July 13, 2023 - 7:00am

When Americans talk about drug policy, someone invariably brings up Portugal. In 2001, the tiny European nation decriminalised possession of all controlled substances, replacing jail time with referral to health-oriented “dissuasion commissions.” Progressives routinely invoke Portugal as a more “humane” alternative to the American approach. Oregon’s pioneering drug decriminalisation initiative, Measure 110, was even ostensibly based on Portugal’s model.

But has Portugal’s drug experiment run aground? Reporting from the city of Porto, the Washington Post recently detailed that city’s struggles with addiction: “people with gaunt, clumsy hands lift crack pipes to lips, syringes to veins. Authorities are sealing off warren-like alleyways with iron bars and fencing in parks to halt the spread of encampments.”

Speaking at Georgetown University’s law school on Tuesday, Portugal drug coordinator Dr. João Goulão conceded that “we are having some difficulties nowadays” with getting people off of treatment wait lists, and with public drug use. But Goulão, widely credited with overseeing Portugal’s transition to a “public health” approach, attributed these problems not to his regime, but to a slackening of public funding and increased demand precipitated by the pandemic.

Goulão may have a point. Drug overdose deaths in Portugal, though rising, have remained low relative to other European countries — a 20-year record of success that has only been marred by recent trouble. And increasing problems are reasonably attributable to, as the Post noted, a decline in both funding for and the number of people referred to drug treatment.

That said, this backsliding suggests that getting a “public health” approach to drugs right is about far more than “decriminalisation.” Just as importantly, there needs to be pressure on problem users to get clean — something progressives don’t seem to grasp. As Stanford addiction specialist Keith Humphreys told the Oregon state legislature last year: “The open use and flagrant drug dealing in West Coast cities are virtually absent in Portugal, which shuts them down and uses court pressure to get people into treatment”.

Drug use in Portugal does not lead to jail time. But possession and use aren’t legal, and individuals identified as engaging in these activities are summoned before “dissuasion commissions,” which ask them about their drug use and its effects. This summons system relies on the police to manage drug use.

All this makes the Portuguese model a far cry from the approach implemented in Oregon. There, since voters passed Measure 110 in 2020, small possession of controlled substances is a ticketable offence, with the ticket waivable if offenders call a hotline to be told about treatment. There are no dissuasion commissions and little follow-up — only about 2% of Portland offenders have paid their fines, and a similar share actually bothers to call.

Measure 110 was also meant to expand funding for treatment, siphoning off money from the state’s marijuana sales tax revenue. But most of the cash has thus far flowed to “harm reduction” and “peer support” services. In the first year of Measure 110, less than 1% of those helped with new funding entered treatment. Is it any surprise that overdose deaths continue to surge?

Porto’s recent challenges suggest that a “public health first” model like Portugal’s can only work with aggressive funding and utilisation of treatment, as well as mechanisms for holding people accountable for the harms of their drug use. And while, It’s reasonable to treat drug addiction like a disease, in need of treatment rather than prison time, doing so doesn’t mean leaving people free to suffer the consequences of their addictions. 

Progressives who invoke Portugal are too quick to assume our problem is just with the “criminalisation” of drug users. The problem that places like Oregon have failed to address, though, is the drugs themselves.

Charles Fain Lehman is a fellow at the Manhattan Institute and contributing editor of City Journal.