Decriminalization of drugs in Portugal: Lessons for public health

In 2000, Portugal enacted a law decriminalizing the possession of all types of drugs within certain quantities. Instead of being arrested and introduced to the criminal justice system, drug users are referred to a civil commission that determines the appropriate sanction for each offender. In addition, the Portuguese government authorized and funded harm reduction programs for drug users, including syringe exchange and drug substitution. After over ten years of this innovative scheme, rates of drug use and addiction in Portugal have declined in almost every category, including among youth and injecting drug users, while treatment admissions have increased. Furthermore, the rate of HIV among injecting drug users, which had been among the highest in Europe, has significantly decreased. Portugal's decriminalization system, although not without shortcomings, provides important lessons for other countries trying to reduce the public health impact of drug use and suggests that decriminalization of drug use can be an impactful means of improving public health. This presentation will describe Portuguese decriminalization in detail and the impacts for public health in Portugal. It will then discuss how the lessons learned can be applied in other countries, particularly the United States. Comparisons will be made between decriminalization in Portugal and Mexico to demonstrate how different methods of decriminalization can produce very different outcomes. The presentation will conclude with recommendations on how to implement the lessons learned from Portugal into drug policy in the United States to help reduce drug use, addiction, drug use-related health consequences, and over-incarceration.