'Drug use is a health problem': inside one of the oldest legal consumption rooms
theguardian.com
theguardian.com
Being Portuguese I've heard the people who were in charge of the decriminalisation program talk on podcasts. They directly talk about it as a "pandemic", and that they saw similar transmission profiles as a contagious disease when they studied the growth in users.
Their solution was to decriminalise personal usage, support users to prevent HIV transmissions through needle reuse (one of the the biggest successes of the program was the enormous reduction in HIV transmission) and treat the issue as a public health problem - send addicts to psychiatrists, not jail.
The result is Portugal, a middle-high income country is somewhere in the top 10 safest countries in the world, and drug usage is either same as its neighbours or lower.
That is just the first Google hit.
https://knowledge.wharton.upenn.edu/article/is-portugals-dru...
The prediction (at the time) by those against the program was that Portugal would become a giant Amsterdam, and drug tourism would rise and the country would be awash in drugs and drug users.
None of that happened. We are still around or below European averages.
Isn’t this consistent with decriminalization that people aren’t afraid to talk about past drug use? You see similar statistics with, say, people coming out of the closet when homosexuality is decriminalized; which conservatives like to paint as “legalization making people gay”. The OD cases could also be from people more readily calling for help rather than trying to cover up.
There might be some conservative people that agree with you, but I think most strongly religious conservatives wouldn't. IMO it does come down to punishment. Druggies have sinned and must be punished, spare the rod and all that.
For 16! Million! That's a preposterous result.
https://www.publico.pt/2023/10/31/sociedade/noticia/consumo-...
After years of economic crisis, Portugal decentralized its drug oversight operation in 2012. A funding drop from 76 million euros ($82.7 million) to 16 million euros ($17.4 million) forced Portugal’s main institution to outsource work previously done by the state to nonprofit groups, including the street teams that engage with people who use drugs."
From the Washington Post article. https://web.archive.org/web/20230816172031/https://www.washi...
If you want to hear from the people who implemented the program itself, their thoughts and how successful they were, there are Portuguese language podcasts. Maybe OAI Whisper can translate them.
There's plenty of coverage in local media about the issues with the program. Many related to underfunding. Something like 80% less than it was in previous years, according to the comments in your HN link. The points I made - focus on public health - psychiatrists instead of jail - HIV transmission massively reduced - remain.
It's mostly a complaint piece by Porto mayor Rui Moreira. Joao Goulao, the actual architect of the program points to what actually happened.
"João Goulão — head of Portugal’s national institute on drug use and the architect of decriminalization — admitted to the local press in December that “what we have today no longer serves as an example to anyone.” Rather than fault the policy, however, he blames a lack of funding.
After years of economic crisis, Portugal decentralized its drug oversight operation in 2012. A funding drop from 76 million euros ($82.7 million) to 16 million euros ($17.4 million) forced Portugal’s main institution to outsource work previously done by the state to nonprofit groups, including the street teams that engage with people who use drugs."
Yes, except that instead of politicians, it's "police" (and statisticians); and instead of a news feed, it's literally the article we are commenting on.
All I found was "Crimes such as robbery in public spaces rose 14% from 2021 to 2022, which police have in part blamed on the rise in drug use."
Are you American? Is this some point of pride for you to be agaisnt this kind of program?
(italics for emphasis)
> Are you American?
Yes
> Is this some point of pride for you to be agaisnt this kind of program?
On the contrary! I am in favor of this kind of program. I am very critical of my country's war on drugs. It is a war with one singular belligerent: US.
That's not one bit compelling, and doesn't support what you're saying
Please check who you are replying to.
> some text
I assumed that to be a quote. Was it not?
---
> and you shouldn't have brought it up in the first place.
You mean the article we are commenting on shouldn't have brought it up in the first place.
I agree! My point is that it did indeed bring it up. Nothing more.
You are arguing with no one, and directing it at me.
I mean that you in particular shouldn't have brought it up. You should apply your reasoning, and not argue using bad arguments. If the article has a bad argument, don't repeat it.
Did you read literally any other part of my comments?!?
I agree that this article's claim really should be backed by a source.
Unnamed sources have been used since forever by journalists to create stronger articles, but I disagree with their use entirely. If you're going to quote someone, quote them. Don't tell me "local residents", or "local police" think this or that. It seems like a journalistic writing tactic that blurs the truth more than it clarifies.
The increase in drug use that's being described happened in the last 3-4 years. The decriminalisation policy is from 2001. So the increase is not connected to the policy, thus the police is not asking for a repeal of it.
The increase in drug use and decriminalisation are not related, basically. So the sentence you quoted, I don't see how that is a request from the police for a review.
I've read this article since everyone here kept quoting it.
It contains two "criticisms".
First Porto's well connected mayor, Rui Moreira, and his people, saying that the problem is out of control. It very likely is, in Porto. I live there and it's kind of shit since the pandemic.
The second one (and in my view the only one that matters) is by the architect of the program Joao Goulao.
"João Goulão — head of Portugal’s national institute on drug use and the architect of decriminalization — admitted to the local press in December that “what we have today no longer serves as an example to anyone.” Rather than fault the policy, however, he blames a lack of funding.
After years of economic crisis, Portugal decentralized its drug oversight operation in 2012. A funding drop from 76 million euros ($82.7 million) to 16 million euros ($17.4 million) forced Portugal’s main institution to outsource work previously done by the state to nonprofit groups, including the street teams that engage with people who use drugs."
So yeah here's the thing.
No one is having second thoughts about the program, they've just massively defunded it to the point its architect says it barely works, and the Porto mayor got to complain about it to the Washington Post, likely because he has a really good PR company.
That's it.
Rui Moreira is not even a part of any major party.
No data on Portuguese support for the program is ever mentioned.
No major politician is ever quoted.
The statement that "the Portuguese are having second thoughts" remains unsourced, unless you are talking about Rui Moreira.
I've read it in July.
The Portuguese are NOT having second thoughts on the matter.
There is a poorly sourced, vague article on the Washington Post.
I've just read this article.
It contains two "criticisms".
First Porto's well connected mayor, Rui Moreira, and his people, saying that the problem is out of control. It very likely is, in Porto. I live there and it's kind of shit since the pandemic.
The second one (and in my view the only one that matters) is by the architect of the program Joao Goulao.
"João Goulão — head of Portugal’s national institute on drug use and the architect of decriminalization — admitted to the local press in December that “what we have today no longer serves as an example to anyone.” Rather than fault the policy, however, he blames a lack of funding.
After years of economic crisis, Portugal decentralized its drug oversight operation in 2012. A funding drop from 76 million euros ($82.7 million) to 16 million euros ($17.4 million) forced Portugal’s main institution to outsource work previously done by the state to nonprofit groups, including the street teams that engage with people who use drugs."
So yeah here's the thing.
No one is having second thoughts about the program, they've just massively defunded it to the point its architect says it barely works, and the Porto mayor got to complain about it to the Washington Post, likely because he has a really good PR company.
Rui Moreira is not part of any major political party.
No major politician is ever quoted in the article.
No data is shown on the topic showing that the Portuguese population is turning against the program.
So the statement that "The Portuguese are having second thoughts on the matter" remains completely unsourced.
The number of Portuguese adults who reported prior use of illicit adult drugs rose from 7.8% in 2001 to 12.8% in 2022 — still below European averages but a significant rise nonetheless. Overdose rates now stand at a 12-year high and have doubled in Lisbon since 2019. Crime, often seen as at least loosely related to illegal drug addiction, rose 14% just from 2021 to 2022. Sewage samples of cocaine and ketamine rank among the highest in Europe (with weekend spikes) and drug encampments have appeared along with a European rarity: private security forces.
If the decriminalisation doesn't lead to increased drug usage vs its neighbours, what's the problem exactly?
Also, funding was cut like 65-70%. Any program that loses 65-70% of funding will face issues. That seems self explanatory.
No one said decriminalisation would decrease drug usage, just that it would keep it in check while avoiding - building more jails - criminalising the population - and keeping infectious diseases in check ie HIV, which was a huge reduction.
So what is it exactly that bothers you about these stats? That drug usage didn't go away? I don't believe the program was sold as doing that at all.
The idea was never that we would reduce drug usage. We were just told that the problem wouldn't become significantly worse than our neighbours, which it didn't.
I don't think it's the only thing that matters. If I would be Portuguese I would like to know the reason for "Sewage samples of cocaine and ketamine rank among the highest in Europe (with weekend spikes) and drug encampments have appeared along with a European rarity: private security forces." that is highest in Europe and trends upwards.
I have no idea who thinks private security is a rarity in Europe. They exist in every European country I can remember.
Seriously perhaps try and be more sceptical of mass media.
Cocaine and ketamine measurements being “among the highest in Europe” continues to make my point. They are not the highest or 2x or 3x higher, which is what a lot of naysayers said would happen. They’re just high but within European levels. Nothing exceptional.
The difference being that Portugal has never engaged in mass incarceration of drug users, or the construction of a police apparatus that would cost 10x the cost of the current program to run so they could chase after drug addicts. Other countries did. And what do they have to show for it? Nothing. Same usage levels as Portugal, which again all naysayers said was on its way to becoming a new Sodom.
Turns out criminalisation makes virtually no difference in usage. The implications of this are more interesting than most comments here about it.
In my opinion people are just medicating in other ways, but life still sucks.
You could make the argument for it, but this seems completely out of left field.
> Depression can increase the risk of chronic illness, including the disease of substance abuse. Up to a third of clinically depressed people engage in drug or alcohol abuse. These chemical intoxicants can become a form of self-medication for soothing the feelings of low self-worth, hopelessness, and despair that characterize this mental health disorder.
Perhaps I miss some nuance of what you're questioning because I find it surprising that my point was strange to you and now I'm confused.
Abuse vs use, unless you can show people didn't get their antidepressants from a psychiatrist or other mental health professional (don't know who is allowed to prescribe them in Portugal).
> In my opinion people are just medicating in other ways, but life still sucks.
Whatever the source of the issue was, we haven't fixed it. We just got better at dealing with the accute issues created by the hard street drugs, minimizing drug related crime and so on. But the answer shouldn't be to just pump all the would-be drug abusers full of ADs. Or maybe it is, what do I know.
You talk about this as if its small potatoes!
These are major major issues that poison society even in richer countries like the UK. Having lived in London for half a decade and seen what a regime of prohibition has led to there - I would take the "flawed" Portuguese program.
My main point is I think we still have loads of mental health issues in Portugal, possibly masked by the super high rate of AD use in our population, which keeps growing. Daily dosages have more than doubled since 2009 (75 DD per 1000 people to 150 DD per 1000 people) and it's accelerating.
I also work with someone from Portugal who says it isn’t all that it’s cracked up be.
I know San Francisco has tried to pilot this but hasn’t been successful.
I also know Vancouver has a problem with dealers fighting over turf near safe consumption sites.
When NY opened up a safe consumption site, the same thing happened.
"not working at all" is an overstatement, but might be logical since they cut funding by 60-70% or so (news to me but helps explain recent issues).
It contains two "criticisms".
First Porto's well connected mayor, Rui Moreira, and his people, saying that the problem is out of control. It very likely is, in Porto. I live there and it's kind of shit since the pandemic.
The second one (and in my view the only one that matters) is by the architect of the program Joao Goulao.
"João Goulão — head of Portugal’s national institute on drug use and the architect of decriminalization — admitted to the local press in December that “what we have today no longer serves as an example to anyone.” Rather than fault the policy, however, he blames a lack of funding.
After years of economic crisis, Portugal decentralized its drug oversight operation in 2012. A funding drop from 76 million euros ($82.7 million) to 16 million euros ($17.4 million) forced Portugal’s main institution to outsource work previously done by the state to nonprofit groups, including the street teams that engage with people who use drugs."
So yeah here's the thing.
No one is having second thoughts about the program, they've just massively defunded it to the point its architect says it barely works, and the Porto mayor got to complain about it to the Washington Post, likely because he has a really good PR company.
That's it. Rui Moreira is not even a part of any major party. No data on Portuguese support for the program is ever mentioned. No major politician is ever quoted.
That still leaves some closely related problems:
* black market drug sales
* people who would rather use drugs than do something else with their lives
* a society that fails to present more attractive opportunities (to every person) than using drugs
These problems need their own solutions. Some people think that criminalization is the solution to all of them. That solution has been tried in every extreme, and utterly failed every time.
Great, it's decriminalised. People will no longer have a record, can get out of the loop easier.
But is anyone out there helping them? Otherwise, you're still getting nowhere
Here in the US, we have a different version of the same problem.
I'd like to know who the man is and what the story is about, tbh. This was just banter.
Combine this with a historical Lutheran view of probity and personal responsibility, and it's easy to see why drugs have been branded as entirely detrimental.
Sweden is a lot more liberal when it comes to the sale and promotion of alchohol nowadays, even if it's hard to believe. The view on recreational drugs is following, albeit slowly. It will be harder and harder to justify treating weed as akin to heroin as people are exposed to cultural norms in the US (where most popular culture comes from here)
As an example, Sara Skyttedal, MEP for the Christian Democrats, has publicly advocated for legalization of certain drugs. Considering her party is part of the right-wing coalition in government, this is kinda big, especially as KD is historically full of teetotallers.
https://www.cnn.com/2019/07/08/health/recreational-marijuana...
One could also argue that removing blackmarket sources would make it more difficult to find drugs as an adolescent, as adults are less likely to buy for teenagers.
This study seems to support that idea https://www.newscientist.com/article/2209053-us-teens-may-be...
Certain classes of drugs are highly addictive. There is a major profit incentive to hook users on such drugs. This really doesn’t apply to marijuana because it’s not that addictive.
What's your source on this, or are you just going by vibes?
That was and is an integral part of the harm reduction pillar besides the opportunity to use in a safe and clean environment.