Noah Bachmann

The international drug policies are mostly based on prohibition. Several treaties from the United Nations (UN) obligate signatory states to criminalize the possession and use of non-medical drugs. In the opinion of a growing community this zero-tolerance policy has failed, and they advocate for a more liberal way. One example is Portugal, who handle addiction more as a disease than as a crime.

Tools for an intravenous heroin injection(Horizon Health Services, 2016).

International Treaties

International drug policies of the UN consist mainly out of three different treaties:

• Single Convention on Narcotic Drugs, 1961
• Convention on Psychotropic Substances, 1971
• United Nations Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances, 1988 (Blienert, 2022).

The 1961 convention is the first uniform international law agreement and is still the underling concept for today’s policies. In the 1961 convention only drugs derived from plants like cocaine and cannabis are regulated, the 1971 convention adds synthetic drugs like LSD to the international control system. The 1988 convention puts an additional focus on substances, who are needed for drug production (cf. Blienert, 2022). The last agreement additionally specified how signatory states should interpret the conventions; member states were called to criminalize the production, possessing and selling of illicit drugs, while allowing them for scientific and medical use for example for pain treatment (Hall). All these treaties have the goal, to completely free the world from drugs and assume that prohibition is the right way. They had a big impact on national laws in many countries, in some countries just possession of a small amount of cannabis can lead to imprisonment(cf. Wieczoreck, 2020).

Do the treaties work?

Freeing the world from drugs has the noble goal to improve public health but a growing community of public figures and civil society groups doubt that prohibition succeeded. This claim is supported by the fact that illicit drug use has globally increased over the last decades. Another health issue that is attributed to repressive drug policies is, the higher risk of getting infected by HIV or hepatitis C. The conditions to take intravenous drugs often are more unsanitary and for example injection needles are shared more often, and can therefore transmit HIV. There is also a higher risk of overdoses because there is no quality control of the substances. In addition, there are high social costs. The agreements have been used to legitimate police measures that repeatedly violate UN human rights conventions. Prohibition also created illegal markets run by criminal networks, that use a lot of violence to achieve their goals, and costs for incarceration are extremely increased by minor drug offenses (cf. Csete et al., 2016; cf. Hall, 2018).

Liberal approaches

Despite all these negative effects a lot of countries and the UN are holding on to their repressive drug policies. But there are also examples of more liberal approaches. Well-known examples are the legal possibility to buy cannabis in the Coffee Shops of the Netherlands or Switzerland’s answer to the heroin problem in the 1990s. Since then, Switzerland has state controlled and financed heroin discharge points. Another interesting way is Portugal’s decriminalization of non-medical drugs, but to explain this I need to make a little Portuguese history excursus.

History excursus

The Portuguese drug journey began in the 1970s. In 1974, an authoritarian regime was deposed by a military coup. In the 40 years under this regime, Portugal was a closed country, even Coca-Cola was banned. It seems that the government wanted to keep the population tame and docile, one measurement for example was, that the school leaving age was lowered. As this regime ended the country wasn’t prepared for drugs like cannabis and heroin and they spread around fast in the whole country. Following this development in the 1980s drugs were a big social problem in Portugal. One out of 100 Portuguese had to deal with a heroin addiction and Portugal had the highest HIV infection rate in Europe (cf. Ferreira, 2017).
Because of these problems, Portugal introduced a new drug policy in 2001 known as the decriminalization of personal use for all drugs. Since then, you don’t go to prison if you possess less than a quantity needed for the average use of ten days. Therefore, dealing with big amounts retained illegal (Csete et al., 2016). If today a Portuguese police officer finds a person with a small amount of drugs, the person has to go to a “dissuasion commission”. This commission can apply a wide range of different sanction, which mainly account to the health and social wellbeing of the person. They can facilitate therapy against drug-addiction, demand regular reporting or administrative sanctions like community work or taking away a driver’s license. At the same time, Portugal presented new health and social services like low threshold possibilities for clean needles, safe and sanatory consumption zones and opioid substitution therapies with methadone. These harm reduction measures have also been introduced in several other countries like Canada or Uruguay (cf. Csete et al., 2016; cf. Eastwood et al., 2016).

Did decriminalization work?

There is no clear answer to this question, some say it was a success others said it didn’t live up to their expectations. There are several indicators to assess the Portuguese strategy. Some show trends in the positive direction but others moved in a negative direction. I’ll give you some examples. Various analyses concluded that the drug prevalence rate remained low compared to the rest of Europe. The incidence of transmissible diseases such as HIV declined sharply among drug users and the incarceration rate for drug offenses decreased since 2001. But there are also studies that have shown that drug use has increased in specific demographic groups like students. There are different statements from different reports on the trend of drug deaths that contradict each other but the deathrate related to drugs is lower in Portugal than in the mean of Europe (cf. Eastwood et al., 2016; cf. Rêgo et al., 2021).

All these developments cannot provide conclusive proof that decriminalization has improved public health in Portugal. It is very difficult to distinguish whether the various positive effects were caused by decriminalization or whether it was rather the harm reduction measures that led to these improvements. From a socio-economic perspective, however, decrimilaization seems to have had clearly positive effects on Portugal. Costs could be saved in various sectors, for example costs associated with the legal system. In addition, less potential income was lost because fewer people were in prison. And as a final point, I would like to mention that decriminalization has made life easier for many drug addicts. Drug addicts are also citizens of the country and do not deserve to have to fear the police on a daily basis due to an addictive disorder. In my opinion, it is a step in the right direction to see drug addicts not as criminals but as people with a health problem (cf. Eastwood et al., 2016).

Conclusion

The Portuguese way will not work all over the world and is especially  politically very unrealistic in different regions of the world. But also strict prohibition doesn’t seem to be the solution for global and national drug problems. Therefore decriminalization may be a way or element in a policy to reduce drug related harm like HIV infections. And is, as mentioned earlier, a more humanistic way to help people with a drug problem.

Refernces

Blienert, B. (2022). Der Beauftragte der Bundesregierung für Sucht- und Drogenfragen Internatinale Drogenpolitik. https://www.bundesdrogenbeauftragter.de/themen/internationales/drogenpolitik-der-vereinten-nationen/

Csete, J., Kamarulzaman, A., Kazatchkine, M., Altice, F., Balicki, M., Buxton, J., Cepeda, J., Comfort, M., Goosby, E., Goulão, J., Hart, C., Kerr, T., Lajous, A. M., Lewis, S., Martin, N., Mejía, D., Camacho, A., Mathieson, D., Obot, I., … Beyrer, C. (2016). Public health and international drug policy. In The Lancet (Vol. 387, Issue 10026, pp. 1427–1480). Lancet Publishing Group. https://doi.org/10.1016/S0140-6736(16)00619-X

Eastwood, N., Fox, E., & Rosmarin, A. (2016). A QUIET REVOLUTION: DRUG DECRIMINALISATION ACROSS THE GLOBE.

Ferreira, S. (2017, December 5). Portugal’s radical drugs policy is working. Why hasn’t the world copied it? The Guardian. https://www.theguardian.com/news/2017/dec/05/portugals-radical-drugs-policy-is-working-why-hasnt-the-world-copied-it

Hall, W. (2018). The future of the international drug control system and national drug prohibitions. Addiction, 113(7), 1210–1223. https://doi.org/10.1111/add.13941

Horizon Health Services. (2016, June 3). How Do You Know If Someone Is Addicted to Heroin? Horizon Blog. https://www.horizon-health.org/blog/2016/06/heroin-addiction-signs/

Rêgo, X., Oliveira, M. J., Lameira, C., & Cruz, O. S. (2021). 20 years of Portuguese drug policy – developments, challenges and the quest for human rights. Substance Abuse: Treatment, Prevention, and Policy, 16(1). https://doi.org/10.1186/s13011-021-00394-7

Wieczoreck, M. (2020, November 27). Internationale Drogenpolitik. Aus Politik Und Zeitgeschichte. https://www.bpb.de/shop/zeitschriften/apuz/rausch-und-drogen-2020/321822/internationale-drogenpolitik/#footnote-target-9