My wife actually asked this of some professionals working in this space yesterday at a local awareness event (she works in community services, unrelated to drug policy). The answer (paraphrased) was it doesn't directly stop the poisonings. It's in the spirit of harm reduction to open up more support channels. One example given was about going to the hospital and honesty with health professionals. Currently there's disincentives for an addict to disclose their addiction due to legal actions that get triggered upon disclosure. Removing those legal triggers could (would?) allow for more supervision without legal consequence to hopefully reduce the overall harm. It gave us something to chat about.

I'm curious, what rules exist? Are they at a federal or state level?

I don't know if the federal government plays a role here, but the duty to report type laws for professionals are typically at a provincial level. That being said, as far as I know, they are fairly consistent across provinces.

One example provided, which I've not fact-checked and might be limited to BC, was that disclosing addiction during a hospital visit opens up a file with child welfare services.

Portugal decriminalized all drugs in 2001 and saw a massive drop in all the secondary issues associated with drug use - overdose deaths, disease, etc. In fact they went from among the worst in the EU to among the best over a decade or so, and saw no material increase in drug use. In fact drug use in Portugal remains below the EU average. [1,2]

It’s long past time for us to follow suit.

[1] https://www.theguardian.com/news/2017/dec/05/portugals-radic...

[2] https://time.com/longform/portugal-drug-use-decriminalizatio...

Portugal situation is a bit more nuanced than 'decriminalized all drugs' implies. Drugs are still very much illegal and cannot be owned or traded. Not even marijuana. What changed is that possession of small quantities of drugs no longer leads to prison, but may lead to administrative penalties.

> 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 as a possible punishment, to an administrative one if the amount possessed was no more than a ten-day supply of that substance.[2] 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.[9] 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.[10][11] Despite this, the law was still associated with a nearly 50% decrease in convictions and imprisonments of drug traffickers from 2001 to 2015.[12]

https://en.wikipedia.org/wiki/Drug_policy_of_Portugal#Regula...

> The offense was changed from a criminal one, with prison as a possible punishment, to an administrative one if the amount possessed was no more than a ten-day supply of that substance.

Indeed this is the difference between decentralization and legalization.

They did a lot of things yes! Very true. I advocate for the whole model.

Are you sure? Litmus test ;) Are you for de-legalization of marijuana?

PS. I always assumed that decriminalization and legalization are synonyms because it never crossed my mind that possessing a tiny quantity of a substance, even illegal, can lead to jail. I'm all for decriminalization of 'personal use' quantities of any given drug.

Haha, myself personally?

No, I think any drugs that have been measured and studied to be less harmful than alcohol should be completely legal. And so that is, checks notes all of big ones. [1]

I see decriminalization as a minimum. I do also think a legalization or decriminalization strategy should take into account the harms associated with these substances and offer programs to mitigate social and individual harms.

[1] https://www.economist.com/graphic-detail/2019/06/25/what-is-...

Appreciate the honesty :) Consider that those with a more conservative position are highly suspicious of underspecified language ('decriminalization', without explicit scope modifiers), which only seem to serve to open the floodgates, and then in a few short years we end up with schools pushing heroin to kids behind their parent backs. All in the name of 'harm reduction' and 'undoing stigma'.

Yep, that's definitely true. In my opinion, for most drug addictions, it is in fact a symptom of a situation than the problem itself. For some people with certain biologies, I suppose that may not be entirely accurate. However one of my favorite studies compares the experiences of GIs before the war, in Vietnam, and when they got back.

Table 1 shows that before the war, 11% of the group surveyed used narcotics. In Vietnam it spiked to 43%. When they got back? 10%. [1]

For most of them, it was heroin. They literally cold turkey quit heroin when they got back from Nam.

What all this tells me is that telling addicts they can’t have drugs and sending them to prison won’t stop them from doing drugs. What will is making them not want to do drugs by changing their situation.

[1] https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.64.12...

The Vietnam story is definitely an interesting datapoint. They went to Vietnam, had easy access to heroin (it was a war zone, certain civilian rules no longer applied) and fell to the vice. Not sure why you discount the possibility that the primary motivations of cold turkey quitting heroin were the elimination of easy access to heroin and the stigma of living the rest of their lives as heroin addicts.

Prison for drug use is cruel punishment, but therapy & community service (hello Portugal) are entirely reasonable (and effective!) approaches to the problem.

I mean, that is in the word "decriminalisation". The idea being that it's not criminal anymore, but that's as far as we go.

That's what is typically meant by "decriminalization".

Unfortunately decriminalization is only a bad half-solution and all of those who profit off of both sides of the drug war will continue to exist, as will the inconsistent, contaminated, or mislabeled doses that are most fatal. It is absolutely imperative that we legalize nearly all recreational drugs along with regulatory measures to ensure that these medications are available OTC as standardized individually-packaged doses.

The minimization of harm from drug abuse does also depend on broader societal factors (e.g. wealth inequality), and the transition will be complex, but there are measures to be taken that could drastically cut down on overdoses deaths in no more than a few weeks.

See also Switzerland.

Illegality of drugs results in riskier behaviours (ie. hiding that you're using, using alone) that result in higher chances of overdose. Decriminalization is thought to yield safer use of drugs that will reduce deaths.

There is also a broader issue of stigma. If the illegal stigma around drug use goes away, and addictions are treated more like a medical issue, it is thought that it will be more normalized for drug users to get help instead of shying away.

On the opposite side there is also a stigma around medical professionals helping "addicts" that are breaking the law and many doctors are reluctant to touch these sort of health issues with a 10 foot pole. Decriminalization could help do away with this problem and pave the way to prescription of a safe supply of drugs.

Drug users having a prescribed safe supply of drugs is the ultimate solution to the core problem here of a utterly toxic drug supply.

It depends on which version of "decriminalization" one subscribes to. If it means not locking people up for possession then that can keep people out of the prison cycle. It means people will be less afraid to ask for help with their addictions. But if decriminalization means all drugs can be openly bought and sold, THAT won't help. Marijuana is one thing, but allowing carfentanil or rohypnol to be easily acquired by all would end very badly.

The idiots mixing in the Fent might actually use a scale if simply having one isn't another charge upgrade etc