“Decriminalization saves lives and money!” Jorge Roque, recently appointed as INPUD’s new director, speaks during UNAIDS PCB in Geneva, on the Portuguese experience of decriminalization over the last decade. 15 Dec 2011
Jorge Roque gave an impassioned speech at INPUD’s side intervention ‘HIV, Drug Use & the Legal Environment’ at the UNAIDS PCB in Geneva, presenting the experience from Portugal where the removal of criminal and administrative laws from people who use drugs has led to significant progress with HIV prevention, a doubling of treatment access, and the easing of pressure from people who use drugs.
Drug Use Decriminalization in Portugal:
In 2000 Portugal approved and implemented a new law, the law 30/2000 that decriminalized the use of any drug. decriminalization means that it is not a crime to use a drug, whether cannabis, cocaine or heroin. The person instead of being arrested by the criminal system is now treated by the health system.
The system has 3 stages:
1) It starts when the person is stopped by the police in possession of drugs. At this point the police take your details and refer the drug user to what we call in Portuguese a ‘comissao de dissuasao da droga’ which is a form of drug advice centre. This is an administrative sanction rather than than criminalising the person.
2) The second stage is that the drug user is required to attend the drug advice centre which is staffed by lawyers and psychologists. There the drug user is assessed and engaged in a conversation about their drug use. If they are a sporadic user they will pay a fine and then the case is finished.
3) However, for habitual users there is a third option. They are referred to drug treatment centre and are not fined. At the drug treatment centre they talk with a psychologist or psychiatrist and then choose if they want to engage in drug treatment or not.
The fact that a person who uses drugs is now not a criminal had fantastic results, allowing a greater stabilization of this person including the opportunity to engage in drug treatment. As the people who use drugs start to go much more often to the drug treatment centre so they start to use the public health care system free from the fear of criminalization and the associated stigma and discrimination. In the past many drug users hid from public institutions because they were fearful of seeking help. The drug user has become a citizen with full rights who may also use drugs.
Alongside this change in legal environment has come a significant scaling up of drug treatment systems such opiate substitution therapy. Community pharmacists exchange or sell needles and syringes and this is further supported by street workers giving out needles and syringes. As such needles and syringes are widely available giving people who inject drugs the chance to reduce and avoid HIV and viral hepatitis. This approach has led to fabulous results with twice as many people now using OST and HIV rates have reduced to half of the previous level. In fact not only HIV rates reduced but infection rates for Hepatitis B and C have also decreased a lot.
Another great evolution is the relationship between people who use drugs and the police. Now the police are not chasing after drug users and trying to arrest them because they were not seen as criminals. In the beginning the police didn’t like this new approach because they were used to arresting people who use drugs. The priority now is to focus on drug dealers and this allows for an improving relationship between drug users and the police when before the police had often been very aggressive and hostile to drug users.
So I hope I have illustrated to you the positive benefits of changing the legal environment.
Investing in harm reduction and drug treatment is possible because so much money is saved from the old approach of heavy policing and imprisonment. In fact this new approach saves not only lives but money.
The best consequence of all was the fact that since the portuguese drug use decriminalization started 10 years ago HIV decreased by much more than a half! I am grateful Dr Henrique Barros from the Portuguese Mission for giving me this slide that so perfectly illustrates the amazing progress in the prevention of HIV among people who inject drugs.
So, now we have scientific data that shows that the decriminalization of drug use delivers fabulous, healthier results, rather than the state spending all its energy and money persecuting and criminalizing a group people who choose a different lifestyle.
I hope you will all take more time to explore Portugal’s positive experience of changing the legal environment and great health, social and individual benefits. INPUD would like to believes that drug law reform should be even more ambitious and be strongly informed by a rights based approach. However we also recognise that change in drug policy is like to happen as a series of steps and the Portuguese model is a very important stepping stone. Importantly the Portuguese model allow people who use drugs to be partners in the drug the policy debate and so even if we have further ideas, we can constructively contribute to this healthy debate about the evolution of Portuguese drug and HIV policy.
I would urge you all to consider adopting a new social system that respects the rights of minorities in the same way that respects the rights of majorities!