Portugal decriminalized the possession and consumption of illicit substances and invested in treatment

In 2001, Portugal became the first country in the world to decriminalize the use, acquisition, and possession of illicit drugs for individual consumption. Since then, Portugal has experienced drastic decreases in the level of HIV and Hepatitis C infections, as well as a reduction in drug-related incarceration rates, and without substantial increases in drug use. While drug trafficking remains illegal, the law transformed the country’s approach towards investing in harm reduction and psychosocial and medical treatment for drug users rather than incarceration.

In 2001, Portugal’s Law n. 30/2000 decriminalized the public and private use, acquisition, and possession of all illegal drugs. While drug trafficking remains illegal, drug use and possession of quantities calculated for individual use of up to 10 days (for example, two grams of cocaine and one gram of heroin) were no longer a crime. Instead, it became a sanctionable misdemeanor where those found with the quantities allowed would either receive fines or be directed to appropriate treatment.¹

The law allowed for a shift towards a health-based approach to drug use, placed under the jurisdiction of the newly created Commissions for the Dissuasion of Drug Addiction (DADC). Those found in possession of drugs are requested to appear before the Commission, which reviews the patient’s consumption history, dependence issues, and social and economic factors to decide the appropriate sanctions or fines, but most importantly direct users to treatment and support services.² The DADC consists of lawyers, health professionals, psychologists, and social workers appointed by the Ministries of Health and Justice.³

Under the law, the Addictive Behaviors and Dependencies Intervention Service (SICAD) was created to coordinate reduction and prevention programs. A wide range of social services for risk and harm reduction, education, and prevention that include street teams, support offices, 24/7 reception centers, and shelter centers; provide hygiene and food services, psychosocial support and education campaigns; and facilitate access to condoms and clean syringes.

Implementation

The 1980s and 1990s saw a surge in drug use in Portugal as the country emerged from a decades-long dictatorship that had suppressed education and weakened institutions, which were unprepared for the increase in drug trafficking that arrived with greater exposure to tourism and new markets.⁴ Levels of HIV and Hepatitis C infection among drug users were of the highest in Europe at the time, and drug-related deaths increased ten-fold between 1989 and 1999.⁵ One in every 100 Portuguese person was battling a heroin addiction. At the time, drug use was a crime punishable by up to three months in prison. Drug possession could result in up to one year of imprisonment,⁶ and crimes associated with drugs were the largest cause of imprisonment in the country.⁷

Surveys showed that in 1997, drugs were the issue of highest concern for the Portuguese population.⁸ Lack of trust in the authorities, particularly among low-income populations, limited the likelihood of people seeking treatment at hospitals or medical facilities,⁹ and stigma over drug use further marginalized certain low-income neighborhoods.¹⁰ In the 1990s, Centros de Atendimento a Toxicodependentes (CATs) started providing community-services to drug users, particularly to those of lower incomes, presenting a less punitive approach to tackling drug use.¹¹

A group of medical, social, psychology, and law experts was tasked by the government to develop a series of recommendations on how to combat drugs in the late 1990s, and one of the key recommendations that arose from the process was to decriminalize drugs for individual consumption, and treat drug use as a health, rather than a criminal issue. The 1999 National Strategy to Combat Drug thus shifted the focus towards ensuring access to medical and psychological support services, access to safe tools such as syringes and condoms, and opioid substitution treatments.¹² The National Strategy has been since then reviewed in 2004 and 2013.

Cost

More than half of the public expenditure on illicit drugs is dedicated towards prevention and treatment (52 percent).¹³ SICAID’s budget amounted to EUR 15.7 million (USD 17.6 million) in 2019.¹⁴

Assessment

Portugal’s experience is often considered an example of the effectiveness of decriminalizing drug use when accompanied by investment in psychosocial and medical treatment, and no administration has sought to reverse it since its establishment.

By 2009, drug use had stopped being the primary concern of the Portuguese public, falling to 13th place ¹⁵ and remains under European averages. Furthermore, the rates of arrests and criminal trials for drug crimes have declined by 60 percent, and the incarceration of people due to drugs decreased from 75 percent to 45 percent of total incarcerations.¹⁶ The great majority (80 percent) of cases submitted to the DADCs are tagged as non-problematic and receive no sanctions, and studies show that the cost of the DADCs was lower than if the cases were brought to court.¹⁷

Between 2000 and 2015, the annual rate of HIV infection decreased from 104.2 new cases per million to 4.2 cases per million,¹⁸ and the number of deaths due to drugs also reduced from 80 to 16, reaching the second-lowest death rate in Europe in 2015. A study concluded that the strategy was responsible for an 18 percent reduction in the per capita cost of drug use. ¹⁹

However, some advocates believe the strategy falls short on numerous fronts, including not providing supervised injection sites and drug consumption facilities, increasing access to anti-overdose medications, and failing to provide safe needle-exchange programs in prisons.²⁰

Additional Information

SICAD has developed partnerships with the Ministry of Education and the Police to support young users, as well as with non-governmental organizations who manage shelters and addiction treatment. Prevention activities take place in schools, sports centers, health centers and festivals, and drug users can access information through a website and a toll-free telephone support line.²¹ Programs also involve “pares” (“peers”), current and former drug users who work with their communities to build trust in the services.²²

The quantities allowed include: 25g for cannabis leaf, 5g for hashish, 2g of cocaine, 1g of heroin, 10 pills of LSD or ecstasy.²³

Tags

• Europe
• Health
• High-Income Country
• Justice
• Low-Income Groups
• Portugal
• Universal