Portugal gave a positive example of what can be done when drug policy prioritises health rather than criminalisation. At the turn of the century, Portugal was in crisis, including high levels of HIV infection among drug users. Many of the effects of the reform were felt immediately: new HIV infections, drug-related deaths and the number of prisoners fell sharply in the first decade. In the second decade, there has been a slower improvement in key interventions as well as an increase in drug-related deaths. However, many of these factors need to be put into context. Drug policy is still only one variable, interacting with a complex mix of social, economic, cultural and political factors, and cuts in universal health coverage during this period will have contributed to this. Nevertheless, Portugal is in a much better position than in 2001 and the proportion of drug use and deaths in the general population is well below the European average. Portugal`s experience is a lesson in what can be achieved when policy innovation and political will are aligned in response to a crisis, and we hope that it will evolve and play a leading role on this issue. While ending the criminalization of drug users is enormous, both in itself and by reducing stigma and paving the way for effective public health intervention, it only addresses some of the harm caused by prohibition.52 While innovations are taking place elsewhere, including the regulated sale of cannabis in North America and the safe supply of opioids and other drugs in Canada, It is also possible for Portuguese drug policy to learn lessons and build on other reform efforts and maintain its global leadership. The PDPM is inextricably linked to its socio-historical context. Contrary to what has been observed in other countries – where the debate on decriminalisation has been linked to the increasing prevalence of cannabis use and some normalisation of its use among young people [18] – the political debate in Portugal has been driven by concerns about the psychosocial vulnerability of high-risk users, whose long drug journeys have highlighted signs of stigma and social exclusion. have.
Problem heroin use was the second highest in Europe in 2000 [41], and although Portugal has lost its importance, it remains among the countries with the highest proportion of high-risk opioids (5.2 per 1000 of the adult population in 2015) [19]. Barometer of viral hepatitis elimination among IDUs in Europe This article historically contextualizes the emergence of PDPM and critically discusses the main current developments and challenges facing Portuguese drug policy in light of the increasing diversity of drug use patterns observed in Portugal. These challenges include (1) the apparent paradox that Portugal has decriminalized drug use and yet has seen a sharp increase in sanctions against drug users over the past decade; (2) ambiguities and anachronisms in the practices of drug commissions; 3) and reluctance to implement harm reduction measures, some of which have been legislated since 2001. Before the start of general population surveys in 2001, there was little reliable information on drug use, injecting behaviour or drug treatment in Portugal. Until then, there were indicators of lifetime prevalence among young people collected by the European School Survey on Alcohol and Other Drugs (ESPAD) and other (less reliable) data available through the EMCDDA. [16] European Monitoring Centre for Drugs and Drug Addiction [EMCDDA]. Portugal – National Drug Report 2019. Lisbon: EMCDDA; 2019. wwwemcddaeuropaeu/system/files/publications/11331/portugal-cdr-2019_0.pdf Retrieved 3 March 2021. EMCDDA. European Report on Drugs: trends and developments.
Lisbon: EMCDDA; 2014. www.emcdda.europa.eu/system/files/publications/963/TDAT14001ENN.pdf. Retrieved 6 February 2020. Levine H. Global drug prohibition: its uses and crises. Int J drug policy. 2003;14(2):145–53. doi.org/10.1016/S0955-3959(03)00003-3. The abandonment of criminalization and incarceration of drug addicts has led to a radical change in the profile of prisoners. In 2001, more than 40% of convicted Portuguese prisoners were incarcerated for drug-related offences, which is significantly higher than the European average, and 70% of reported offences were drug-related.13 While the European average has gradually increased over the last twenty years (from 14% to 18%), The proportion of people convicted of drug-related offences in Portuguese prisons fell dramatically to 15.7% in 2019, which is below the European average.14 Most of this decline occurred in the first decade following decriminalisation and the introduction of a health-based approach. Since 2010, the actual number of people incarcerated for drug-related offences has remained relatively constant, but an increase in the total number of prisoners means that the proportion of people convicted of drug-related offences has continued to decline.15 It has also been suggested that the reform has resulted in a reduction in drug seizures.16 However, Data on drug seizures are difficult to analyze.
All findings must therefore be treated with caution: the reduction in seizures may be due to fewer drugs on the market or simply to lower police activity. Manichean beliefs have long dominated the ideology behind drug policy. Despite widespread advocacy for evidence-based policies [1] and human rights policies [2], these beliefs have presented drug use as exceptionally dangerous behaviour and have maintained the goal of a drug-free society to this day [3]. Nevertheless, the decriminalization movement around the world seems to be becoming more and more attractive [4]. An example of this is the so-called Portuguese Drug Policy Model (PDPM), whose implementation since 2001 decriminalizes the public and private use, acquisition and possession of all illicit drugs (which is quite innovative in this respect), as long as they do not exceed the amount required for the consumption of an average person for 10 days (Law No.
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