Is it potty to re-think the War on Drugs? Portugal reversed Europe’s worst addiction crisis with an injection of radical thinking – it decriminalised drugs. Sounds crazy? A former Tory leader says not… while others insist it would backfire horribly here
An immaculately dressed, petite 44-year-old woman approaches what looks like an ice cream van and whispers a personal code number through a hatch.
Inside, a server prepares her daily heroin substitute, ensuring it is the correct strength, before passing it out in a small paper cup. She knocks it back in one and says: ‘Obrigada’, or thank you — and well she might. ‘This is what saved my life,’ she says. ‘Without this van, these kind people, I’d be dead.’
Behind Dulcineia Mendes Correia, other addicts turn up for their dose of the synthetic drug methadone. They come from all walks of life. One is a smart businessman. Another, who appears a little bedraggled, requests a clean needle kit to inject heroin. A third politely asks for free tin foil on which to burn the drug, a method known as ‘chasing the dragon’.
Anything, the experts will tell you, is better than injecting with dirty needles.
This is the sharp end of what Portugal calls its integrated drug strategy, a programme launched 20 years ago with decriminalisation of narcotics at its heart, but with important add-ons, such as harm-reduction, treatment, education and re-integration.
Dulcineia Mendes Correia approaches what looks like an ice cream van and whispers a personal code number through a hatch. Inside, a server prepares her daily heroin substitute, ensuring it is the correct strength, before passing it out in a small paper cup
And last month, in the wake of an Office For National Statistics report that revealed there were 4,561 drug fatalities in the UK last year — the highest total since records began in 1993 — an unlikely advocate of the Portuguese approach called for it to be adopted by the UK. Former leader of the Conservative Party, William Hague, wrote an article in The Times headlined ‘Decriminalising drugs is the only way forward’.
‘Many Tories are reluctant, as I was two decades ago, to abandon a ‘tough’ law-and-order approach,’ said Mr Hague, pointing out that politicians are fearful of even raising the issue because it is such a political hot potato. ‘Yet two truths about this issue seem clear. The first is that it has become a massive social problem. The annual deaths represent tens of thousands more people trapped in addiction and heading for the same fate. The victims match closely with child poverty and areas of deprivation.
‘The second truth, awkward though it may be for those of us who always wanted to get tougher, is we will never suppress the supply of drugs while the demand goes on.’
A parliamentary report by Dame Carol Black last year found that the cost to society of illegal drugs was about £20billion a year in England and Wales but that we were spending only £600million on treatment and prevention.
An unlikely advocate of the Portuguese approach called for it to be adopted by the UK. Former leader of the Conservative Party, William Hague, wrote an article in The Times headlined ‘Decriminalising drugs is the only way forward’
Since 2012, deaths from heroin had doubled and those from cocaine increased five-fold — while 27,000 young people now identified as being gang members, many drawn into drug dealing and violence.
This was enough to persuade the Commons Health and Social Care Committee to recommend in 2019 ‘that the Government should consult on the decriminalisation of drug possession for personal use from a criminal offence to a civil matter’.
‘After decriminalisation [in Portugal], all major indicators in a variety of studies improved,’ Mr Hague said. ‘Including an 18 per cent fall in the total costs to society. Might this not be worth a try?’
In a bid to establish exactly how successful Portugal’s bold move has been, the Mail travelled to Lisbon. What I discovered will shock some readers and surprise others who — quite understandably — have an instinctive aversion to any weakening of laws banning the possession of the sort of drugs that wreck so many young lives.
First, though, it is important to explain what Portugal’s approach is, how it came about — and to understand that decriminalisation is not the same as legalisation.
In the 1990s, the country found itself in the grip of a heroin epidemic. The roots of the problem lay in Portugal’s opening up to the outside world after the Carnation Revolution of 1974 ended the longest dictatorship in Europe.
Portugal was suddenly exposed to new markets and influences and when, first marijuana then heroin, began flooding in, a country which the Swinging Sixties had passed by was utterly unprepared.
By the late 90s, one per cent of the population was hooked on heroin. Almost half were injecting and, with few opportunities for acquiring new needles on a regular basis, addicts shared them, resulting in an incredible 56 per cent becoming HIV-positive. By 2001, Portugal accounted for 50 per cent of new needle-related HIV cases in the EU, despite having just 2 per cent of its population.
‘It was desperate,’ says Hugo Faria from Ares do Pinhal, the organisation that runs the van from which Dulcineia has just received her methadone. We are in Casal Ventoso, a once rundown and dangerous gathering place for addicts. ‘There were incredibly high levels of criminality, with addicts using heroin everywhere. People were dying in the streets,’ recalls Hugo.
Since 2012, deaths from heroin had doubled and those from cocaine increased five-fold — while 27,000 young people now identified as being gang members, many drawn into drug dealing and violence
In the late 1990s, 70 per cent of all Portuguese crime was drug-related, with more than 40 per cent of the prison population in for offences related to drugs. ‘Everyone, be it a family from a poorer district, or from the wealthiest areas — or even elected politicians — knew someone who had died from drug abuse or HIV,’ says Dr Manuel Cardoso, Deputy General-Director of SICAD, Portugal’s drug dependency agency. ‘It was the number one concern at the time and we all knew something different had to be done.’
The then prime minster, António Guterres — now Secretary-General of the United Nations — put together a panel of experts who, in 1999, reported back with ‘The National Strategy for the Fight Against Drugs’.
Introduced in 2001, it involved a combination of better treatment facilities, reducing harm (by, for example, providing clean needles), better education for the public and offering free and safer drug substitutes, such as methadone. The biggest change involved the decriminalisation of personal possession of small amounts of drugs, focusing instead on support to manage or get clear of drug use.
Possession was no longer a criminal offence but regarded as an administrative one — no more serious than a speeding fine. However, trafficking, dealing and possessing more than enough for one’s own personal consumption for 10 days remain illegal and are punished firmly by the courts.
When a person is caught in possession of a small amount of a drug, their supply is confiscated and they are ordered to appear before district panels called Commissions for the Dissuasion of Drug Addiction, comprising health, legal and social work professionals.
I went to see one in action near Praça de Espanha on the edge of central Lisbon. A nervous-looking 20-year-old man had been caught with 3.08 grams of hashish.
He was being interviewed by a social worker for an initial assessment. ‘We are never judgmental and the atmosphere is relaxed,’ says Nuno Capaz, vice-president of the Commission for Dissuasion of Drug Addiction, which administers the panels. ‘We will usually explore why the person is using drugs, ask them whether they could use less, maybe try with none at all for a while, but we never tell them what to do. That would be counter-productive.
I went to see one in action near Praça de Espanha on the edge of central Lisbon. A nervous-looking 20-year-old man had been caught with 3.08 grams of hashish (file image)
‘If it’s their first offence the case will be suspended and no more action taken — as it has been with this young man. However, for second and subsequent offences, they will be fined or asked to perform community service.’
Fines are usually in the region of 35 to 40 euros, but in very rare cases, can be as much as 665 euros. ‘Where there are signs of addiction, we can offer people treatment, counselling and harm-reduction medicine such as methadone,’ continues Capaz. ‘But they are not forced to do this. That won’t work. They have to want treatment for it to be effective.’ When chef Tiago Filipe, 32, was caught with 7.45 grams of cannabis at the age of 19, he was told he faced jail — five grams is usually the limit allowed as ‘personal’ — but his case was suspended on condition he agreed to receive help from one of the commission’s counsellors. Tiago is now head chef at Lisbon’s Lince Brewery Kitchen and he credits the more relaxed approach to possession with saving his career.
It left him without a criminal record and enabled him to move on to senior positions in the UK — at The Savoy, Annabel’s members’ club and Hawksmoor steak restaurant.
‘God knows what would have happened to me if I’d simply been thrown into prison,’ he tells me. ‘I didn’t have a drug problem — I just smoked a bit of weed recreationally — but the counsellor made me ask myself why. It changed my behaviour and probably saved my career. It’s a more humane system that tries to support people and help them change rather than simply punish them.’
But doesn’t this mean that more people will take drugs? Surely if there’s nothing to fear, then there’s nothing to deter? ‘That’s what we were worried about at the beginning — it was seen as a gamble that could backfire,’ says SICAD’s Dr Cardoso. ‘We had to be brave, and it paid off.’ New cases of HIV — the problem that prompted reform — fell from 1,287 in 2001 to just 16 by 2019. In the same year, the number of drug deaths fell to just six per million — about 50 times lower than the current rate in Scotland, which is still rising. Levels of drug use fell, too. According to the European Monitoring Centre for Drugs and Drug Addiction, Portugal now has some of the lowest rates of drug use among 15 to 34-year-olds in the EU.
And, as a consequence of decriminalising small consumers of drugs, the profile of the prison population has changed dramatically. In 2001, more than 40 per cent of inmates were there for drug offences. That is now around 15 per cent.
Yet spending per head of population on prevention and treatment is less than in England and Wales — 65million euros (£55million) in Portugal for a population of 10 million, compared with £600million in England and Wales for a population pushing 60million.
The police, who were resistant to change at first, also came round when they began to see results.
Commissioner Rui Cruz of Lisbon’s Criminal Investigation Department, says: ‘Drug users were seen as criminals before the law changed. There were many impoverished neighbourhoods where lots of people consumed on the streets. We dealt with consuming as a crime — and that criminalised whole neighbourhoods.
‘When the law changed, we were able to apply more resources to trafficking. When we reduce the supply, we reduce the demand.’
Some critics believe admissions to hospital for cannabis-related psychological problems in Portugal — a 29-fold increase from 20 to 588 between 2000 and 2015, according a group of Portuguese psychologists — could be related to relaxing attitudes to possession.
But this might well have been caused by its once-high numbers of heroin users moving to cannabis. And the strength of cannabis has increased considerably over the past 20 years. In England, numbers of cannabis-related hospitalisations have risen by 50 per cent to 31,130 since 2013.
Not everyone believes that a relaxation of drug laws is the answer. In a 2018 report on the legalisation of cannabis, the centre-right think tank, The Centre for Social Justice, predicted that removing legal constraints in the UK would result in a million more users and 100,000 new addicts. Andy Cook, its chief executive, said it would ‘open the floodgates to hundreds of thousands of new users, many of whom will be young and vulnerable.’
In America, sales have boomed as laws have been relaxed. There, 48 of the 50 states allow the sale of medical marijuana and 16 states have legalised it recreationally, including New York and the entire West Coast. In December last year, the cannabis-focused Leafly reported that Americans had purchased $18.3billion in cannabis products, up 71 per cent on the previous year, based on marijuana state tax and revenue records.
It is figures such as these that give many British politicians pause. The last time Boris Johnson was asked about relaxing laws on drug use — when London Mayor Sadiq Khan suggested reviewing the legality of cannabis — his then spokesperson Allegra Stratton, said: ‘The Prime Minister has spoken about this on many occasions — illicit drugs destroy lives and he has absolutely no intention of legalising cannabis, which is a harmful substance.’
Labour leader Sir Keir Starmer has also expressed opposition to decriminalisation. In an interview this year, he said: ‘When I was Director of Public Prosecutions, I prosecuted many cases involving drugs and drug gangs and the criminality that sits behind, and it causes huge issues to vulnerable people across the country.’
Advocates of the Portuguese system say they are not arguing that simply decriminalising personal possession works — treatment, harm-reduction and re-integration policies must be in place, too. These have all been made possible in Portugal because of SICAD, which oversees dozens of charities, NGOs and associations that work on the ground to help addicts. Each is funded in full or part by the government.
At one such association, IN-Mouraria, run by the Group of Activists on HIV Treatments (GAT), I meet Patricia Pestana, 49, and Pedro Carvalho, 46. They share similar stories of having tried heroin with their friends when they were teenagers. ‘We smoked it,’ says Patricia. ‘There was no information about the drug back then. We had no idea how bad it could get. We heard of people having problems from injecting but thought that wouldn’t be us.’
Each, in their own way, found IN-Mouraria, where they were given health checks, counselling and clinically administered methadone in order to wean them off heroin. The organisation also helps to treat Hepatitis C — a big problem for drug addicts.
Patricia is now clean of heroin and works for GAT as a peer counsellor advising other drug users. Pedro, who has been living in a subterranean dwelling he dug in a forest on the outskirts of town for the past two years, has just been told he is to be given a rental home of his own. ‘After that, I’m going to study to become an archaeologist,’ he tells me. ‘I have an ambition to find Atlantis.’
Across town, I visit CRESCER, a program that provides help, advice and harm-reduction for homeless addicts. Its director, Andreia Alves, tells me proudly that they also provide homes for more than 100 addicts — every one of whom has gone on to either reduce their drug consumption or get clean.
Out on the street, CRESCER psychologist Ary Teixeira and social worker Mariana Gomes find Carlos Figueiredo, 49, chasing the dragon. They give him some clean tin foil and ask how they can help. Before saying goodbye, they have arranged a meeting with a homeless charity to try to get him off the street.
Around the corner, Dulcineia is just receiving her ‘ice cream van’ delivery of methadone, a substance that does not get her ‘high’ but simply stabilises her and removes cravings for heroin. ‘My mother died of a heroin overdose by injection,’ she tells me. ‘So, I never injected, but I should never have started at all. I was 19 and thought smoking it wouldn’t get me addicted, but it did.
‘At the worst of my addiction, I was stealing things from shops and supermarkets to pay for my habit. You get desperate. I was so desperate that I would agree to have sex with men and ask for the money first — then run away with it. One night, a man locked me in a house and I had to escape through the bathroom window.
‘Then I heard about this van and walked up one day and said, ‘Please help me’. And they did blood tests, finding out I was HIV positive, and I was given help and treatment and methadone to get me away from heroin. That was seven years ago.’
Dulcineia, who — unlike some addicts — does not wear the ravages of heroin use on her face, adds: ‘Now I live a normal life and I have a job cleaning for two nice old ladies, who each have given me a key to their homes knowing I would never take anything from them.
‘But most important of all, I have two children of my own, a boy and a girl, and they will never have to experience their mother dying from a heroin overdose.’
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