The drug policy of Portugal was put in place in 2001, and was legally effective from July 2001. The new law maintained the status of illegality for using or possessing any drug for personal use without authorization. However, the offense was changed from a criminal one, with prison as possible punishment, to an administrative one if the amount possessed was no more than a ten-day supply of that substance.
In April 2009, the Cato Institute published a White Paper about the "decriminalization" of drugs in Portugal, paid for by the Marijuana Policy Project Data about the heroin usage rates of 13-16-year-olds from EMCDDA were used to claim that "decriminalization" has had no adverse effect on drug usage rates. However, drug-related pathologies - such as sexually transmitted diseases and deaths due to drug usage - have decreased dramatically. In 1999, Portugal had the highest rate of HIV amongst injecting drug users in the European Union. The number of newly diagnosed HIV cases among drug users has decreased to 13.4 cases per million in 2009 but that is still high above the European average of 2.85 cases per million. There were 2,000 new cases a year, in a country of 10 million people. 45% of HIV reported AIDS cases recorded in 1997 originated among IV drug users, so targeting drug use was seen as an effective avenue of HIV prevention. The number of heroin users was estimated to be between 50,000 and 100,000 at the end of the 1990s. This led to the adoption of The National Strategy for the Fight Against Drugs in 1999. A vast expansion of harm reduction efforts, doubling the investment of public funds in drug treatment and drug prevention services, and changing the legal framework dealing with minor drug offenses were the main elements of the policy thrust.
Harm reduction
The needle exchange program, "Say NO! to a used syringe," is a
nationwide syringe exchange program which has been ongoing since October
1993, involving some 2,500 pharmacies throughout Portugal. It is run by
the National Commission for the Fight against AIDS - set up by the
Ministry of Health and the National Association of Pharmacies - a
non-governmental organisation representing the majority of Portuguese
pharmacies. All drug users can exchange used syringes at pharmacy
counters across the country. They get a kit with clean needle syringes, a
condom, rubbing alcohol and a written message motivating for AIDS
prevention and addiction treatment. From 1994 to 1999, pharmacies
delivered around 3 million syringes annually.
Several low threshold projects were initiated after 1999,
particularly in the period 2003-2005, where outreach teams have promoted
safe injection practices and supplied needles and injecting equipment
on the street. Many of these projects are still running.
At programme start, a media campaign was launched by television,
radio and the press, and posters were put up in discothèques and bars in
order to attract the attention of the target population to the problems
associated with drug addiction, in particular HIV transmission through
needle-sharing.
Project objectives have been threefold: To reduce frequency of
sharing needles and syringes, to change other IDU (Intravenous Drug
User) behaviors that create negative attitudes among the population in
general, and to change attitudes towards IDUs in the general population
to facilitate addiction prevention and treatment.
Expanding drug treatment
In
1987, the Centro das Taipas in Lisbon was created, an institution
specialising in the treatment of drug addicts. This centre consisted of a
consultation service, a day centre and a patient detoxification unit.
This facility was the responsibility of
the Ministry of Health, and was the first in the network of centres
specialising in treating drug addiction which now covers the whole
country.
Healthcare for drug users in Portugal is organised mainly through the public network services of treatment for illicit substance dependence,
under the Institute on Drugs and Drug Addiction, and the Ministry of
Health. In addition to public services, certification and protocols
between NGOs and other public or private treatment services ensure a
wide access to quality-controlled services encompassing several
treatment modalities. The public services provided are free of charge
and accessible to all drug users who seek treatment.
There are 73 specialised treatment facilities (public and
certified private therapeutic communities), 14 detoxification units, 70
public outpatient facilities and 13 accredited day centres. Portugal is
divided into 18 districts. There is full coverage of drug outpatient
treatment across all but four districts (districts not covered are
located in the north of the country: Viana do Castelo, Bragança, Viseu
and Guarda).
Substitution treatment
Substitution
treatment is today widely available in Portugal, through public
services such as specialized treatment centers, health centers,
hospitals and pharmacies as well as NGOs and non-profit organizations.
The Portuguese substitution program started in 1977 in Oporto. The CEPD/North (Study Centre on Drug Prevention/North), using methadone
as the substituting substance, was the only unit using opioid
substitution until 1992. However, the increase in numbers of drug
addicts (including an "explosion" at the beginning of the 1990s),
together with the growth of AIDS and hepatitis C among this population,
led to a change in attitude. After 1992, methadone-substitution programs
were extended to several CATs (Centres of Assistance to drug addicts).
Overall, the programmes were medium or high threshold. With the
exception of occasional activities in a slum area in Lisbon, there were
no true low-threshold programs (risk- and harm reduction) prior to 2001.
From 2000 to 2008, the number of people in Portugal receiving
substitution treatment increased from 6040 to 25 808 (24 312 in 2007),
75% of whom were in methadone maintenance treatment. The remaining
patients received high dosage buprenorphine treatment.
Buprenorphine had been available since 1999, and later also the buprenorphine/naloxone combination.
Decree-Law 183/2001 Article 44.1 and Decree-Law 15/93
Article 15.1-3 stipulate that methadone treatment can be initiated by
treatment centers whereas buprenorphine treatment can be initiated by
any medical doctor, specialized medical doctors and treatment centers.
From 2004, there was also the provision of buprenorphine in pharmacies.
After-care and social re-integration
After-care
and social re-integration of drug users in Portugal is organised
through three major programmes targeting different regions in Portugal
(Programa Vida Emprego, Programa Quadro Reinserir and the PIDDAC
incentives for re-integration). All three programmes finance different
initiatives and projects supporting drug users through training
opportunities, employment support, and/or housing.
Monitoring drug treatment
A
national treatment monitoring system is being developed but has not yet
been implemented in all regions. National routine statistics from
outpatient centres on substitution clients are available (for clients in
methadone and buprenorphine programmes).
Laws and regulations
In
July 2001, a new law maintained the status of illegality for using or
possessing any drug for personal use without authorization. The offense
was changed from a criminal one, with prison a possible punishment, to
an administrative one if the amount possessed was no more than a ten-day
supply of that substance.
This was in line with the de facto Portuguese drug policy before the
reform. Drug addicts were then to be aggressively targeted with therapy or community service rather than fines or waivers.
Even if there are no criminal penalties, these changes did not legalize
drug use in Portugal. Possession has remained prohibited by Portuguese
law, and criminal penalties are still applied to drug growers, dealers
and traffickers.
Despite this, the law was still associated with a nearly 50% decrease
in convictions and imprisonments of drug traffickers from 2001 to 2015.
Regulation
Individuals found in possession of small quantities of drugs are issued summons.
The drugs are confiscated, and the suspect is interviewed by a
“Commission for the Dissuasion of Drug Addiction” (Comissões para a
Dissuasão da Toxicodependência – CDT). These commissions are made up of
three people: A social worker, a psychiatrist, and an attorney.
The dissuasion commission have powers comparable to an arbitration
committee, but restricted to cases involving drug use or possession of
small amounts of drugs. There is one CDT in each of Portugal’s 18
districts.
The committees have a broad range of sanctions available to them when ruling on the drug use offence. These include:
- Fines, ranging from €25 to €150. These figures are based on the Portuguese minimum wage of about €485 (Banco de Portugal, 2001) and translate into hours of work lost.
- Suspension of the right to practice if the user has a licensed profession (e.g. medical doctor, taxi driver) and may endanger another person or someone's possessions.
- Ban on visiting certain places (e.g. specific clubbing venues).
- Ban on associating with specific other persons.
- Foreign travel ban.
- Requirement to report periodically to the committee.
- Withdrawal of the right to carry a gun.
- Confiscation of personal possessions.
- Cessation of subsidies or allowances that a person receives from a public agency.
If the person is addicted to drugs, they may be admitted to a drug rehabilitation
facility or be given community service, if the dissuasion committee
finds that this better serves the purpose of keeping the offender out of
trouble. The committee cannot mandate compulsory treatment, although
its orientation is to induce addicts to enter and remain in treatment.
The committee has the explicit power to suspend sanctions conditional
upon voluntary entry into treatment. If the offender is not addicted to
drugs, or unwilling to submit to treatment or community service, he or
she may be given a fine.
Law enforcement
Every
year, Portuguese law enforcement bodies confiscate several tonnes of
cocaine, with a record amount of more than 34.5 tonnes seized in 2006. A
regular increase in quantities of cannabis resin seized could also be observed over recent years, though there
has been a recent decline between 2008 (61 tonnes) and 2009 (23 tonnes).
Observations
There is little reliable information about drug use, injecting
behaviour or addiction treatment in Portugal before 2001, when general
population surveys commenced. Before that, there were the indicators on
lifetime prevalence amongst youth, collected as part of the European School Survey Project on Alcohol and Other Drugs (ESPAD), and some other (less reliable) data available through the EMCDDA.
Thorough studies on how the various efforts have been implemented
were not conducted. Thus, a causal effect between strategy efforts and
these developments cannot be firmly established.
There are, however, statistical indicators that suggest the following
correlations between the drug strategy and the following developments,
from July 2001 up to 2007:
- Increased uptake of treatment (roughly 60% increase as of 2012.)
- Reduction in new HIV diagnoses amongst drug users by 17% and a general drop of 90% in drug-related HIV infection
- Reduction in drug related deaths, although this reduction has decreased in later years. The number of drug related deaths is now almost on the same level as before the drug strategy was implemented. However, this may be accounted for by improvement in measurement practices, which includes a doubling of toxicological autopsies now being performed, meaning that more drugs related deaths are likely to be recorded.
- Reported lifetime use of "all illicit drugs" increased from 7.8% to 12%, lifetime use of cannabis increased from 7.6% to 11.7%, cocaine use more than doubled, from 0.9% to 1.9%, ecstasy nearly doubled from 0.7% to 1.3%, and heroin increased from 0.7% to 1.1% It has been proposed that this effect may have been related to the candor of interviewees, who may have been inclined to answer more truthfully due to a reduction in the stigma associated with drug use. However, during the same period, the use of heroin and cannabis also increased in Spain and Italy, where drugs for personal use was decriminalised many years earlier than in Portugal [while the use of Cannabis and heroin decreased in the rest of Western Europe. The increase in drug use observed among adults in Portugal was not greater than that seen in nearby countries that did not change their drug laws.
- Possibly unrelated, homicide rate increased from 1.13 per 100 000 in 2000 to 1.76 in 2007, then decreased to 0.96 in 2015.
- Drug use among adolescents (13-15 yrs) and "problematic" users declined.
- Drug-related criminal justice workloads decreased.
- Decreased street value of most illicit drugs, some significantly
- The number of drug related deaths has reduced from 131 in 2001 to 20 in 2008. As of 2012, Portugal's drug death toll sat at 3 per million, in comparison to the EU average of 17.3 per million.
Legal status of cannabis in Portugal
Consumption and possession
In Portugal, recreational use of cannabis
is forbidden by law. In July 2018, legislation was signed into law to
allow for the medical use of cannabis in Portugal and its dispensation
at pharmacies. Portugal signed all the UN conventions on narcotics and
psychotropic to date. With the 2001 decriminalization bill, the consumer
is now regarded as a patient and not as a criminal (having the amount
usually used for ten days of personal use is not a punishable crime) but
repression persists. One can be sent to a dissuasion committee and have
a talk or must pay a fee. According to the libertarian think tank Cato Institute,
illegal drug use among Portuguese teenagers declined after 2001, and 45
percent of the country's heroin addicts sought medical treatment. But
critics of the policy, such as the Association for a Drug-Free Portugal,
say overall consumption of drugs in the country has actually risen by
4.2 percent since 2001 and claim the benefits of decriminalization are
being "over-egged."
Cultivation and distribution
The cultivation of cannabis,
even on a very small-scale home grown basis for personal use only, can
legally be prosecuted. However, an unknown number of enthusiasts of
small-scale home-cultivation grow the plants with a high degree of
secrecy due to the legal punishment they could face if prosecuted, and
due to potential social stigma
as well. In neighboring Spain, small-scale cultivation of cannabis
plants for personal use only, is tolerated by the authorities and there
are many grow shops
across the country selling their products physically and online. In
2003 another update to the "Portuguese drugs law" brought the
criminalization of the possession of cannabis seeds, except certified
industrial hemp seed.
This law made the buying of cannabis seeds from legal and financially
transparent online cannabis seed shops based in other European Union
member states, such as neighboring Spain or the Netherlands, an unlawful
transaction when performed by Portuguese residents. The provision of
seeds and tools to produce and consume cannabis is also illegal in the
country. Production and distribution of hemp products is legal but
regulated. There are a small number of hemp shops in Portugal and hemp
products are legal.
