STEVE INSKEEP, HOST:
Now we have a real-world experiment in how to attack drug addiction. Many parts of the United States are fighting the spread of opioids or heroin. Portugal fought its own drug problems differently. That country decriminalized drugs - even heroin - treating addiction as a health issue, not a crime. Our colleague Lauren Frayer reports from Lisbon.
LAUREN FRAYER, BYLINE: Seventy-eight-year-old Gandelina Damiao is permanently hunched carrying her sorrow. She lost three children to heroin in the 1990s.
GANDELINA DAMIAO: (Speaking Portugese).
FRAYER: She points to framed photos of Paulo, Miguel and Liliana on the wall of her cottage in a cobblestoned Lisbon slum with views of the river.
DAMIAO: (Speaking Portugese).
FRAYER: "It was a huge blow," she says. "I was a good mother. I never gave them money for drugs but I couldn't save them."
Drugs flooded into Portugal after the end of authoritarian rule in 1974. By the 1990s, 1 percent of Portugal's population was hooked on heroin. Joao Goulao was a family physician at the time.
JOAO GOULAO: Every family had its own drug habit. So it was so, so present in everyday life that it turned public opinion. OK, we are dealing with a chronic relapsing disease. And this is a disease like the others. I do not put a diabetic in jail, for instance.
FRAYER: Goulao is now Portugal's drug czar. He wrote the 2001 law that decriminalized all drugs. Drug dealers go to jail but anyone caught with less than a 10-day supply of any drug, including heroin, gets mandatory medical treatment - no judge, no courtroom, no jail. Instead, they end up in a sparsely furnished discrete unmarked office in downtown Lisbon for counseling with sociologists like Nuno Cabaz.
NUNO CABAZ: It's cheaper to treat people than to incarcerate them. If I come across someone that wants my help, I'm in a much better position to provide it than the judge would ever be. Just as simple as that.
FRAYER: His team of 10 counselors handle all of Lisbon's roughly 2,500 drug cases a year. In case that sounds like a lot, it's a 75 percent drop in the capital since the 1990s. Field psychologists take me to meet some of Portugal's remaining users along a row of abandoned buildings littered with needles and bursting with wildflowers.
There's a philosophy book on the stoop next to a middle-aged man smoking crack cocaine. He gives his name as Rui and says the stigma against addicts has eased since decriminalization.
RUI: Now, not so much because the methadone is coming. They see the drugs with another perspective.
FRAYER: Every day, a government van pulls up and gives him a dose of methadone, an opioid that helps wean people off heroin. It's a step toward harm reduction. He still does cocaine but he no longer shoots up. And drug-related HIV infections have dropped 95 percent. Drug workers hand out kits with clean needles and condoms. And listen to another addict, Antonio, describing his anxiety.
ANTONIO: If the drugs hurts too much my body, I escape a little, and then I come back again. And I - it's a world I cannot escape. If I turn there, it's there. It's everywhere. I cannot escape.
FRAYER: For every person in Portugal who cannot escape addiction, there's daily methadone, counselling and free treatment. A generation ago, these addicts were put in jail. And now they're on the street. But polls show the Portuguese, having lived through the ravages of a heroin epidemic, overwhelmingly support this policy. For NPR News, I'm Lauren Frayer in Lisbon.
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