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[Tourists exploring Porto, Portugal, bear witness to the grim reality of addiction in the city. They pass by individuals engaging in drug use, with drug-ridden areas situated in close proximity to popular tourist spots. The local authorities have implemented measures such as sealing off alleyways and fencing in parks to contain the spread of drug encampments. However, the problem persists, and the mentality of siege is palpable among residents of nearby affluent neighborhoods.
While Portugal decriminalized all drug use, including marijuana, cocaine, and heroin, as an experiment that inspired similar efforts worldwide, the police are now attributing the rise in crime to an increase in drug users. In some neighborhoods, one can observe state-issued drug paraphernalia, like syringe caps and packets of citric acid, littering the sidewalks near an elementary school. Although Porto’s police have stepped up their patrols in drug-infested areas, their hands are tied due to existing laws. One can witness the helplessness of law enforcement, as officers pass by a emaciated man assembling a crack pipe in front of a state-funded drug-use center.
Portugal’s drug decriminalization model once served as an inspiration for progressive jurisdictions globally, including the state of Oregon. However, there is now a growing sentiment of weariness. The police are less motivated to register individuals misusing drugs, and the waiting period for state-funded rehabilitation treatment has significantly increased, despite a sharp decline in the number of people seeking help. The resurgence of visible drug use in urban areas has prompted the mayor and others to question the efficacy of Portugal’s acclaimed drug model.
The global drug landscape is a cause for concern, with cocaine production reaching record highs, and an alarming increase in amphetamine and methamphetamine seizures. The prolonged pandemic has exacerbated personal struggles and led to a surge in drug use. In the United States alone, overdose deaths, primarily driven by opioids and deadly synthetic fentanyl, surpassed 100,000 in both 2021 and 2022, double the number in 2015. The National Institutes of Health reports that 85% of the U.S. prison population either has an active substance use disorder or was incarcerated for a drug-related offense.
Portugal once seemed to hold the answer to these challenges. In 2001, the country replaced punitive drug policies with a harm reduction approach, decriminalizing the consumption of all drugs for personal use, including the purchase and possession of a 10-day supply. Although consumption remains technically illegal, individuals caught misusing drugs are registered by the police and referred to “dissuasion commissions.” For the most severe cases, authorities can impose sanctions, such as fines and recommend treatment. However, attendance at these commissions is voluntary.
Other countries have also diverted drug offenses away from the criminal justice system, but none have institutionalized this approach like Portugal. Within a few years, HIV transmission rates through syringes, one of the primary reasons for decriminalization, plummeted. Prison populations dropped by 16.5% from 2000 to 2008, and overdose rates decreased as public funds were redirected from prisons to rehabilitation centers. The catastrophic scenarios predicted by opponents of decriminalization did not materialize.
However, for the first time since decriminalization, Portuguese voices are calling for a reassessment of this long-praised policy. Law enforcement officers argue that visible drug problems in urban areas are at their worst levels in decades. State-funded non-governmental organizations, which have largely shouldered the responsibility of responding to addiction, seem more focused on affirming lifetime drug use as a human right rather than prioritizing treatment.
Portugal’s prevalence of high-risk opioid use is higher than that of Germany, but lower than that of France and Italy. Nevertheless, even advocates of decriminalization admit that something has gone wrong. Overdose rates have reached their highest levels in 12 years, with a nearly doubling of cases in Lisbon from 2019 to 2023. Sewage samples confirm high levels of cocaine and ketamine detection, indicating heavy usage during weekends. The collection of drug-related debris from city streets in Porto has surged by 24% between 2021 and 2022, with this year on track to surpass previous records. The increase in drug use has also contributed to a 14% rise in crime, including public space robberies.
In the southern part of Porto, right next to the police headquarters, is a new state-funded drug use center. Its purpose is to provide the growing population of homeless individuals struggling with heroin and cocaine addiction with a discreet place to use drugs. Inside the facility, a nurse observes as a 47-year-old man prepares a combination of heroin and crack cocaine, injecting it into a vein in his neck. Another person at the center remarks that they choose to use there to avoid trouble at home, even if it means driving an hour and a half.
In the tourist quarter, just below Porto’s fortress-like cathedral, social workers from a government-funded nonprofit distribute clean syringe packages to heroin users. When crack pipes are available, they provide those as well. There is no judgment, few questions, and no pressure to change. The prevailing philosophy is to respect the users and acknowledge their right to choose.
Other regions around the world that have implemented drug decriminalization are facing their own challenges. In Oregon, where the policy was put into effect in early 2021, taking Portugal as a model, attempts to divert people with addiction from jail to rehabilitation have faced significant obstacles. The police have shown little interest in issuing toothless citations for drug use, grants for treatment have been insufficient, and very few individuals have shown interest in voluntary rehabilitation. Meanwhile, overdose cases in Portland, the state capital, have surged by 46% this year.
Amsterdam, known for its cannabis cafes, recently implemented a ban on smoking marijuana in public places. In Norway, a plan similar to Portugal’s drug decriminalization was abandoned in 2021, with the country opting for a more fragmented approach.
As enforcement eases, there tends to be initially fewer people crossing the line of what was previously prohibited, leading the public to perceive that the policy is successful. However, as word spreads that there is an open market with limited penalties, more drug users are drawn in. This results in a more entrenched drug culture, which may not be as appealing as it initially seemed.
An eight-minute walk uphill from Porto’s safe drug-use center, in an elegant neighborhood with picturesque views of the city, locals express their frustration at the pervasiveness of drug addiction in their community. They contend that rather than providing drug users with a supportive environment, the focus should be on helping them become drug-free and reintegrate into society. The question now remains: where will Porto and Portugal go from here in their battle against drug addiction?
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