You’d expect drug use to go up – but, surprisingly, sometimes it drops, as in Portugal
A man lies on the floor in a squalid bedsit, a rubber rope tied around one arm, a needle in his hand. The door bursts open and two armed police officers run in. They take in the scene and swiftly find a bag of powder. What should they do next? The answer depends on the country they’re in.
The Home Office has published a major report into drug use across various countries, apparently surprising even itself with the findings. “We did not in our fact-finding observe any obvious relationship between the toughness of a country’s enforcement against drug possession, and levels of drug use in that country,” the report said.
It is a hugely counter-intuitive finding – common sense suggests that if the threat of punishment hangs over something, people will be less willing to do it. But, in the 11 countries studied, that does not seem to be the case. How strict you are on drug users – whether you punish them as criminals or treat them as patients – does not seem to have any effect on how many people actually take drugs.
Back to those police officers bursting through the door. In Britain, according to the law, they ought to lock the man up and charge him with possession of an illegal substance, which is a criminal offence. But there are at least two countries in Europe that would take a very different approach: the Czech Republic and Portugal. Neither would treat the man as a criminal – and yet the drug situation in the two countries is very different.
In 2001, Portugal was facing what Ann Fordham, the executive director of the International Drug Policy Consortium, describes as a public health crisis. “There was a large number of users of intravenous drugs, which had brought with it a mini-HIV epidemic,” she says. The country’s drug users had the highest levels of HIV in Europe. Huge amounts of money were being spent on imprisonment of drug users, as well as health care for the HIV-positive population. “Communities were seeing the same people go through the criminal justice system again and again,” says Fordham. “There was a sense that they needed to try something different.”
So the country did something almost completely unprecedented: it removed all criminal penalties for drug use. The police officers would not be allowed to arrest the man at all. Instead, they would only be allowed to send him to something called a Commission for the Dissuasion of Drug Addiction, a panel consisting of a psychologist, social worker and legal adviser, which reported only to the department of health. The dissuasion panel had no power to imprison people; it could only refer users to treatment, and, if someone turned up before the panel again within six months, it could issue a fine.
There was understandable concern in Portugal that the country would see an increase in drug use – and it did, of a kind. “It’s important to note that decriminalisation was not followed by a drop in overall drug use,” says Fordham. By 2007, according to the Home Office report, the percentage of the population who had used cannabis in the previous year had gone up from 3.25 to 3.6; cocaine, 0.25 to 0.6; and heroin, 0.3 to 0.5. Not a huge spike, but not irrelevant either.
But, fascinatingly, that was only the beginning. By 2012, the figures had changed again. Cannabis use in the previous year had dropped to about 2.7 per cent; cocaine to 0.3; heroin to less than 0.2. Despite drug users no longer being punished, fewer people were taking drugs – and this was especially true among the young.
Perhaps more importantly, while the number of people taking drugs may have gone down slightly, the level of problem drug use fell much more dramatically, says Fordham, “because people were more willing to come forward and seek treatment”. According to research by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), the number of people receiving treatment for HIV leapt from 6,000 in 1999 up to more than 14,000 in 2003. Meanwhile, the number of new cases was plummeting. According to Dagmar Hedrich, of the EMCDDA, there were almost 100 new drug-related HIV cases per million people in Portugal in 2001; by 2012, it was just five. The rate of HIV infection had dropped by almost 95 per cent in barely a decade.
How much of this is to do with decriminalisation? It’s hard to say. Brendan Hughes, legal analyst at the EMCDDA, says: “The decriminalisation is a red herring. It’s the dissuasion panels that make Portugal unique.” Everywhere else, he says, still puts drug users under the authority of their equivalent of the Home Office or the Department of Justice; it’s only Portugal which hands them over to the health ministry.
But if Portugal is apparently a success story for liberal drug policies, the Czech Republic is the opposite, at least on the face of it. After the fall of communism in 1990, drug laws in the country became extremely relaxed. “The law became, if you’re a drug dealer, you’ll be punished, but if you take them, you’re only harming yourself,” says Dr Tomas Zabransky, an epidemiologist at the University of Prague.
Regulations were slightly toughened in 1999, but still, as in Portugal, the police have no power to arrest people for drug possession – or at least possession of an amount that isn’t “greater than small”, as the legislation puts it. Anything less than that is considered a misdemeanour, similar to a parking ticket.
But whereas in 2007 just 11.7 per cent of Portuguese people reported having used cannabis in their lifetime, the figure is more than twice as high among Czechs: 27.6 per cent, according to 2012 EMCDDA data. While there is no real problem with drug tourism in Portugal, Prague has a reputation as a pill-popping, joint-smoking stag party capital. It also has high levels of methamphetamine (“crystal meth”) abuse.
But, according to Zabransky, there is more to the story in the Czech Republic than the bald numbers of how many people take drugs. The country began treating drug users very early, says Zabransky: “We had our first drop-in centre in 1991, our first needle exchange in 1992, and now there are six million needles exchanged a year.” This policy, according to Hedrich, is behind the country’s extraordinarily low incidence of HIV among drug users: less than one new case per year per million people (compare that to the figure of 100 per million in Portugal in 2001).
In response to the new report, the Home Office issued a statement: “This government has absolutely no intention of decriminalising drugs. Our drugs strategy is working and there is a long-term downward trend in drug misuse in the UK.” They’re absolutely right: drug use has been dropping for years. And there is no reason to think that decriminalisation will reduce it further: yes, use has gone down in Portugal, but so it has in many places. As the Home Office report notes, there is no obvious link between strict laws and levels of use.
What does seem to be true, however, from the experience of both Portugal and the Czech Republic and many other places is that treating drug use as a health problem, rather than a criminal one, has the effect of reducing the harms that drug use causes: the addiction, the crime, the disease, not to mention the cost to the state. “For chronic drug users, drug use is usually the least of their problems,” says Fordham. “They’re often homeless, or unemployed, vulnerable. But drug use exacerbates those problems.”
by Tom Chivers, telegraph.co.uk
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