel’ of experts who try to help users to understand drugs harms and diagnose any underlying problems that may be contributing to drug use. This goes for cannabis users as well as those using hard drugs, and provides an entry point into a wide range of counselling and support services, all of which are voluntary.