In 2001, amid a runaway opioid crisis, Portugal decriminalized the possession and consumption of all drugs. Warnings, small fines and orders to attend meetings to discuss treatment plans replaced arrests and incarceration.
While this shift in policy didn’t end Portugal’s drug crisis, rates of HIV and hepatitis, overdose deaths and drug-related crime all fell dramatically in the years that followed.
It’s time America did something similar.
It’s been nearly 50 years since President Nixon declared drug abuse “public enemy number one.” Since then, the war on drugs ethos that defined American drug policy has proven to be an abject failure. From 1970 to 2010, the amount spent on drug control skyrocketed while the addiction rate remained flat. More recently, overdose deaths more than tripled from 1999 to 2019, largely driven by opioids.
The war on drugs under the Reagan administration gave rise to mandatory minimums: particularly draconian sentencing requirements that tie the hands of judges and have saddled offenders with disproportionately harsh sentences. For those not subject to mandatory minimums, incarceration does little to prevent recidivism.
Drug laws also have racial and political roots. In 1994, top Nixon adviser John Ehrlichman let slip to a writer for Harper’s Magazine that the war on drugs was engineered to target certain groups.
“The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin. And then criminalizing both heavily, we could disrupt those communities,” Ehrlichman said. “We could arrest their leaders, raid their homes, break up their meetings and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.”
The racial inequalities continue to this day. Black people are far more likely than white people to be arrested for marijuana possession despite comparable usage rates between the two groups. Black people also receive harsher sentences than their white counterparts.
So, if the war on drugs is built on racial discrimination hasn’t significantly reduced drug usage and fails as a public health initiative, shouldn’t we try something different?
The brilliance of the Portuguese approach is it recognizes the need to treat drug use and addiction as a health issue rather than a criminal offense or moral failing. In the early days of Portugal’s drug crisis, public officials took a similar approach to America’s war on drugs: demonizing users and substances alike. But the transformation from then to now is night and day.
The Guardian reports Portugal’s drug policy “rests on three pillars: one, that there’s no such thing as a soft or hard drug, only healthy and unhealthy relationships with drugs; two, that an individual’s unhealthy relationship with drugs often conceals frayed relationships with loved ones, with the world around them and with themselves; and three, that the eradication of all drugs is an impossible goal.”
Health professionals understand the importance of this distinction, including some here at Baylor. In a September 2020 article about the university’s Beauchamp Addiction Recovery Center, Lilly Ettinger, assistant director of wellness and recovery services said, “We don’t call eating disorders food abuse, and we don’t call gambling disorders abuse, but we still use this really pejorative language when it comes to addiction.”
Another crucial distinction is the difference between “decriminalized” and “legalized.” It isn’t like you can go to the corner store in Lisbon and buy a gram of cocaine; dealing drugs is still illegal. Portugal just recognizes that the way to help drug users is to keep them safe and offer them a way out instead of putting them behind bars.
The United States has made baby steps in recent years. Twenty-seven states plus Washington D.C. have at least decriminalized small amounts of marijuana, the most common drug people are arrested for. Many states have also reformed, reduced or eliminated mandatory minimums for certain drug convictions.
A 2004 study from the Justice Policy Institute found using treatment programs instead of incarceration both reduces the likelihood someone will commit a repeat offense and is more cost effective. Programs focusing on bringing ex-offenders back into society and addressing factors that contribute to drug use such as unemployment and lack of education can be particularly effective.
Oregon recently went as far as to become the first state to decriminalize drug possession. The measure also includes funding for traditional treatment programs and housing and job assistance.
It is long past time America reevaluated its drug enforcement policies. The path forward is treating drug use as the public health issue it is rather than the criminal justice initiative it has become.
