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This briefing updates our report on Portugal's groundbreaking reforms, and marks the 20th anniversary of their introduction. It is also available as a free PDF download. In , Portugal decriminalised the personal possession of all drugs as part of a wider re-orientation of policy towards a health-led approach. Possessing drugs for personal use is instead treated as an administrative offence, meaning it is no longer punishable by imprisonment and does not result in a criminal record and associated stigma. Fines can be issued for subsequent referrals. Where some problematic trends are identified moderate risk , brief interventions are proposed — including counselling — but these are non-mandatory. Portugal was not the first country to decriminalise some or all drugs, and it has not been the last. The Portuguese model directly influenced the decriminalisation measure passed in Oregon, for example, as well as proposed decriminalisation in Norway. In the first five years after the reforms, drug deaths dropped dramatically. They rose slightly in the following years, before returning to levels in , with only 10 drug overdose deaths recorded in that year. Since , drug deaths have risen again but remain below levels when there were 76 recorded deaths. While rates fell in Portugal following reform, they increased across the rest of Europe in the same timeframe. In real terms, drug death rates in Portugal remain some of the lowest in the EU: 6 deaths per million among people aged , compared to the EU average of They are practically incomparable to the deaths per million aged experienced in Scotland, which is over 50 times higher than the Portuguese rates. The move away from criminalising and imprisoning people who use drugs has led to a dramatic change in the profile of the prison population. Since , the actual number of people in prison for drug offences has remained relatively steady, but a rise in overall prison numbers means the proportion of people serving sentences for drug offences has continued to fall. Levels of drug use in Portugal have been consistently below the European average over the past twenty years. This is particularly the case among younger people: Portugal has some of the lowest usage rates in Europe among those between the ages of Use among year olds fell throughout the decade, and among the general population was lower in than in However, consumption trends in Portugal have been keenly disputed and often misrepresented. While drug use during individual lifetimes among the general population appeared to increase in the decade following reform, use within the past 12 months fell between and Both the World Health Organization and the United Nations Office on Drugs and Crime consider use in the past 12 months recent drug use or within the past month current drug use as better indicators of trends among the general population. Since , past-year use appears to have risen, particularly among those over the age of In any event, Portugal continues to retain one of the lowest rates of drug use in Europe. Consumption figures alone tell us relatively little about the level of harm experienced through drug use. A rise in drug use among individuals using only occasionally, and recreationally, is unlikely to lead to large rises in deaths or other harms. For this reason, measuring levels of high-risk drug use, particularly among people who inject drugs, is important. Rates in were roughly the same as In line with European trends, as reported by the European school survey on alcohol and drugs ESPAD , they have shown a gradual, consistent decline in the last 10 years. ESPAD also reports that perceived availability of drugs among children in Portugal is lower than the European average. Drug policy reform in Portugal included wide-reaching needle and syringe programmes aimed at reducing risk of infection among people who inject drugs. In , Portugal had 1, new HIV diagnoses attributed to injecting drug use. In , with only 16 new diagnoses, it only had 1. While HIV diagnoses have gone down across Europe in this period, the trend in Portugal is much stronger. Hepatitis C prevalence among people who inject drugs has been estimated as the highest in Western Europe and is a result of multiple epidemics in the late 20th century linked in part to unsafe drug injecting practices up to the s. A key feature of the new Portuguese drug policy, alongside decriminalisation, was the expansion of treatment services. Between , outpatient treatment units increased from 50 to A study comparing patients entering treatment for heroin dependence pre- and post-reform found an overall decrease between and , which the authors suggest could be linked to a fall in the number of newly dependent individuals. The latest available data indicate that 1. This is significantly down since , when the figure was at 2. Portugal has set a positive example for what can be done when drug policies prioritise health rather than criminalisation. At the turn of the century, Portugal was facing a crisis, including high levels of HIV infection among people who use drugs. Many impacts of reform were felt immediately: new HIV infections, drug deaths and the prison population all fell sharply within the first decade. The second decade saw slower improvement in key measures, as well as an upturn in drug deaths. However, many of these factors need to be put into context. Drug policy is still only one variable interacting with a complex mix of social, economic, cultural and political factors, and cuts to wider health provision in that period will have played a part in this. Nevertheless, Portugal is in a much better position than it was in and recorded drug use and drug deaths as a proportion of the general population are both well below the European average. However, while ending the criminalisation of people who use drugs is hugely important both in its own right, in reducing stigma and as an enabler of any effective public health response, it only addresses part of the harms caused by prohibition. The time is right for real reform of our drug laws — and you can help. Please support us by giving what you can. Sign up for our monthly newsletter for drug policy news, event details, as well as volunteer and job opportunities. This website uses cookies to ensure you get the best experience on our website. Learn more. Accept Decline. Background In , Portugal decriminalised the personal possession of all drugs as part of a wider re-orientation of policy towards a health-led approach. Drug-related deaths In the first five years after the reforms, drug deaths dropped dramatically. Decriminalisation significantly reduced the Portuguese prison population and eased the burden on the criminal justice system Drug use Levels of drug use in Portugal have been consistently below the European average over the past twenty years. Threshold quantities for drug offences. SICAD et al Guidelines for the Intervention in Dissuasion. Carapinha, L. Stevens, A. Mouvements Pombo, S. Heroin addiction patterns of treatment-seeking patients, Comparison between pre- and post-drug policy reform in Portugal. Heroin Addiction and Related Clinical Problems One handy web-tool. Abraham, R. Next City 5 January. Statistical Bulletin — overdose deaths. Drug-related deaths: Methods and definitions. European Drug Report Trends and Developments. Drug-related Deaths in Scotland in The UK was included in the dataset as it was in the EU for the years measured. Death data on either measure was not available for Poland, meaning the EU death rate will be a slight underestimation as Polish population data have been included but death data have not. Population on 1 January by age and sex. It is based on population on 1 January each year rather than average yearly population, however. The whole country population data is used, meaning the death rates produced for this graph are not age-aggregated. Torres, A. Council of Europe Space Project: Annual Reports Statistical Bulletin Illicit Substances. IZA DP Statistical Bulletin — prevalence of drug use. Hughes, C. A resounding success or a disastrous failure: Re- examining the interpretation of evidence on the Portuguese decriminalisation of illicit drugs. Drug and Alcohol Review SICAD Statistical Synopsis: Portugal Portugal, Country Drug Report Statistical Bulletin — problem drug use. Roy, L. Forbes 31 August. Trends across 25 countries. EuroHIV Harm Reduction International Global State of Harm Reduction ECDC HIV Surveillance Reports. For this graph, therefore, the most recently recorded data is used in each instance. Palladino, C. Epidemic history of hepatitis C virus genotypes and subtypes in Portugal. Scientific Reports 8. Statistical Bulletin — drug-related infectious diseases. Khalip, A. Reuters 13 August. Global Health Expenditure Database. Portugal Country Drug Report Statistical Bulletin — health and social responses. Ferreira, S. The Guardian 5 December. Taylor, H. Prospective client survey and participatory process ahead of opening a mobile drug consumption room in Lisbon. Harm Reduction Journal A social cost perspective in the wake of the portuguese strategy for the fight against drugs. International Journal of Drug Policy 26 — INPUD Is Decriminalisation Enough? Drug User Community Voices from Portugal. Take action. Support transform The time is right for real reform of our drug laws — and you can help. Latest Articles. Transform announces new trustees 3rd October Our vision for regulated cannabis in the UK 15th August What about the kids? Regulating adult-only cannabis access 6th August

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