I grew up in one of the "drug towns" of the late 80's/early 90's in Portugal. It was bad, really bad. There wasn't any extended family without a drug problem. That generation, bornt after the 1974 revolution, now in the mid 40's, was almost erased from there. Some died and those remaining, after a life of petty crime and prison, eventually escaped.
Completely agree with your comment. I would just add another relevant factor to the roll: decriminalization gave even more visibility to the addiction problem and newer generations didn't like what they saw. It wasn't cool to use drugs anymore.
I had a friend begging for help with treatment and the only in patient place at the time for substance abuse in the area had an 8 week waiting list... and you had to pay your way so unless you had a family/friend with extra resources you were on your own.
We wonder why the drug problem still exists in this country where we punish those struggling instead of help them.
I’ve got an older friend who did a lot of drugs back in the day, but got his life mostly figured out until a few years ago when he had to get shoulder surgery. Prescribed Oxy for recovery, even after telling the surgeon about his past addiction struggles. As expected, they become less effective over time, he likes getting high, so he starts taking larger doses. Gets to the end of his prescription and can’t get a refill.
Did he make bad choices here? Definitely. But then the health care system screws up:
“I want to detox and get clean again.”
“Sorry, you’ve never overdosed, so you can’t detox in the hospital. Maybe you can get on a waiting list for a private (out of pocket) facility. Oh, and no refills, you’re an addict”
“Maybe I can be a short-term patient at a mental health facility?”
“Sorry, you’ve never tried committing suicide because of your drug use. Maybe you can get on a wait list at a private facility? Oh, and no refills, you’re an addict!”
So... what does an opioid addict who is in withdrawal and can’t get support from the health care system do? Goes and scores some heroin...
Today he’s mostly clean again. I think he pops a pill here and there but isn’t high all day. But... this could have all been avoided. The health care system had many opportunities to help out here, but didn’t.
Edit: one last note: the private facilities are quite expensive and have massive waiting lists. Even if he had had the cash to go, he would have still been in limbo for weeks-to-months with no access to clean drugs nor support to get clean.
I can believe this. My father used to tell me that drugs like heroin have recurring waves of popularity, because when a dangerous drug becomes popular enough, the Russian roulette aspect becomes so obvious. Everybody knows somebody whose life has been ruined by it. When a drug becomes niche, the few people you know who use it might be handling it okay (or early in their trajectory with the drug) and their experience with it can look cool and attractive. He also said his generation was the last one where basically everybody had seen firsthand what heroin could do to people, but he was optimistic that it had "killed enough famous musicians" that it couldn't come back. That was in the 1990s, so....
Just skimming, I see 21 links to other sources. I haven't clicked through on all of them. It appears to weigh various pros and cons. It seems even handed to me on a quick skim.
Further, the NYT has many sections and voices. This piece is specifically from from The Upshot which has this tagline: "Analysis that explains politics, policy and everyday life, with an emphasis on data and charts."
And this specific piece is written not by a reporter, but by a expert in the field: Austin Frakt is director of the Partnered Evidence-Based Policy Resource Center at the V.A. Boston Healthcare System; associate professor with Boston University’s School of Public Health; and a senior research scientist with the Harvard T.H. Chan School of Public Health.
I appreciate the rest of your comment.
It is great that they paint a positive picture of Portugal as a forward-thinking progressive nation, the point that Portuguese people often take an issue with this and other pieces, in american and british press, is that they fail to explain the motivation behind this policy.
These measures were not a hippie social experiment, they were created out of a desperate lack of alternatives in the face of a de facto public health crisis due to a heroin epidemic.
I cannot put in words that make it justice, you had entire neighbourhoods become drug slums with hundreds of heroin dealers and people inject on the sidewalks in broad daylight. It was crime problem, it was a health problem, it was a whole generation of people lost to this. It's this omission in the 'why' of decriminalization that feels somewhat dishonest.
I'd also add that there is still a Heroin problem, albeit diminished. It is not unusual to see someone walking though the local village, out-of-their head drunk at 9am on a Wednesday. It isn't alcohol though, it's Heroin. But it is also an economically poor area. The weather is amazing and the place is gorgeous, but for someone raised here who doesn't manage to escape it can also be a trap. Many of the older people work in the fields in the morning, the in the late afternoon they meet in the cafes and chat about village life. Coffee is $0.15, a beer is $0.7. There a very few younger people. Those that can leave have left for a city. The ones who remain are that ones who were not able to leave. I spoke with the local President last week and he himself said that the area has become a skills desert.
So yes, I think the route to Heroin addition looks something like this. Get financially stuck in the local area. Get a bad reputation for being lazy. Try to become YouTube/Insta famous. Give up. Turn on those that tried to help. Drink & smoke weed as an escape. When those stop working try Heroin. I know a couple of people in my village that are on this path right now.
There is some crime here. It seems to fall into two categories. First is petty crime where something goes missing that's worth about $100. That's enough to quickly sell for immediate cash (likely for some form of drug). This has happened to me twice, and I don't really mind.
There is more 'organised' crime where a place gets methodically burgled when someone is away. I know people this has happened to.
There is a rapidly growing contingent of foreigners here now, and we're mostly accepted. Economically, I get the impression that most businesses prefer to deal with the foreigners. Even the guy that sells firewood says that 95% of his customers are now foreigners, and that he prefers it that way. There are lots more foreigners arriving too (leaving cities due to covid, basically), very few Portuguese people being added. Most people in my village are over 60. It'll be interesting to see how the demographics play out over the coming years.
Anyway, maybe that is of some interest. The region of Portugal I am in is Castelo Branco. I'm starting an ISP here too: https://gardunha.net
The situation is not perfect, and will never be, but is a LOT better than before! Portugal is a lot safer. The crime that you talk about is probably not drug related and probably not local people. Just read the news. Did you find any place to sell used things? No except for gold.
And if you find someone "drunk" at 9am you bet he is drunk lol "evita a ressaca, mantente bebado" something like "void hangover, stay drunk" every village has a chronic drunk! Maybe now the biggest problem is alcool, not heavy drugs. Why do you think police stop people at 9am and force them to do an alcohol test? They are drinking since 6am!
Regarding your ISP. Your target is people in a rural area? In one of the most less dense population area in Portugal? I will be waiting for the pricing. Good Luck.
People "gouching out on smack" do not look like they are drunk, so I think you're correct.
> most businesses prefer to deal with the foreigners.
Businesses prefer to deal with costumers able to pay more (or quicklier) for the same services/products.
(edited - typo)
20ml is a very small amount of beer. Maybe you meant something else?
There were politicians that publicly spoke about their personal experiences. Others that had family members that were caught up with it.
It was a widespread issue across all classes, not just the poor.
Here's a recent interview about one of the main drivers of this policy (in Portuguese).
It seems like these problems are not directly caused by the drug, but by the fact users cannot buy clean medical grade with a safe method of administration. Portugal model doesn't seem to address that, but only makes consumption slightly more "comfortable" to the users.
This is true, but you're saying something different than what you started off saying.
I agree with you that the government should be supplying heroin to addicts, and if you're decriminalizing drug usage, there's no reason that you shouldn't be doing this. A doctor having the ability to monitor addicts under their care would give us the means to keep them happy and productive, and to make sure they can get off the drug when they're willing to risk the effort.
In general, the main drug-related vector for disease is needle sharing. Most pathogens wouldn't survive long in the actual heroin, and it's not clear how they'd get there in the first place.
In principle only.
In practice: how much have you spent on dentist bills in the past year?
It’s free in practice.
It's not by accident that Portugal has oral health on par with the poorest Eastern European countries.
- The main public opinion driver for both the needle exchange programs and the decriminalization was a _massive_ Heroin epidemic which lead to an HIV, Hepatitis B/C, AND Tubercolosis epidemic, the last one of those is particularly airborne contagious. I often see the lumping of 'heavy' drugs but (although decriminalized) Cocaine consumption in Portugal was marginal at the time (mostly because the majority of the population couldn't afford it). The main precipitator was Heroin consumption.
- These programs served as a 'trojan horse' anchor point to bring these, often homeless/missing, people back into the healthcare system. For added controversy for the americans out there, healthcare is universally free in Portugal.
- There was a clear rupture point both in crime rates and the prison system capacity due to the heroin epidemic. Police forces could no longer be bothered with the 'noise' of the numerous small possessions of 'non-heavy' drugs like haxixe or marijuana. Offloading that to mental health practioners was also logistically useful for law enforcement.
- It took a considerable amount of additional healthcare funding for these programs to be implemented. This would _not_ have been possible for an economy like Portugal without supplementary funds from the European Union economic development programs.
- I am very suspicious of the counter-argument insinuation that the program initially _caused_ an increase in crime rates and consumption, because the start of the program also matched the start of a fairly large economic downturn. The main idea of the program was that people could go and ask for help, without the fear of being put in jail. If you have a desperate person, willing to do desperate things, not pushing them against a corner is usually a good policy for crime rates.