A Dramatic Policy Change Ended Portugal's Heroin Epidemic. Could The U.S. Do The Same?

The number of Portuguese citizens that use heroin has quartered.

In the 1990s, Portugal was in the midst of a heroin epidemic not unlike the one that was also plaguing the United States, but by making some very significant policy changes regarding how they address and deal with addiction, the Portuguese government was able to end the epidemic and transform the country into a place with one of the lowest rates of drug-induced deaths in Europe.

So how did they do it? According to the video from ATTN: below, Portugal was able to end their own heroin epidemic thanks to a combination of decriminalization and treatment — and a switch-up in how they thought of addiction. The Portuguese government decriminalized the use of all drugs in 2001 (including heroin and cocaine) and unleashed a major public health campaign in an effort to fight addiction. In other words, instead of being sent to prison for drug-related crimes in Portugal, it is treated as an administrative offense, and people are given treatment to combat addiction, which is seen as an illness.

By contrast, The Sentencing Project reports that since the official beginning of the "War on Drugs" in America in 1982, the number of people incarcerated for drug offenses in the U.S. skyrocketed from 40,900 in 1980 to 469,545 in 2015 and has continued to rise. In fact, the push to incarcerate drug users instead of treat their addiction has lead to more people behind bars for a drug offense today than the number of people who were in prison or jail for any crime in 1980.

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Years later, it seems Portugal had the right idea. According to the New York Times, the Health Ministry estimates that only about 25,000 Portuguese use heroin, down from 100,000 when the policy began. And despite a slight rise in drug use in the aftermath of the European economic crisis of recent years, Portugal's drug mortality rate remains the lowest in Western Europe — one-tenth the rate of Britain or Denmark — and about one-fiftieth the latest number for the U.S.

So how might the U.S. use this effective and compassionate approach to drug use to enact change at home? As many experts have said, we can start by taking a page out of Portugal's playbook and work to decriminalize drug crimes, which is part of what The Sentencing Project fights for. According to the organization, in 2014 the United States Sentencing Commission unanimously voted to reduce excessive sentences for up to 46,000 people serving time for federal drug offenses and in 2010 Congress passed the Fair Sentencing Act, which reduced the disparity in sentencing between crack and powder cocaine offenses. 

However, given the rhetoric of some members of the current administration, there's reason to believe the government is backing away from that approach and doubling down incarcerating people for drug use and possession.

Since policy changes will likely be incredibly difficult to enact in a timely manner, the U.S. might also consider making methadone and other drug treatment programs easy to access. While such programs are typically very expensive stateside, they are free in Portugal, where the Health Ministry dispatches workers into the most drug-infested neighborhoods to pass out needles and urge users to try methadone. 

By decriminalizing drug offenses and offering free treatment, Portugal has made it so people stand a much better chance of overcoming addiction. Maybe we can learn something from their pragmatic and compassionate approach.

Cover image via kittirat roekburi / Shutterstock.

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