Portugal faced a severe heroin and HIV crisis in the 1990s, with approximately one percent of its population addicted to heroin and the highest rate of HIV infection in the European Union. In response, Portugal implemented a groundbreaking approach known as the "Portugal model" in 2001. This approach involved decriminalizing drug possession and shifting from a criminal justice approach to a public health approach. The results have been remarkable, with the number of heroin users dropping from 100,000 to 25,000, and HIV diagnoses related to drug use decreasing by over 90 percent.
Under the Portugal model, drug-dependent individuals are offered treatment programs instead of facing imprisonment. Police officers can now focus on intercepting large-scale trafficking and smuggling. The approach also led to an 18 percent decrease in the per capita social cost of substance use. Along with decriminalization, Portugal focused on prevention, education, and harm reduction, improving treatment programs and helping individuals reintegrate into society.
Challenges still exist, including a lack of affordable housing for those seeking treatment. However, harm reduction programs, such as mobile units offering services like methadone distribution and education, have contributed to positive outcomes. The willingness of individuals to seek help without fear of consequences is one of the notable effects of decriminalization. Treatment options like methadone and suboxone are more accessible in Portugal, dispensed by harm reduction groups, which has contributed to preventing overdoses.
While Portugal faced setbacks during the COVID-19 pandemic, with an increase in overdoses due to restricted access to treatment, the overall success of the Portugal model is evident. In comparison, regions like Sudbury, Canada, continue to grapple with high overdose rates and the limitations of a criminal justice-focused approach. The experience of Portugal suggests that alternative solutions, such as decriminalization and a public health approach, should be considered to address the drug crisis effectively.
Since 2016, Canada has witnessed over 30,000 opioid-related overdose deaths, highlighting the urgent need for effective solutions. Portugal faced a similar crisis in the early 1990s but implemented significant changes to address the issue. Decriminalization played a crucial role in shifting the perception and attitudes towards addiction in Portugal. It allowed for a transition from the criminal justice system to the healthcare system, offering support and treatment without involving law enforcement. This approach reduced prejudice and stigma, creating a more open environment for individuals to seek help and work towards recovery.
In Portugal, when someone is arrested for personal drug use, they are given the opportunity for treatment rather than being sent to jail or facing charges. Treatment options can include rehabilitation programs or the use of substances like methadone and Suboxone, which help manage withdrawal symptoms. Unlike in Canada, where prescriptions are required for these medications, Portugal provides easier access to them, allowing individuals to maintain a stable life while reducing the risk of relapse. Harm reduction practices, such as safe sex education and general healthcare services, including treatment for communicable diseases, are also available to support individuals throughout their recovery journey.
However, social determinants of health, including the lack of affordable housing, remain challenges in Portugal, similar to Northern Ontario. Despite this, healthcare options continue to be an essential part of the treatment approach in Portugal, providing crucial support for individuals seeking to overcome addiction.