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Arriving in his small office in Lisbon, the year-old tosses his jacket aside, leaving his shirt collar crooked. He looks a little tired from the many trips he's taken lately -- the world wants to know exactly how the experiment in Portugal is going. He adds his latest piece of mail to the mountain of papers on his desk. One gram of heroin, two grams of cocaine, 25 grams of marijuana leaves or five grams of hashish: These are the drug quantities one can legally purchase and possess in Portugal, carrying them through the streets of Lisbon in a pants pocket, say, without fear of repercussion. MDMA -- the active ingredient in ecstasy -- and amphetamines -- including speed and meth -- can also be possessed in amounts up to one gram. That's roughly enough of each of these drugs to last 10 days. Portugal paved a new path when it decided to decriminalize drugs of all kinds. As part of its war on drugs, Portugal has stopped prosecuting users. Now the head of Portugal's national anti-drug program and an important figure in Portuguese health policy, he still talks like an easygoing family doctor. The question at stake: How can a government keep its citizens from taking dangerous drugs? One way is to crack down on those who provide the drugs -- the cartels, the middle men and the street dealers. Another approach is to focus on the customers -- arresting them, trying them and imprisoning them. Legal prosecution -- as both a control mechanism and a deterrent -- is the chosen approach for most governments. Pinto Coelho wants his country to return to normalcy, in the form of the tough war on drugs that much of the rest of the world conducts. Pinto Coelho is a doctor too. He has run rehab centers and written books about addiction. Now he's at odds with former colleagues and with 'the system,' as he says. His greatest concern is that his country has given up on the idea of a drug-free world. How, Pinto Coelho asks, is it possible to keep young people away from drugs, when everyone knows exactly how many pills can legally be carried around? He still believes deterrents are the best form of prevention and that cold turkey withdrawal is the best treatment method. He is also fighting the extensive methadone program Portugal began as part of its drug policy reform, which now provides tens of thousands of heroin addicts with this substitute drug. These days, Pinto Coelho earns his living running diet clinics, but he spends his evenings writing letters and drafting presentations on his country's 'absurd drug experiment. At home in Portugal, his critical perspective has made him an outsider, but he says he's been well received abroad. As if offering proof, he shows a fact sheet issued by the United States Office of National Drug Control Policy, a brief and skeptically worded report on the Portuguese experiment. In , Portugal broke free from nearly 50 years of military dictatorship, a political shift symbolized by the carnations soldiers stuck in the muzzles of their rifles. He was in his early twenties and 'drugs promised us freedom. But it was a freedom that soon overwhelmed the country. In the s, cheap heroin from Afghanistan and Pakistan began flooding Europe. The number of people taking illegal drugs in Portugal was low compared with other countries, but of those who did consume drugs, an unusually high number of them fell into the category that specialists in this field refer to as 'problem drug users. Flipping through it, he finds the figure he's looking for: , This is the number of severely drug-addicted people in Portugal at the height of the epidemic, in the mids. Portugal's total population at the time was just under 10 million. The number of drug addicts who became infected with HIV was also considerably higher than in most other countries. A drug slum formed in Lisbon, at the edge of a neighborhood known as Casal Ventoso. Here junkies slept in shacks or in the garbage, in extremely poor conditions. Anyone in Portugal could observe this phenomenon -- on TV, in newspaper pictures or even from the nearby highway. Most of the members of the commission were not politicians. Not everyone agrees -- Pinto Coelho, for example. But the anti-drug commission quickly agreed on this position, which formed the basis for Portugal's experiment in dealing with drug users without dealing in deterrents. More surprising is that a Lisbon police commissioner, whose officers spend their days searching for drugs, says it too. The logical extension of this statement is that people who are not criminals should not be treated as criminals. They should not be arrested, put on trial or thrown in jail. The punishment for drug possession in Portugal prior to decriminalization was up to a year in prison. Hashish, cocaine, ecstasy -- Portuguese police still seize and destroy all these substances. Before doing so, though, they first weigh the drugs and consult the official table with the list of day limits. Anyone possessing drugs in excess of these amounts is treated as a dealer and charged in court. Anyone with less than the limit is told to report to a body known as a 'warning commission on drug addiction' within the next 72 hours. In Lisbon, for example, the local drug addiction commission is housed on the first floor of an unremarkable office building. The idea is that no one should feel uncomfortable about being seen here. A year-old in a white polo shirt waits in one room. Police caught him over the weekend with about a gram of hashish. A social worker has already questioned him for half an hour and learned that he attended vocational training at an agricultural school, lives with his parents and smokes pot now and then. This was the first time he was caught in possession of drugs. Next, a psychologist and a lawyer speak to the young man. They want to know if he's aware of the dangers of cannabis. As long as he isn't caught again within the next three months, his case will be closed. But later, asked to explain these consequences in more detail, nothing comes to her mind that sounds particularly serious. A couple days of community service, perhaps. The commission can also impose fines, but the lawyer says it doesn't like to do so for teenagers. The fines are likewise not intended for people the commission determines to be addicts -- they're already paying to maintain their habit. Lisbon police send around 1, people to the commission each year, which averages out to less than five a day. Seventy percent of these cases concern marijuana. Those who fail to turn up receive a couple of reminders, but coercion is not an intended part of this system. Warnings, reminders and invitations to rehab -- it seems Portugal's war on drugs is a gentle one. It is based on decriminalization, which should not be confused with legalization. Portugal considered that path too, but ultimately decided not to take things quite that far. Our entire country will become a drug-ridden slum, these parties said. The left-wing parties in parliament held a majority, though. The data show, among other things, that the number of adults in Portugal who have at some point taken illegal drugs is rising. At the same time, though, the number of teenagers who have at some point taken illegal drugs is falling. The number of drug addicts who have undergone rehab has also increased dramatically, while the number of drug addicts who have become infected with HIV has fallen significantly. What, though, do these numbers mean? With what exactly can they be compared? There isn't a great deal of data from before the experiment began. And, for example, the number of adults who have tried illegal drugs at some point in their lives is increasing in most other countries throughout Europe as well. Still, taking stock after nearly 12 years, his conclusion is, 'Decriminalization hasn't made the problem worse. Decriminalization is pointless, he says, without being accompanied by prevention programs, drug clinics and social work conducted directly on the streets. Frank Zobel works here, analyzing various approaches to combating drugs, and he says he can observe 'the greatest innovation in this field' right outside his office door. No drug policy, Zobel says, can genuinely prevent people from taking drugs -- at least, he is not familiar with any model that works this way. As for Portugal, Zobel says, 'This is working. Drug consumption has not increased severely. There is no mass chaos. For me as an evaluator, that's a very good outcome. Zum Inhalt springen. News Ticker Magazin Audio Account. Warum ist das wichtig? Much the Same as a Parking Violation As part of its war on drugs, Portugal has stopped prosecuting users. Why set the limits on these drugs at 10 days' worth of use, though? At that point, he says, the heroin epidemic was just beginning. The Second Time Brings Consequences In Lisbon, for example, the local drug addiction commission is housed on the first floor of an unremarkable office building. Decriminalization, Not Legalization Warnings, reminders and invitations to rehab -- it seems Portugal's war on drugs is a gentle one. Translated from the German by Ella Ornstein. Portugal Drugs. Die Wiedergabe wurde unterbrochen. Audio Player minimieren. Helfen Sie uns, besser zu werden. Haben Sie einen Fehler im Text gefunden, auf den Sie uns hinweisen wollen? Oder gibt es ein technisches Problem? Melden Sie sich gern mit Ihrem Anliegen. Redaktionellen Fehler melden Technisches Problem melden. Sie haben weiteres inhaltliches Feedback oder eine Frage an uns? Zum Kontaktformular. 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Decriminalization: A Love Story
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When the drugs came, they hit all at once. It was the eighties, one in ten residents slipped into the deep of heroin addiction—bankers, university students, carpenters, socialites, miners—and Portugal fell into a panic. I met Pereira three decades later. He was sprightly and charming, with a trim athletic build, thick wavy white hair that bounced when he walked, a gravelly drawl, and a seemingly bottomless reserve of warmth. It had long been his way. A general practitioner can get to know his community of patients fairly intimately in a small town. His wife, an educator, came to know generations as students or parents at the local schools. Local headlines terrified with news reports of overdose deaths, of rising crime. If the national average meant one in every one hundred Portuguese was battling a problematic heroin addiction at that time, the number was higher in the south. He described how desperate patients and families began beating down his door, terrified, bewildered, begging for help. To be fair, back then nearly everyone in the country was ignorant. First, in a literal sense: the authoritarian rule of Salazar, whose forty-year regime died a few years after he did in , had suppressed education, thinning out institutions and lowering the minimum legally required schooling level to the second grade in a strategy to keep the population docile. Coca-Cola was banned under his regime, and owning a cigarette lighter required a license. When marijuana, then heroin, and then other substances began flooding in, the country was utterly unprepared. Pereira tackled this growing wave of addiction the only way he knew how: intimately, and one patient at a time. The twenty-something student who still lived with her parents might have her family involved in her recovery; the forty-something man, estranged from his wife and living on the street, faced different risks and needed other support. Rather than being arrested, those caught with a personal supply might be given a warning, assessed a small fine, or sent to have a chat with a local dissuasion commission—a doctor, a lawyer, and a social worker—about treatment, harm reduction, and support services available to them. A bold stance was taken, an opioid crisis stabilized, and the ensuing years saw dramatic drops in problematic drug use, HIV and hepatitis infection rates, overdose deaths, drug-related crime, and incarceration rates. HIV infection rates, for example, plummeted from an all-time high in of The data from what is now a decade and a half of largely positive results have been studied and held up as example, and have given weight to harm-reduction movements around the globe. In many ways, the law was merely a reflection of transformations that were already happening in clinics, in pharmacies, and around kitchen tables across the country. The language people used began to shift, too. The Portuguese opioid addiction epidemic was contained, not made to disappear. The consequences of the eighties and nineties weigh heavily today, as the oldest generation of chronic users and ex-users grapple with complications that include hepatitis C, cirrhosis, and liver cancer. The long-term costs of problematic drug use are a burden on a public healthcare service that is still struggling to recover from a recession filled with cutbacks. Many Portuguese harm-reduction advocates have been frustrated by what they see as stagnation and inaction; they criticize the state for dragging its feet on establishing supervised injection sites and drug consumption rooms, for not making the anti-overdose medication naloxone more readily available, for not implementing needle exchange programs in prisons, and for not demonstrating the same bold leadership that led the country to decriminalize drugs in the first place. In the U. Overdoses are now the leading cause of accidental death, and the leading cause of death period for Americans under fifty, with prescription drugs and the synthetic opioid Fentanyl to blame for much of the horrific jump. More than a quarter of global overdose deaths happen in the United States, according to the most recent UN World Drug Report, with an overwhelming fifty-nine thousand overdoses recorded just last year. Families and communities are being ravaged, as they were during a wave of heroin and then crack addiction in African-American communities in the s and s respectively—epidemics that were largely demonized, criminalized, and untreated. Drugs were called evil, drug users called demons, and proximity to either was criminally and spiritually punishable. Treatment approaches and experiments sprang up throughout the country as doctors, psychiatrists, and pharmacists worked independently to address the flood of drug dependency disorders piling at their doors, sometimes risking ostracism or arrest in order to do what they hypothesized was best for their patients. His efforts earned him vicious public backlash and the insults of his peers, who considered methadone therapy nothing more than state-sponsored drug addiction. In Lisbon, Odette Ferreira no relation to the author , then a sixty-something pharmacist and pioneering HIV-2 researcher, took on death threats from drug dealers and legal threats from politicians when she started an unsanctioned needle exchange program to address the growing AIDS crisis. Along with clean needles, she brought in washing machines; collected and distributed donated clothing, soap, razors, condoms; and gave out fruit and sandwiches. He sent a few people for inpatient treatment there, hoping that time away from their dealers and triggers would help their recovery. Initially, the focus there was on abstinence. To get around that—and to avoid the wrath of the psychiatrists at Taipas—Pereira sometimes asked a nurse to sneak methadone south in the trunk of his car. Pereira relished that great Portuguese tradition of self-deprecation, and performed it with gusto. Tourist dollars and plentiful fishing made scoring dope easy, and the young doctor struggled over how to treat the addicts who began pouring in daily, looking for help. Like Pereira, he ended up specializing in drug addiction treatment by accident. It had become apparent that the response to addiction had to be as personal and rooted in communities as the damage it was causing. The resulting recommendations, including the full decriminalization of drug use, were presented in , approved by the Council of Ministers in , and a new national plan of action went into effect in He has been the lodestar through eight alternating conservative and progressive prime ministers, through heated standoffs with lawmakers and lobbyists, through shifts in scientific understanding about addiction and in cultural tolerance for drug use, through brutal Eurocrisis austerity cuts, and through a delicate global policy climate that only very recently became slightly less hostile. He travels almost nonstop, invited again and again to present the successes of the national harm-reduction experiment he helped birth to curious, desperate authorities from Norway to Brazil. He found the practice of jailing people for taking drugs to be counterproductive and unethical. Every family had their addict, or addicts. My parents first left Portugal for Angola in the early seventies. Salazar was still president, my big brother still a wriggling baby, and it would be another decade and an additional transcontinental move to Canada before I came along. Our parents brought us back for summertime visits every five years or so, adamant that my brother and I connect with our vast extended families, and that we touch the mountainous rock and soil of the northern villages that held our roots. Their once-vivid hope that we immigrants would return home grew fainter as the years passed. The word, heavy with that classic Catholic cocktail of judgment and pity, weighed on both sides of the family. Before the drugs, the hills were filled with the rumble of trucks carrying hefty blocks of granite from any one of the quarries scattered throughout the region. The quarries had long since closed, though. The jobs left with them. Most working-aged men followed, scattering from their families in search of work in Spain, France, Abu Dhabi, Angola. Some of those who stayed turned to heroin. I remember when, decades later, the heaviness began to lift. On a walk with my grandmother a few years before she passed, high in the eucalyptus- and pine-fringed footpaths in the hills above her mountain home, she said what a relief it was to be able to walk without fear of being mugged. This was where the drogados used to come to smoke their drugs, she said, their used foils discarded throughout. The only smoke in the air now was from nearby forest fires, a lamentably regular summertime phenomenon. But in fact, the inverse happened. Months later, one neighbor came to Pereira for forgiveness. The CAT building itself is drab, brown, two stories, with offices upstairs and an open waiting area, bathrooms, storage, and clinic areas down below. The front doors open every morning at , seven days a week, days a year. Patients wander in throughout the day for appointments, to chat, to kill time, to wash up in the toilets, or to pick up their weekly supply of methadone doses, biweekly if they live farther away. Anyone receiving methadone treatment elsewhere in the country or even outside of Portugal could easily have their prescription sent over to the CAT, making the Algarve an ideal harm-reduction holiday destination. Sending patients to other countries, however, could often be trickier. They had a hard time sending methadone patients to France sometimes, the nurse said. Depended on the region. Spain was easy. Pereira turned away from the methadone bottles to face me. The question gave me pause. My first solo trip, in , was also the first time I reported on drug decriminalization. Back in Portugal once more, I wanted to have a closer look at what he meant. I spent weeks crisscrossing the country, visiting community-based programs that nurtured personal connections as a form of harm reduction, accompanying psychologists who spent day after day seeking out vulnerable users who would much prefer to stay hidden from the outside world. I drank coffee with users and activists from families that redefined the meaning of love and loyalty in order to stay together, and sat and listened in small towns that were still in the process of shedding shame and healing the wounds from several long, hard decades. These conversations flipped what I thought I knew about addiction on its head. In vibrant Lisbon I spent my afternoons at a drop-in center called IN-Mouraria, in a lively neighborhood and longtime enclave of marginalized communities that was rapidly gentrifying. Between and p. A staff of psychologists, doctors, and peer support workers—themselves former drug users—offered clean needles, pre-cut squares of foil, crack kits, sandwiches, coffee, clean clothing, toiletries, rapid HIV testing, and consultations—all free and anonymous. Rosy-cheeked youth stood around waiting for HIV test results while others played cards, complained about police harassment, tried on outfits, traded advice on living situations, watched movies together, and gave one another pep talks. They varied in age, religion, ethnicity, and gender identity, from all over the country, from all over the world. When a slender, older man emerged from the bathroom, unrecognizable after having shaved his beard off, the energetic young man flipping through magazines to my right threw up his arms and cheered. Both had been longtime drug users, and they understood the language of the people who came in to see them. Failure was part of the treatment process, he told me. And he would know. He had stopped doing speedball after several painful, failed treatment attempts, each more destructive than the last. He had long smoked cannabis as a form of therapy—methadone did not work for him, nor did any of the inpatient treatment programs he tried—but the cruel hypocrisy of decriminalization meant that although smoking weed was not a criminal offense, purchasing it was. He had already rebuilt his life after his last relapse years prior: after he and his wife temporarily split, he found a new girlfriend, got a new job, and started his own business, at one point presiding over thirty employees. But then financial crisis hit. In the mornings, I went out with street teams to the crusted extremities of Lisbon. I met Raquel and Sareia—light of step, soft of voice, slender limbs swimming in the large neon vests they wear on their shifts—who worked with Crescer na Maior, a harm-reduction NGO. Six days a week they loaded up a large white van with drinking water, wet wipes, gloves, boxes of tinfoil, and piles of state-issued drug kits: green plastic pouches with single-use servings of filtered water, citric acid, a small metal tray for cooking, gauze, filter, and a clean syringe. Another man updated them on his online girlfriend, how he had managed to get her visa approved for a visit. The man looked sheepish. He was accompanied by his beaming girlfriend, and waved a warm goodbye to the girls as they handed him a square of foil for a swan-song hit. The last stop was the once-notorious Casal Ventoso, the neighborhood Odette Ferreira had taken on decades before with her renegade needle exchange project, perched high on a lonely hill overlooking dry bush and freeways. Here we met Carlos, tall and trim with few grey hairs, his swollen hands the only sign of long-term intravenous drug use. Raquel passed him a few needle kits, and he tucked those into his canvas shoulder bag next to an extra pair of clean socks he carried at all times. He had learned to take care of his feet in the military, he said. Raquel smiled brightly. I do this for you. He came here every Tuesday morning to down espresso, fresh pastries, and toasted sandwiches with his fellow peer support workers from CASO, the only association by and for drug users and former users in Portugal. They met to talk out challenges, debate drug policy which, a decade and a half after the law came into effect, was still confusing for many , and argue with the warm rowdiness characteristic of people in the northern region. I was told again and again in the north: thinking of drug addiction simply in terms of health and disease was too reductionist. Some people are able to use drugs for years without any major disruption in their personal or professional relationships. It only became a problem, they told me, when it became a Problem. Their award-winning Check! If drugs were legalized, not just decriminalized, I was told more than once, these substances would be held to the same rigorous quality and safety standards as food, drink, and medication. Bills went unpaid, appliances were sold, all in the name of supplying the cash he needed to support his habit. She offered them hot lunches, regular pay, and easy access to the heroin and cocaine they were hooked on as part of her employment package, all in the name of shielding her son—and the sons of others, whose own mothers had turned their backs on them—from further harm. To these other mothers she was unforgiving. Twice, she was arrested and jailed. From Porto I took a train and then a car ride into the rural mountains, to the quiet village where my grandmother had raised her children, the air filled once more with the ash of forest fires. My relatives reacted to my cross-country reporting with amusement. You want to learn about drogados? I can take you to meet some right now. One of my uncles, more reflective than the others, told me after a late lunch one day about one family in particular, how their history with drugs was an open secret—everyone in the village knew—but he himself had never spoken to them about it directly out of politeness. Small towns are the same everywhere. The scent of chicken stewing in garlic and wine wafted in from the kitchen. For the two decades that he struggled with addiction, Grandmother stayed quiet when items went missing from the house, when euros went missing from her purse, and when withdrawal drove her son-in-law to make wild and desperate threats. Not even my husband knows about this. When the Girl was still young, her parents moved to France. There, far from his friends, far from his dealers, far from the stresses of small-town life and the depressed northern Portuguese economy, they seem to have finally found a new sort of normal. The Girl has gone to visit, and says with some pride that both of her parents have jobs and a home with a beautiful garden. The Girl, still a student, stayed behind in Portugal with her grandmother. What is that called? I asked the Girl how she and her friends in town viewed drugs, and she shrugged. All the kids in school knew. Grandmother had been listening to her intently. She leaned closer to her granddaughter, seeming to forget I was in the room for a moment. Latin American member states pressed for a radical rethinking of the prohibitionist War on Drugs at the first UNGASS, but every effort to examine public-health-rooted alternate models, such as decriminalization, was blocked. Once again, Latin American member states turned up the pressure. Despite that letdown, did see a number of promising developments: Chile and Australia opened their first medical cannabis clubs; four U. The biggest change in global policy climate in recent years has been the momentum surrounding cannabis legalization. For years, he responded the same way: the time was not yet ripe. As is the case in regional and national scenarios, massive international cultural shifts in thinking about drugs and addiction are needed to make way for decriminalization and legalization globally—a Drug-War-Free World. But, as the harm-reduction adage goes: one has to want the change in order to make it. He stepped down as director some years ago, but his replacement asked him to stay on to help with day-to-day operations; the few doctors who specialize in addiction treatment in the Algarve region are spread thin. At age sixty-eight, Pereira should be retired by now—and, boy, has he tried to retire—but Portugal is suffering from an overall shortage of health professionals, and there are simply not enough young doctors interested in stepping into this specialization. They treat themselves. My function is to help them to make the changes they need to make. The glass doors at the entrance slid open to a facility that was bright and clean without feeling overwhelmingly institutional. This facility, like the others, is connected to a web of local, regional, and national addiction, health, and social reinsertion public services. It can house up to fourteen people at once: treatments are free, available on the reference of a doctor or therapist, and normally last between eight and fourteen days. When people first arrive, they put all of their personal belongings—photos, cell phones, everything—into storage, retrievable on departure. To the left, there were intake rooms, a padded isolation room, clunky security cameras propped up in every corner. Patients received their own suites—simple, comfortable, private. In another room, colored pencils and easels for drawing. A kiln, and next to it a collection of excellent handmade ashtrays. Many patients remained heavy cigarette smokers; tobacco addiction, like alcoholism, has a troublingly large and socially accepted presence throughout Europe. The schedule here was more or less the same every day: wake up, have breakfast, take meds. Then exercise or physiotherapy, followed by a group psychotherapy session. After lunch, most patients gathered to smoke in a courtyard overlooking the basketball court and a small soccer pitch. Then they made art all afternoon, broke for lanche a late-afternoon Portuguese snack , and, if there was more medication to take, a second round of meds. Patients were always occupied, always using their hands or their bodies or their senses, always filling their time with something. After so much destructive behavior—messing with their bodies, their relationships, their lives and communities—learning that they could create good and beautiful things was sometimes transformational. I came back to visit the Center for Dishabituation the following day, and after clearing it with them first, Pereira said I could meet some of the patients. There was one man, a former patient who fell into using heroin again after twelve years, the bumpiness of a long financial crisis sending him back into a spiral. Another was a very poor, frail-looking farmer whose wife brought him in on the back of a donkey; she was desperate for him to get help with his alcoholism. This, too, was part of the process. He was firm, but never punished or judged his patients for their relapses or failures. Patients were free to leave the center at any time, and they were welcome to return if they needed, even if it was more than a dozen times. He offered no magic wand, no ready-to-wear, one-size-fits-all solution—only this daily negotiation for balance, a mark that shifted constantly: getting up, having breakfast, making art, taking meds, doing exercise, going to work, going to school, going into the world, going forward. Being alive, he said to me more than once, can sometimes be very complicated. Susana Ferreira is an award-winning freelance writer and radio producer. The tools hung in their places. The floor was swept clean. Along the walls, DIY wood shelving was stacked high with boxes labeled according to their contents. Herb Toys. Xmas Decorations. Home Subscribe Issues Support Us. Right, right. Illustration by Peter Wieben. October 21, August 5, Get Our Newsletter. Discover the extraordinary in The Common. Receive stories, poems, essays, and interviews in your inbox every week. Please enable JavaScript in your browser to complete this form. Subscribe to The Common.
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