Image above: João Goulão with VIEW editor Brian Pelan
VIEW editor Brian Pelan travelled to Lisbon in Portugal to hear at first hand from the country’s Drugs and Alcohol National Coordinator João Goulão on how they have led the way in Europe on tackling addiction-related issues
I left Ireland just as Storm Ciara was hitting Ireland and the UK. All my research on addiction for this issue of VIEW had shown that a visit to Portugal was a must. I was keen to find out how the country had found its way out of a heroin epidemic that had ravaged many of its inhabitants. I also wanted to know what lessons can we learn from its harm reduction policies.
In the 1990s, Portugal was in the grip of heroin addiction which affected all sectors of society. The country also had the highest rate of HIV infection in the entire European Union.
In 2001, nearly two decades later, Portugal became the first country to decriminalise the possession and consumption of all illicit substances and witnessed a huge reduction in drug use. Rather than being arrested, those caught with a personal supply might be given a warning, a small fine, or told to appear before a local commission – a doctor, a lawyer and a social worker – about treatment, harm reduction, and the support services that were available to them.
Our overall policy is about trying to focus on the needs of each citizen. Drug addiction is not a crime. It does not improve with imprisonment
I met João Goulão at the offices of SICAD (The Intervention Service on Addictive Behaviours and Dependencies) in Lisbon. He is credited as being one of the architects of Portugal’s drug policy which was established in 2000.
From 2009 to 2015, he served as chairman of the European Monitoring Centre for Drugs and Drug Addiction and has been a delegate at the United Nations Commission on Narcotic Drugs.
How important was it for Portugal to decriminalise drug consumption in 2001, I asked João?
“The policy change was based on the idea that drug addiction is mostly a health and social issue rather than a criminal/justice issue. Decriminalisation was important because it meant that the country moved away from the stigma and segregation of people to a more inclusive set of policies for drug users.
“Decriminalisation, along with a set of other policies (prevention, treatment, harm reduction and reintegration) led us to an improvement in indicators for overdoses, HIV infection and criminality since our strategy was put in place.”
Was there much opposition to these policies from politicians and other people who argued that decriminalisation would encourage drug use?
“Yes. It was discussed at our parliament,” replied João. “You had left-wing parties supporting the idea and conservatives opposing it who argued that drug use would increase, children would start using drugs, and that ‘Portugal would become a paradise for drugs users’.
“But now no one in Portugal keeps to that idea. Today there is a broad consensus about the benefits of decriminalisation.
“Following the world economic crash in 2008 we had a bit of a relapse with people going back to injecting drugs. After a lot of discussion we have opened our first mobile safe injecting facility in Lisbon and we are preparing the opening of two more fixed facilities in the city. We may also open one in Porto.”
I was curious to know what type of help is available if you have a drug addiction issue in Portugal.
“Treatment is free in Portugal. We have a quite solid network of centres throughout the country,” said João. “It’s an open door policy for free. The outpatient clinics are the gateway to the system. Help for people is very fast. We do not have a big waiting list.”
What is the situation like in Portugal when it comes to alcohol consumption?
“Alcohol use is the most severe addictive issue that we have in Portugal. We have recently seen some improvement among young people. There is still a huge acceptance of using alcohol in our culture.”
He also said that people becoming addicted to prescribed opioids was not a huge issue in Portugal at the moment.
“We have a quite different tradition when it comes to prescribing opiates to the US and other countries as our doctors are very cautious about prescribing.
“It is not an issue now but we are anticipating that it might arise given the situation that people can now order opiates on the internet.”
“Our overall policy is about trying to focus on the needs of each citizen. Drug addiction is not a crime. It does not improve with imprisonment.”