British Columbia·The Fentanyl Fix

How decriminalizing drugs helped Portugal solve its overdose crisis

In 2012, Portugal had just 16 deaths, or 2.3 for every million people in the country between 15 and 64 years of age.

Portugal shares its views as part of our series, The Fentanyl Fix, solutions to B.C's overdose crisis

In this photo from Nov. 2010, Tiago, a patient and resident, picks up his lunch from the kitchen of a treatment centre in Lisbon, Portugal. At the treatment centre where he lives, he plays table tennis, surfs the Internet, watches TV and also helps with cleaning and other odd jobs. (The Associated Press)

When people discuss bold options for dealing with British Columbia's drug crisis, decriminalization of all illegal drugs comes up with regularity

There are two main reasons for this: one is that B.C. already employs many of the strategies that other countries are still debating, from needle exchanges to supervised injection sites.

The other is the story of Portugal. Once ridden with a heroin epidemic that affected approximately one per cent of the country's entire population, the European country decriminalized all illegal drugs in 2001. 

Over time, the drug crisis in Portugal stabilized to the point where, going by the 2016 United Nations World Drug report, they have the one of the lowest fatal overdose rates in the world. In 2012, they had just 16 drug-related deaths in a country of 10.5 million.

However, the person who has overseen that transformation cautions British Columbians not to believe decriminalization would be a silver bullet.

"It was a part of a much broader strategy, focused not only on decriminalizing. It's not a magic solution," said Dr. Joao Goulao, the head of Portugal's Service for Intervention in Addictive Behaviour and Dependencies. 

"We can't establish a direct link between decriminalizing and the results. It's the complete responses that led to a positive resolution." 

Comprehensive treatment

In Portugal, people can have the equivalent of an up to 10 day individual supply for a drug, without being charged. But Goulao says the most important thing isn't the lack of punishment: it's the presence of support systems.

"If you are [caught with drugs], you are asked to present yourself to an administrative body, under the Ministry of Health ... which can apply penalties, such as fines, but its main goal is to evaluate the kind of user you are," he said. 

"If you're a problematic one in need of treatment or help, you are invited to join a treatment facility. If you're not a problematic drug user, just an occasional one, even so, the commission tries to assess if there's any kind of conditions in your life — social, family, psychological — that along with the drug use can lead you to become a problematic user. The attempt is to intercept a [path]  that can lead to more problems."

Tiago drinks his daily dose of methadone in the infirmary of the treatment center. After almost six months on methadone, each day trimming his intake, he was brimming with hope about his upcoming move to a home run by the Catholic church where recovered addicts are offered a fresh start. (The Associated Press)

Use destigmatized 

It's the multi-faceted approach with decriminalization and substitution treatment next to counselling and employment opportunities, that he says was crucial for the way in which Portugal tackled its crisis.

But Goulao says laws need to go hand in hand with changing the culture of a country towards drug use.

"The big impact is that drug use and drug addiction is no longer a taboo. We can talk openly about it … the way society started to look at this problem, is mostly as a health issue, like diabetes or other chronic relapsing diseases," he said.

"Addiction is a health and a social issue, rather than a criminal one."

With files from CBC Radio One's On The Coast

To hear the full story, click the audio labelled: How decriminalizing drugs helped Portugal solve its overdose crisis