Portugal’s Approach to Drug Policy – what works and what does not?

From Movendi’s website

The Swedish Drug Policy Centre (NPC) has published a new report Decriminalisation of Drugs: What can we learn from Portugal?, written by Pierre Andersson, about Portugal’s approach to drug policy and the lessons that can be learned from the country’s decriminalization of drugs.

In drug policy debates reference is often made to Portugal as an example of a country with a successful approach to drug policy. Often, the country’s good results in reducing the drug problem are attributed to the decriminalisation policy instituted in 2001. But knowledge and understanding of the exact policy and its results is not always accurate and well-informed. Therefore, Pierre Andersson has conducted a series of interviews on the ground in Lisbon and studied the reports on Portugal’s drugs policy published in scientific journals in recent years.

The report makes it clear that Portugal’s reforms in 2001 were more far-reaching than the abolition of penalties for using and possessing small quantities of drugs. Above all, they included major efforts to improve services for rapid and effective treatment, and good coordination between various healthcare interventions. This is likely to have contributed to the development that fewer people developed drug dependency, and, as a result, to a reduction in the number of drug-related deaths.

But, the report also shows that the drug-related death rate fell after the reform, when major efforts were made to expand healthcare, only to then increase again to almost the same level as before decriminalisation.

The Swedish drug policy debate often compares the figures for drug-related deaths between Portugal and Sweden. As the new report shows, these comparisons are flawed because the measurement methods differ from between countries. For example, over 75% of all deaths in Sweden that screened positive for drugs are ultimately classified as “drug-related” according to the definition by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA).

But the corresponding figure in Portugal is below 5%. The report also shows that Sweden undertakes twice as many post-mortem examinations and three times as many forensic analyses as Portugal. Comparisons between the figures make little sense when the methods differ as much as they do.

Concerning drug consumption trends in Portugal, the new report shows that cannabis use has increased among schoolchildren and is now at a higher level than that of the corresponding age group in Sweden.

Countries still have a lot to learn from Portugal’s drug policy, especially with regard to the short waiting time for treatment and the coordination between the various healthcare services. For example, Portugal’s Commissions for the Dissuasion of Drug Abuse (CDT), which people charged with possession or use have to appear before, is quick to make referrals to addiction specialists. The quick and effective response and follow-up increase in all likelihood people’s chances of overcoming – or avoiding – drug use disorders and addiction.

The report also highlights the risk of overlooking some really good lessons from both Portugal and other countries, overshadowed by the framing that decriminalisation in itself is the solution to all drug problems.

The purpose of the report is therefore to contribute to a focused and informed drug policy debate taking into view the initiatives that hold substantial potential to reduce and prevent harm, provide adequate services to all who need it and help prevent drug use and harm among children and youth.

The analysis of Portugal’s drug policy is complemented with a broader overview of ten more European countries which have decriminalised drugs. You can read the additional report “Decriminalization in Europehere>>>.

Comparison of the developments following decriminalisation in these eleven European countries shows that drug-related deaths increased in some countries and decreased in others. It therefore does not seem to be decriminalisation in itself that is the decisive factor in the developments.

To read the report, please follow this link>>>.

 

Drug overdoses in Europe

Drug overdose deaths in Europe have risen for the fifth consecutive year, with a record 9 461 lives lost in 2017 (EU 28, Turkey and Norway). Reducing drug-related deaths is therefore a major public health challenge. Fighting this problem, the EU drugs agency (EMCDDA) launches today three new resources looking at drug overdoses in Europe and the interventions in place to prevent them.

Most overdose deaths in Europe are linked to the use of opioids (heroin or synthetic opioids), although cocaine, other stimulant drugs and medicines also play a role. In a new online resource, Prevention of drug-related deaths in Europe, the agency provides an overview on the issue and the risk factors involved.

Drug-induced deaths in the European Union, Norway and Turkey, 2017

The EMCDDA illustrates how overdose prevention can be addressed on three levels: reducing vulnerability to overdose (e.g. accessible treatment and services); reducing the risk of overdose (e.g. retention in opioid substitution treatment, prison aftercare and overdose risk assessments); and reducing the likelihood of fatal outcomes (e.g. take-home naloxone policies and supervision of drug consumption). Currently, 87 supervised drug consumption facilities exist in 8 EU Member States, Norway and Switzerland providing a safer drug-using environment.

While naloxone – a medicine used to reverse opioid toxicity – has been used in hospitals for over 40 years, it is also now available in the community in many countries. The EMCDDA launched its first overview of Take-home naloxone (THN) programmes in Europe.

Practical solutions have been found to allow non-medical personnel to receive and administer injectable naloxone and enable the distribution of the medication to the homes of potential bystanders. Some countries now make the emergency medication available without a prescription to, or have lifted prescription regulations for, specific establishments or those registered as formally trained. The resource summarises the different products used in THN programmes, including naloxone nasal spray, authorised in 2017 by the European Commission for marketing in all EU countries.

Where have drug-related deaths increased most over the last 10 years? Are women and men affected equally? What are the current concerns in Europe? These are some of the questions answered in new Frequently asked questions (FAQs): drug overdose deaths in Europe published on the EMCDDA website. These present the overdose situation and trends as well as a range of maps and graphics. The EMCDDA monitors closely alerts on harms related to fentanyl and its derivatives due to the very high toxicity of these substances and their potential to result in large clusters of incidents and deaths.

Through its Strategy 2025, the EMCDDA is committed to contributing to a healthier Europe. While opioids are involved in the vast majority of overdose fatalities, other substances (e.g. cocaine, benzodiazepines, synthetic cannabinoids) also contribute to the overdose burden and should not be neglected. The resources contribute to a better understanding of drug overdoses and responses to them in Europe to support sound policymaking in this area.