Mixed Results For Portugal's Great Drug Experiment When Portugal decriminalized all illegal drugs in 2000, officials hoped to reduce addiction rates and drug-related violence. Today, more users are in rehab, but drug use is on the rise, and reporter Keith O'Brien says the policy has made the problem worse.

Mixed Results For Portugal's Great Drug Experiment

Mixed Results For Portugal's Great Drug Experiment

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When Portugal decriminalized all illegal drugs in 2000, officials hoped to reduce addiction rates and drug-related violence. Today, more users are in rehab, but drug use is on the rise, and reporter Keith O'Brien says the policy has made the problem worse.


Ten years ago, Portugal decriminalized drugs - all of them - from marijuana to cocaine. The decision followed troubling increases in drug addiction and violence. As much as one percent of the country's population was addicted to heroin, and addicts shot up in the streets of the slums of Lisbon. The decriminalization came paired with rehabilitation, and the Portuguese government declared the program a success. Others note that drug use there is actually up now, and that when the government removed the legal risk, drugs became more appealing.

Journalist Keith O'Brien describes what happened in a piece titled "Drug Experiment" of The Boston Globe, and he joins us now from member station WWNO in New Orleans. Nice to have you with us today.

Mr. KEITH O'BRIEN (Freelance Writer): Thank you, Neal. Good to be here.

CONAN: And you described Portugal's result as really a Rorschach Test -it depends who's looking.

Mr. O'BRIEN: That's absolutely right. You know, people who are in favor of decriminalization and legalization of marijuana or other illicit drugs, look at what's happened in Portugal over the last decade and say, here's an example of how things can go right. And people who are against decriminalization and legalization look at the very same data and say the exact opposite.

CONAN: And tell us what happened, beginning with the impetus. It looked like a pretty bad situation 10 years ago.

Mr. O'BRIEN: Absolutely. So Portugal was late to the drug abuse problem. Even though they were a country located there on the seas and had great ports where drugs could have moved in and out, it wasn't until the late '90s or mid-'90s when things really became problematic there. You had drug-related deaths going up 56 percent within two years. You had the highest rate of drug-related AIDS in the entire European Union. And as you said, you had slums where people were literally injecting themselves openly in the streets. One in particular, was named Casal Ventoso, which is in Lisbon, just a few minutes from the parliamentary seat. And people literally came there to use drugs, lived there, living and dying in the streets. It was declared European - the European drug supermarket.

CONAN: So, given this situation, a lot of people said, time to crack down. Portugal took a different tack. Why?

Mr. O'BRIEN: Well, they convened an expert commission in the late '90s, and the decision they made was a bold one. They decided instead of trying to fight this with incarceration or Draconian drug laws, they opted to make all illicit - possession of all illicit drugs decriminalized. If you were under this new law, to be found in possession of drugs, you would not go to prison, but to a commission -it was called the Commission for Dissuasion of Drug Addiction. CDTs, they called them. These were very informal panels that would meet, say, around a boardroom table, very casual, not at all like a courtroom. Social workers would be there, counselors.

They would meet with the person who had been picked up in possession of whatever drug it was and discuss the issue. These CDTs would then hand down various, sort of, not punishments, but treatments. Some people would, you know, be asked to enter counseling. Some people would be banned from, say, going to raves, if that's where they were doing their drugs; or banned from attending certain concerts or bars, if that's where they were doing drugs. And, you know, this is very controversial, even in Portugal, as you can imagine.

CONAN: Mm-hmm.

Mr. O'BRIEN: Even some politicians, at the time, were worried about it. One said, in particular, that he was worried that Portugal was going to become a junkie nirvana, a sort of drug tourist mecca. And he said, our motto may as well be we promise sun, beaches and any drug you like.

CONAN: Yet they had some good experiences. Particularly, the police said, this, being freed from focusing on low-level users, gave them the chance to focus on dealers and importers, the kingpins.

Mr. O'BRIEN: That's right. I mean, in the first few years that these reforms took place in July 2001, drug seizures in Portugal went up almost 500 percent. Within seven years of the reforms, drug users in treatment in Portugal has gone up 63 percent. At the same time, you've got the number of problematic drug users in decline.

In the mid-to-late '90s, at the peak of the panic over Portugal's drug problem, it was estimated that about 1 percent of the Portuguese population was a problematic drug user, was hooked on heroin or some other drug, as you said. And today, that number has fallen by about 50 percent, while the population of Portugal has gone up about 10 percent.

CONAN: So that seems to be a pretty good argument, saying, hey, this has all worked. What's on the other side of the argument?

Mr. O'BRIEN: Well, people on the other side of the argument say that, in fact, there has been an increase, and the data bears that out. In -those reporting drug use, personal drug use over the course of their lifetime has gone up about 40 to 50 percent in the last decade.

The - people reporting the use of cannabis, cocaine, heroin, amphetamines, ecstasy, you name it, it's all gone up. At the same time, there has been an increase in drug-related deaths in Portugal. So there's an argument to be made there.

Now, the people on the other side of that argument, the researchers who have studied this, including a couple who did a paper last year for the British Journal of Criminology, Caitlin Hughes and Alex Stevens, they say that, in fact, the increases aren't as problematic as some people would like to say.

While people reporting drug use over the course of their lifetime has gone up, somewhat significantly in the last decade in Portugal, people reporting drug use over the last 12 months of their lives has actually gone up only slightly.

So it has become something of a Rorschach test, where people in this very polarized debate - not just in Europe, but certainly in the U.S. -can look at these numbers and make almost whatever argument they'd like to make.

CONAN: I hate that balancing report. We like to keep things simple here.

(Soundbite of laughter)

Mr. O'BRIEN: Sorry, Neal. I'm sorry. I can't help you.

CONAN: So what lessons does the Portuguese government draw? Ten years after the experiment began - a long time for an experiment, but 10 years after it began, they say, are we going to change anything?

Mr. O'BRIEN: No. The Portuguese government is holding this up, perhaps not unsurprisingly, as a great success. You know, they point to some of the numbers we've mentioned here.

CONAN: Mm-hmm.

Mr. O'BRIEN: They point to the - a prison population with far smaller drug use problems, and a general population that is getting more treatment than ever before, and say things are working.

You know, they do say, however, that - their drug czar in Portugal says that he would, under no circumstances, recommend that a country pursue this tack without going with a very strong treatment and prevention policy program. And that's really maybe the crux of this debate.

There are very smart people who - very smart drug policy experts in this country who say that what Portugal has done is very interesting, but it may be the case that they could have turned around their problem by simply pouring all the money into treatment and prevention. And, you know, there's an argument to be made for that.

CONAN: So the question, then, is: Are the lessons of Portugal exportable to a place like, say, the United States?

Mr. O'BRIEN: Well, people close to the Obama administration will say no. Portugal is obviously a very different place from the U.S. Lisbon is not the Bronx, nor is it Washington, D.C. However, there are certainly lessons to be learned here.

The argument over drug policy and drug abuse in this country has become an argument of two entrenched parties. On the one hand, you have people who are arguing against decriminalization and legalization. These people will say: If we decriminalize drugs, we'll have havoc in the streets, people behind the wheel getting high, dogs and cats living together, mass hysteria.

What the Portuguese experiment shows is that, in fact, nothing catastrophic happened there in that country. In 2001, July, people went to sleep, woke up the next morning, possession of drugs was decriminalized, and life went on with small changes.

CONAN: Did...

Mr. O'BRIEN: On the other side of the argument - I'm sorry. Go ahead, Neal.

CONAN: I was just going to ask, that politicians feared, did Lisbon become a mecca for people who fly there on vacation to get high?

Mr. O'BRIEN: Well, there are certainly people who've likely gone there over the last 10 years, nine years and experimented. But as someone who's traveled to Portugal in the last 10 years, I didn't notice the difference when I was there, you know. I didn't see drug tourism, you know, happening in the streets. So in general, no. That fear was not borne out.

CONAN: And so the other side, you were just going to go to before I interrupted you.

Mr. O'BRIEN: Well, obviously, the other side of the argument are those people who are in favor of decriminalization or legalization.

CONAN: Mm-hmm. Yeah.

Mr. O'BRIEN: And these people say that the Portuguese experiment shows that decriminalizing drugs will reduce overcrowding in prisons, will reduce the burden on the criminal justice system, and will lead to no ill side effects. But, of course, there have been increases in drug use, drug experimentation there. And so, you know, at the end of the day, what the Portuguese data may show is that there's a little bit of fiction in the arguments of both of these entrenched physicians in this country. And some may say that the answer to drug abuse and drug policy questions in this country may lie somewhere in the middle.

CONAN: We're talking with Keith O'Brien, a freelancer reporter who wrote a piece called "Drug Experiment" in The Boston Globe. You can go to our website and find the link to that story. Go to npr.org, click on TALK OF THE NATION.

And you're listening to TALK OF THE NATION, which is coming to you from NPR News.

And, of course, Keith O'Brien, it's not just the United States and Portugal, which are in big debates over drug policy. There are any number of countries in Europe, which might see themselves as much more analogous to Portugal, smaller countries more - well, more homogeneous countries than certainly the United States.

Mr. O'BRIEN: There are. And it's fair to say that people - other nations are certainly looking at the Portuguese data and trying to determine what it means for them. There have been a lot of countries that have pursued what are known as harm-reduction strategies in the last decade, focusing less on incarceration and more on treatment. You know, to be clear, neither the U.S. Office of National Drug Control Policy nor the Obama administration is interested in pursuing decriminalization or legalization policies.

However, there is a shift that's subtly happening here in this country. You will not hear the term war on drugs, this famous term that we all know, spoken in the Obama administration. There has been a focus in Obama's drug-control strategy on treating addiction as a disease, on emphasizing early intervention. You know, the DEA, for the first time recently, sponsored a national Take-Back Day, where they took expired and unneeded pills, no questions asked. So there is a movement here in this country for harm-reduction strategies, for treating addiction more as a disease and less as a crime.

CONAN: Yet we saw the proposal in California that would not just -obviously, medical marijuana legal in California. And some people say, in many places in that state, it amounts to more or less legalization. But the idea to both legalize it and allow people to grow it in the state, to tax it, that was defeated.

Mr. O'BRIEN: It was. And - but not by much. This proposal that you're talking about was just last year, that would have allowed California municipalities to allow farmers, say, to grow hemp, to go - to grow marijuana, sell it, to tax it, regulate it. That is legalization, or something very close to legalization. Decriminalization is what happened in Portugal. Decriminalization - if anything radical were likely to take place in states in this country, decriminalization is probably the first step that will be made, if anything is made. And that was what they did in Portugal.

CONAN: And there - a similar situation now exists in California. If you get arrested and you have marijuana in your possession, small amounts, you're likely to get something equivalent to a traffic ticket - not necessarily a rehabilitation program, though. And that was one of the key lessons that Portuguese authorities cite, that you must have two things working together.

Mr. O'BRIEN: That's right. And, you know, the same thing has happened in Massachusetts in the last couple of years. And there are likely other states that are going to follow that model. And one critic of the Portuguese data - who believes that it maybe doesn't tell us very much at all about how things would go in this country - says that the way to determine how well decriminalization might work in this country is not to dive into the Portuguese numbers and try to extrapolate them for what they mean for us, but to study what's happening in California right now, to study what's happening in Massachusetts right now and follow those states for a few years, five years, 10 years. And from that, maybe we'll learn something.

CONAN: But...

Mr. O'BRIEN: As you pointed out, as opposed to Portugal, where treatment has become a major focus of their battle, it is not necessarily a part of what some states are doing right now.

CONAN: Andre's on the line, calling from San Rafael, California.

ANDRE (Caller): Yes. Thanks for taking my call.

CONAN: Go ahead.

ANDRE: I wanted to comment that the numbers from Lisbon that you are reporting, about the increase need to be parsed out a little bit, because you've got experimental drug use. You've got recreational drug use, and you've got habitual drug use. And I think if you - you know, if there were some way to look at what those different numbers were, I think we might find that maybe habitual's down and experimental is up, or something. I don't know.

CONAN: Keith O'Brien?

Mr. O'BRIEN: Well, they don't measure it exactly with those terms. What - how they do measure it is lifetime reported drug use and drug use reported in the last year and problematic drug use.

CONAN: What do you mean by lifetime?

Mr. O'BRIEN: Lifetime report...

CONAN: Have you ever used drugs any time ever in your life.

Mr. O'BRIEN: Correct. And this is self-reporting. So you know, we're trusting people to tell us the truth. In Portugal - lifetime - people reporting drug use over any course of their lifetime has gone up somewhat significantly over the last decade, from about 7.8 percent to 12 percent. Now, the people who are reporting drug use in the last year in Portugal has gone up at a smaller - much smaller, 3.4 percent to 3.7 percent.

And, you know, the authors of this paper in the British Journal of Criminology say that the numbers over the last year is much more significant because that tells us what's happening right now. And at least between 2001 and 2007 - which is the latest data we have in Portugal - people reporting drug use over the last 12 months only went up just slightly.

CONAN: Keith O'Brien, thanks very much for your time.

Mr. O'BRIEN: Thank you, Neal. A pleasure to be here.

CONAN: Freelance journalist Keith O'Brien wrote "The Drug Experiment" for the Boston Globe. Again, there's a link to our - that story in on our website, at npr.org.

Tomorrow, TALK OF THE NATION: SCIENCE FRIDAY. Ira Flatow will be here to talk about climate change and its effects on the oceans. I'll be back with you again on Monday. Have a great weekend, everybody.

This is TALK OF THE NATION, from NPR News. I'm Neal Conan, in Washington.

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