Wall Street Journal (US)

20 Jul 2010

Author: Susana Ferreira

PORTO, Portugal-This country’s move to decriminalize illicit
substances-Europe’s most liberal drug legislation-turns 10 years old
this month amid new scrutiny and plaudits.

Portugal’s decriminalization regime has caught the eye of regulators
in Europe and beyond since it was implemented in 2001. Proponents
credit the program for stanching one of Europe’s worst drug epidemics.
Critics associate it with higher crime and murder rates. Approaching a
decade in force, it is providing a real-world model of one way to
address an issue that is a social and economic drag on countries world-wide.

Norway’s government formed a committee to look at better strategies
for dealing with drug abuse and sent two delegates to Portugal in
early May. Danish politicians have also talked of moving toward full
decriminalization. In March, Danish parliamentarian Mette Frederiksen
of the opposition Social Democrats praised the Portuguese model.

“For us, this is about the addicts leading a more dignified life,” she
told Danish daily Berlingske. “We want to lower the death rates, the
secondary symptoms and the criminality, so we look keenly to Portugal.”

Decriminalization has been criticized by United Nations bodies. In its
2009 annual report, the International Narcotics Control Board
expressed “concern” over approaches that decriminalize drugs or
introduce alternative treatments. “The movement poses a threat to the
coherence and effectiveness of the international drug-control system
and sends the wrong message to the general public,” the board wrote.

In July 2000, Portugal moved beyond previous liberalization regimes in
places like the Netherlands by passing a law that transformed drug
possession from a matter for the courts to one of public and community
health. Trafficking remained a criminal offense but the government did
away with arrests, courts and jail time for people carrying a personal
supply of anything from marijuana to cocaine to heroin. It established
a commission to encourage casual users to quit and backed 78 treatment
centers where addicts could seek help.

In 2008, the last year for which figures are available, more than
40,000 people used the rehab centers and other treatment programs,
according to the Institute for Drugs and Drug Addiction, a branch of
Portugal’s Ministry of Health. The ministry says it spends about •50
million ($64.5 million) a year on the treatment programs, with •20
million more provided through a charity funded by Portugal’s national
lotteries.

Before decriminalization, Portugal was home to an estimated 100,000
problem heroin users, or 1% of the country’s population, says Joao
Goulao, director of the Institute for Drugs and Drug Addiction. By
2008, chronic users for all substances had dropped to about 55,000, he
says. The rate of HIV and hepatitis infection among drug users-common
health issues associated with needle-sharing-has also fallen since the
law’s 2001 rollout.

Portuguese and European Union officials are loath to give publicly
funded treatment centers sole credit. They say the drop in problematic
drug users could also be attributed to heroin’s declining popularity
in Portugal and the rising popularity of cocaine and synthetic drugs
among young people.

At the same time, Portugal’s drug-mortality rate, among Europe’s
lowest, has risen. Mr. Goulao says this is due in part to improved
methods of collecting statistics, but the number of drug-related
fatalities can also be traced to mortality among those who became
addicted to heroin during the country’s 1980s and 1990s epidemic.

Violent crime, too, has risen since the law’s passage. According to a
2009 report by the U.N. Office on Drugs and Crime, Portugal’s drug-use
and murder rates rose in the years after decriminalization. The
general rise in drug use was in keeping with European trends, but the
U.N. noted with some alarm that cocaine use doubled and cocaine
seizures jumped sevenfold from 2001 to 2006.

Murders rose 40% in the period. The report tentatively links that with
drug trafficking, but points out overall murder rates in Portugal remain low.

Pedro do Carmo, deputy national director of Portugal’s judiciary
police, says he doesn’t see link the rise in violent crime with
decriminalization. Instead, he praises the program for reducing the
fear and stigma attached with drug use. “Now, when we pick up an
addict, we’re not picking up a criminal,” he says. “They are more like
victims.”

The Portuguese began considering drug decriminalization following a
leap in heroin addiction decades ago in the country, a major entry
point for drug trafficking from Latin America and North Africa.

The then-ruling Socialist Party government of Prime Minister Antonio
Guterres launched a political debate to discuss how to resolve the
problem. Members of the right-wing People’s Party decried any
tolerance for drug use, saying it would invite drug tourism.

Mr. Guterres’s government pushed through a full decriminalization law.
A subsequent center-right coalition led by Jose Manuel Barroso, now
president of the European Commission, didn’t repeal it.

The legislation was the first in a series of liberal policy shifts in
this predominantly Roman Catholic country. In May, President Anibal
Cavaco Silva ratified a law allowing same-sex marriage, making it the
sixth European country to do so. In 2007, Portugal went from having
among the toughest restrictions on abortion to among the most liberal.

Portugal’s focus on close-knit community and protecting the family may
be at the heart of many of these reforms, say some observers. In a
1999 report that paved the way for new drug legislation, current
Portuguese Prime Minister Jose Socrates implored that “drugs are not a
problem for other people, for other families, for other people’s children.”

Portugal’s rehab clinics, called Centros de Atendimento de
Toxicodependentes, are central to the strategy. In the lively northern
port city of Porto, dozens of patients pop in daily to the Cedofeita
rehab center to pick up free doses of methadone. Others have scheduled
therapy or family counseling sessions, also free.

“The more they can be integrated in their families and their jobs, the
better their chances of success,” says Jose Gonzalez, a psychiatrist
at Cedofeita. Mr. Gonzalez says that about half of his 1,500 patients
are in substitution treatment, 500 of which take methadone daily. He
says there is no defined model or timeline for treatment.

The European Monitoring Centre for Drugs and Drug Addiction, a
Lisbon-based European Union agency, says methadone or other
substance-substitution programs are generally viewed as successful but
has observed that some Portuguese are beginning to question long-term
methadone therapy.

“Now that the epidemic is under control for the most part, people
start asking questions,” says Dagmar Hedrich, a senior scientific
analyst with the EMCDDA. “The question now is what is going to happen
next? There is a part of the population who do not have the
possibility of leaving the treatment.”