How can I buy cocaine online in Pereira
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How can I buy cocaine online in Pereira
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.
Decriminalization: A Love Story
How can I buy cocaine online in Pereira
Since it decriminalised all drugs in , Portugal has seen dramatic drops in overdoses, HIV infection and drug-related crime. W hen the drugs came, they hit all at once. It was the 80s, and by the time one in 10 people had slipped into the depths of heroin use — bankers, university students, carpenters, socialites, miners — Portugal was in a state of panic. The crisis began in the south. Headlines in the local press raised the alarm about overdose deaths and rising crime. Pereira recalled desperate patients and families beating a path to his door, terrified, bewildered, begging for help. In truth, there was a lot of ignorance back then. The country was closed to the outside world; people missed out on the experimentation and mind-expanding culture of the s. When the regime ended abruptly in a military coup in , Portugal was suddenly opened to new markets and influences. Under the old regime, Coca-Cola was banned and owning a cigarette lighter required a licence. When marijuana and then heroin began flooding in, the country was utterly unprepared. Pereira tackled the growing wave of addiction the only way he knew how: one patient at a time. A student in her 20s who still lived with her parents might have her family involved in her recovery; a middle-aged man, estranged from his wife and living on the street, faced different risks and needed a different kind of support. Pereira improvised, calling on institutions and individuals in the community to lend a hand. 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. The opioid crisis soon stabilised, 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 plummeted from an all-time high in of The data behind these changes has been studied and cited as evidence by 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 official policy of decriminalisation made it far easier for a broad range of services health, psychiatry, employment, housing etc that had been struggling to pool their resources and expertise, to work together more effectively to serve their communities. The language began to shift, too. This, too, was crucial. While drug-related death, incarceration and infection rates plummeted, the country still had to deal with the health complications of long-term problematic drug use. Diseases including hepatitis C, cirrhosis and liver cancer are a burden on a health system that is still struggling to recover from recession and cutbacks. They criticise the state for dragging its feet on establishing supervised injection sites and drug consumption facilities; for failing to make the anti-overdose medication naloxone more readily available; for not implementing needle-exchange programmes in prisons. Where, they ask, is the courageous spirit and bold leadership that pushed the country to decriminalise drugs in the first place? Drugs were denounced as evil, drug users were demonised, and proximity to either was criminally and spiritually punishable. Informal treatment approaches and experiments were rushed into use throughout the country, as doctors, psychiatrists, and pharmacists worked independently to deal with the flood of drug-dependency disorders at their doors, sometimes risking ostracism or arrest to do what they believed was best for their patients. Lopes was the first doctor in continental Europe to experiment with substitution therapy, flying in methadone powder from Boston, under the auspices of the Ministry of Justice, rather than the Ministry of Health. His efforts met with a vicious public backlash and the disapproval of his peers, who considered methadone therapy nothing more than state-sponsored drug addiction. In Lisbon, Odette Ferreira, an experienced pharmacist and pioneering HIV researcher, started an unofficial needle-exchange programme to address the growing Aids crisis. She received death threats from drug dealers, and legal threats from politicians. She collected donations of clothing, soap, razors, condoms, fruit and sandwiches, and distributed them to users. A flurry of expensive private clinics and free, faith-based facilities emerged, promising detoxes and miracle cures, but the first public drug-treatment centre run by the Ministry of Health — the Centro das Taipas in Lisbon — did not begin operating until But Porto was at the other end of the country. To get around that, Pereira sometimes asked a nurse to sneak methadone to him in the boot of his car. Now 68, he is sprightly and charming, with an athletic build, thick and wavy white hair that bounces when he walks, a gravelly drawl and a bottomless reserve of warmth. By the time he finished school, got his licence and began practising medicine at a health centre in the southern city of Faro, it was everywhere. Like Pereira, he accidentally ended up specialising in treating drug addiction. These kinds of centres have used different names and acronyms over the years, but are still commonly referred to as Centros de Atendimento a Toxicodependentes , or CATs. Local residents were vehemently opposed, and the doctors were improvising treatments as they went along. It had become clear to a growing number of practitioners that the most effective response to addiction had to be personal, and rooted in communities. Treatment was still small-scale, local and largely ad hoc. He found the practice of jailing people for taking drugs to be counterproductive and unethical. He recommended that drug use be discouraged without imposing penalties, or further alienating users. The resulting recommendations, including the full decriminalisation of drug use, were presented in , approved by the council of ministers in , and a new national plan of action came into effect in He has been the lodestar throughout eight alternating conservative and progressive administrations; through heated standoffs with lawmakers and lobbyists; through shifts in scientific understanding of addiction and in cultural tolerance for drug use; through austerity cuts, and through a global policy climate that only very recently became slightly less hostile. Every family had their addict, or addicts. A drop-in centre called IN-Mouraria sits unobtrusively in a lively, rapidly gentrifying neighbourhood of Lisbon, a longtime enclave of marginalised communities. From 2pm to 4pm, the centre provides services to undocumented migrants and refugees; from 5pm to 8pm, they open their doors to drug users. A staff of psychologists, doctors and peer support workers themselves former drug users offer clean needles, pre-cut squares of foil, crack kits, sandwiches, coffee, clean clothing, toiletries, rapid HIV testing, and consultations — all free and anonymous. On the day I visited, young people 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 and gave pep talks to one another. They varied in age, religion, ethnicity and gender identity, and came from all over the country and all over the world. When a slender, older man emerged from the bathroom, unrecognisable after having shaved his beard off, an energetic young man who had been flipping through magazines threw up his arms and cheered. And he would know. He had stopped doing speedballs mixtures of cocaine and opiates after several painful, failed treatment attempts, each more destructive than the last. He long used cannabis as a form of therapy — methadone did not work for him, nor did any of the inpatient treatment programmes he tried — but the cruel hypocrisy of decriminalisation meant that although smoking weed was not a criminal offence, purchasing it was. After this relapse, he embarked on a new relationship, and started his own business. At one point he had more than 30 employees. Then the financial crisis hit. I met Raquel and Sareia — their slim forms swimming in the large hi-vis vests they wear on their shifts — who worked with Crescer na Maior , a harm-reduction NGO. Six times 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. Portugal does not yet have any supervised injection sites although there is legislation to allow them, several attempts to open one have come to nothing , so, Raquel and Sareia told me, they go out to the open-air sites where they know people go to buy and use. 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. In the foggy northern city of Porto, peer support workers from Caso — an association run by and for drug users and former users, the only one of its kind in Portugal — meet every week at a noisy cafe. They come here every Tuesday morning to down espressos, fresh pastries and toasted sandwiches, and to talk out the 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 that is characteristic of people in the northern region. I was told this again and again in the north: thinking of drug addiction simply in terms of health and disease was too reductive. Some people are able to use drugs for years without any major disruption to their personal or professional relationships. It only became a problem, they told me, when it became a problem. Caso was supported by Apdes , a development NGO with a focus on harm reduction and empowerment, including programmes geared toward recreational users. Their award-winning Check! I was told more than once that if drugs were legalised, not just decriminalised, then these substances would be held to the same rigorous quality and safety standards as food, drink and medication. High-level UNgass meetings are convened every 10 years to set drug policy for all member states, addressing trends in addiction, infection, money laundering, trafficking and cartel violence. By the time of the next session, in , worldwide drug use and violence related to the drug trade had vastly increased. The biggest change in global attitudes and policy has been the momentum behind cannabis legalisation. Massive international cultural shifts in thinking about drugs and addiction are needed to make way for decriminalisation and legalisation globally. But if conservative, isolationist, Catholic Portugal could transform into a country where same-sex marriage and abortion are legal, and where drug use is decriminalised, a broader shift in attitudes seems possible elsewhere. But, as the harm-reduction adage goes: one has to want the change in order to make it. But the opposite happened. The CAT building itself is a drab, brown two-storey block, with offices upstairs and an open waiting area, bathrooms, storage and clinics down below. The doors open at 8. Patients wander in throughout the day for appointments, to chat, to kill time, to wash, or to pick up their weekly supply of methadone doses. Anyone receiving treatment elsewhere in the country, or even outside Portugal, can have their prescription sent over to the CAT, making the Algarve an ideal harm-reduction holiday destination. After lunch at a restaurant owned by a former CAT employee, the doctor took me to visit another of his projects — a particular favourite. Several such UDs, as they are known, have opened in other regions of the country, but this centre was developed to cater to the particular circumstances and needs of the south. Pereira stepped down as director some years ago, but his replacement asked him to stay on to help with day-to-day operations. Pereira should be retired by now — indeed, he tried to — but Portugal is suffering from an overall shortage of health professionals in the public system, and not enough young doctors are stepping into this specialisation. 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 health and social rehabilitation services. It can house up to 14 people at once: treatments are free, available on referral from a doctor or therapist, and normally last between eight and 14 days. When people first arrive, they put all of their personal belongings — photos, mobile phones, everything — into storage, retrievable on departure. To the left there were intake rooms and a padded isolation room, with clunky security cameras propped up in every corner. Patients each had their own suites — simple, comfortable and private. In another room, coloured pencils and easels for drawing. A kiln, and next to it a collection of excellent handmade ashtrays. Many patients remained heavy smokers. Patients were always occupied, always using their hands or their bodies or their senses, doing exercise or making art, always filling their time with something. To help bring the body back, there was a small gym, exercise classes, physiotherapy and a jacuzzi. And after so much destructive behaviour — messing up their bodies, their relationships, their lives and communities — learning that they could create good and beautiful things was sometimes transformational. He believed that everyone — however imperfect — was capable of finding their own way, given the right support. He was firm, he said, but never punished or judged his patients for their relapses or failures. Patients were free to leave 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 or one-size-fits-all solution, just this daily search for balance: 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 be very complicated. A longer version of this piece appears on thecommononline. By Susana Ferreira. View image in fullscreen. What Britain could learn from Portugal's drugs policy. Read more. Reuse this content. Most viewed.
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