Drug decriminalisation in PortugalBMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c4554 (Published 10 September 2010) Cite this as: BMJ 2010;341:c4554
- Paula Vale de Andrade, harm reduction coordinator, Harm Reduction Unit,
- Ludmila Carapinha, Harm Reduction Unit
- Correspondence to: P Vale de Andrade
In the late 1990s the subject of drug use in Portugal had come to the fore. In 2000, 131 people died from something related to drug use. The rate of drug injecting users among the general population was very high (2.3-6.4 per 1000 population aged 15 to 64 years old) as a result of a steady increase in the decade. The associated social and health problems were considerable. The number of notifications of new cases of HIV related with drug addiction was 1430 in 2000, and the prevalence of HIV infection among drug users who started treatment in the public network was 14%. The problem was regularly reported in the news and had become a primary concern of the Portuguese people. The judicial system was overloaded with drug users and traffickers. Fearful of being prosecuted, many users didn’t present to health services.
In 1998 the prime minister invited a panel of practitioners and academics to propose a comprehensive national drug strategy based on humanistic values and the concepts of harm reduction, which challenged the criminalisation of drug use.
Law 30/2000, enforced from July 2001, includes two strands: the decriminalisation of drug use and possession of up to 10 days’ supply of drugs for personal use, and the referral of users identified by law enforcement agencies to the Drug Addiction Dissuasion Commissions. These administrative commissions were set up throughout the country. They comprise multidisciplinary teams that assess users and decide the most appropriate sanction and referral to educational or treatment programmes. The intervention process is faster, smarter, and more personalised than the former one.
In the year of the implementation of law 30/2000, decree-law 183/2001 was also published. This provides a legal framework for the deployment of programmes of harm reduction, which led to the expansion of the national network, which now has more than 40 projects. In parallel, provision of prevention and treatment was increased and those combating drug trafficking moved to focus on large seizures.
After this strategic reorientation more drug users began to be contacted. Law 30/2000 and subsequent public discussion changed the view of drug users from criminals to people needing help. It also led to the conclusion that approaches that focus only on abstinence are not appropriate for every drug user.
In the decade after decriminalisation several statistics have improved. In 2005, for example, the rate of drug injecting users among the general population was 1.5-3.0 per 1000 population aged 15 to 64. The number of deaths associated with drug use has decreased, from 131 deaths in 2001 to 20 in 2008. The number of notifications of new diagnoses of HIV related to drug addiction has also decreased, from 1430 in 2000 to 352 in 2008. The prevalence of drug users with HIV among those who started treatment this year was 9%.
Cite this as: BMJ 2010;341:c4554
Competing interests: None declared.
Provenance and peer review: Commissioned; not externally peer reviewed.