[lmickh]

Find it misleading that almost all of the recent articles on this subject talk about decriminalization as the cause for the drop in drug related health issues.

They shifted a significant chunk of money to health services. If it proves anything, it is only that health services can reduce drug related health issues. Without a control, there is nothing to point to regarding criminalization vs decriminalization. People are now paid to go out to drug dens and offer medical help. You can't simply say "people were scared to get help before" when instead you start sending help straight to their location.

Even when an article mentions the change in spending/focus, it is framed in the context of legalizing drugs. No one is making articles titled "After years of improving health services, Portugal's drug policy paid off".

I get that some folks want to legalize drugs, but make an argument for it that doesn't involve this twisting of results to match the desired outcome.

[jdmoreira]

I'm Portuguese and I grew up watching the heroin epidemic we had in Portugal. It was horrible, like the article mentions 1% of the population was addicted to heroin. Curiously I now live in Sweden, but I lived in Portugal for the first 11 years of the decriminalization. And the solution actually started years before, in the early 90s. It's a bit like you said, it was an huge investment in public health - the first success was that you could get a kit to inject heroin for free in any pharmacy, paid by the state, no questions asked! It was a huge win against the spread of HIV.

The biggest difference I see comparing the Portuguese reality to the Swedish one is the lack of social stigma regarding drugs. Drugs are just openly discussed in Portugal and addicts are well integrated in society. I have friends whose parents are heroin addicts and for the most part they are a normal family with jobs and responsabilities. Sometimes they relapse but it's not a big deal because they have a network and feel safe to get help quickly and the state sponsors replacement therapies in the meanwhile.

These are people that started doing heroin in the late 80s and for the most part still raised a family and are good parents and neighbors.

It's just a disease like any other and Portuguese people see addiction that way.

[rwnspace]

It's peculiar how reports of sensible policy make me feel Portugal is adorned in rubies and roses. Here in the UK the Home Office recently said they have no plans to look at even the classification of cannabis. Despite most local police forces not bothering with anything but factories, a majority of population supporting legalisation/decriminalisation, and global trends. We are comparatively medieval but for a few smart initiatives. I have heard that Germany and Norway/Sweden also have some very similar attitudes: I blame Calvinism.

I could rant for hours on alcohol and tobacco policy in the UK. A little knowledge of the field of Harm Reduction opens a lot of avenues for criticism. Particularly increasing taxation, which extracts most from the working class and is effective in few use-cases. The UK isn't alone: look up the EU's May 2017 'Tobacco Product Directive' regarding E-cigs. Read: lobbying from groups that are responsible for millions of deaths and public cost are strangling and monopolising a market and technology that is an incredible source of harm reduction... I'm struggling to hold my tongue at this point.

We have a large problem with a political class who don't listen to reason or evidence, simply an innately conservative discourse makes the problem look smaller than it really is. It's fantastic to read a positive outlook on Portugal's policy - it has been smeared countless times here.

[wyclif]

I blame Calvinism

If you blame Calvinism for either medievalism or postmodern bureaucracy, let alone the drug war, I suggest you don't know what Calvinism is. I'm for drug legalisation, but if you want the UK to adopt the policies of Portugal (or something similar) it will not help to blame the problem on the wrong people. You ought to be directing your anger at the social planners and the nanny state. That group, I can assure you, is very decidedly anti-Calvinist in nature.

[rwnspace]

I was hoping that because the statement was so glib and so placed, it would be communicated that I was being tongue-in-cheek; I made it only because the countries I mentioned happen to be so important to Calvinism, which roughly connects to recreational drug use being perceived as antithetical to the Protestant work ethic. Apologies if that's still too far off the mark even for a jibe.

I admit I probably only know a little more than the average about Calvinism, but far less than those who 'know' about it, so I didn't understand your point entirely. You prompted me to do more reading, which was interesting, so thank you for that.

More seriously, I think the causes are so multi-faceted it's difficult to interpret precisely where to place the blame. I think 'Reaganism' is a fine target, but it's a little short-sighted to lay all the blame there. 'Social planners' triggers associations with Edward Bernays' and his legacy, and what else I know from Manufacturing Consent, if that's your gist. Would you mind expanding on your view?

[libertine]

Here in Portugal I think there's still quite a path to go to legalize some drugs honestly - some country's are jumping right into it, heads first, but they are forgetting precisely the addiction factor and what health care structures and mindset are required to deal with this.

No matter how harmless a drug is, there are always inherent issues bound to it's consumption.

[rwnspace]

I am not entirely sure that legalisation alone increases unhealthy usage. I think people that fit profiles which make substance addiction a significant risk, are mostly the same profiles that don't respect 'the law because it's law'. At the same time, I know of plenty of people who drink dangerously but don't touch other substances. The comparison is difficult because of all the factors that promote drinking in society.

Mindset/cultural attitudes are the central question. Say if the UK's binge-drinking culture transposes to binge-consumption, and introducing legality is considered an opened door, then the healthcare structures are critical. It's also probably quite hard to educate GPs - who seem to be big on drinking away their stresses at uni but avoiding other drugs - into an open mindset that identifies the right problems.

The pros and cons seem to accommodate a careful optimism and evolution-of-culture outlook. Not necessarily sweeping reforms. The problem for this view is that those with vested interests support sweeping anti-reform, whatever way you want to look at it.

[CamelCaseName]

I don't have much to say other than that I really admire that sense of thinking, and I hope more countries can adopt a similar vision.

[alkonaut]

What most keeps me away from hard drugs isn't that the addiction is similar to a horrible disease, but to 99% that it (society's stigma) would cost me my job and my family. I admire the way in which Portugal removed the stigma of existing addicts and how it's considered a disease and not as stigmatized as here (Sweden) but I can't say the "threat of being stigmatized" is 100% negative. You can't have it both ways I guess.

[bjelkeman-again]

I wish we could get the same attitude in Sweden. What do you think is the main barrier in Sweden?

[vidarh]

I'm Norwegian, not Swedish, but there is this lutheran/protestant culture that's very deeply embedded in the Scandinavian/Nordic countries that have one hand contributed to the success of things like criminal reform and welfare, because those areas happened to unite a lot of Christians and a lot of liberals and left wing people around a shared belief of how to treat people with decency and compassion, but which at the same time can be very paternalistic when applied to other areas.

You see this in terms of policies on things like alcohol and drugs in particular, but also areas like prostitution, where the attitude is often that the people involved are sinners who both need help and punishment, and where there is an attitude of "we know best" about legislation and treatment options.

The Nordic countries often looks liberal on the surface, but while they have secularised rapidly there is still an undercurrent of Christian moralistic ideas that have had a very firm grip in many areas, aided by the long lasting state churches (e.g. the Norwegian Lutheran church was a state church with the government appointing key people until 2012).

[rasjani]

I can echo the same is very valid in Finland. Certain behaviors that are very stereotypical here are Protestant/Lutheran by nature. It's also a bit amuzing as mostly people don't recognize that and are typically very anti religion or atheist.

[kpil]

Here are some topics that have actively not been a topic for political discussions for at least the last 15 years: The immigration, the housing bubble, the failed city planning on all scales, the inefficient patchwork of regional authorities (Kommuner) in the large regions, the overinflated financial system, the deindustrialization, and the drug politics.

All of them are rather urgent, but instead we get virtue signalling and distancing from the nationalist party, pseudo debates about tax-levels (55% or 54%) and endless mantras regarding "healthcare" and "schools" while ironically those systems are still good but are slowly deteriorating due to New Public Management, unhinged privatisation and a good deal of incompetence. None of which is discussed except maybe the last few weeks when a properly virtue-signalling but spectacularly incompetent General Director managed to outsource classified information to Serbia of all places.

It's obvious that the drug politics has failed. The only thing we need to do is to look at the facts (almost worst in EU), think and discuss, and then modify. But no.

Right now we are just feeding the criminal gangs earning money on lighter drugs such as cannabis where there is an unstoppable demand, while coming down so hard on the heavier users that they literally die on the streets. One mistake or relapse while on a program - and they are kicked out on the street again.

But why? I honestly don't know. Swedish government bodies seems to have a very hard time changing their position, especially when it involves admitting that they have been wrong. Swedes are also very conformist - almost like a big insecure high school class where everyone say the same thing, wear the same things, and bully anyone that sticks out even just a little bit, so it could be hard to discuss sensitive topics.

[aidenn0]

I think regardless of the details of legality, it is strong anecdotal evidence that dollars spent on treatment reduce OD deaths more than dollars spent on enforcement. It adds to a strong body of research that already points in that direction

[lmickh]

Yes, it appears to affirm that law enforcement is not the best bang for the buck. There has been plenty of work indicating that like you mentioned. That wasn't a "bold risk".

That is separate from saying that changing the legality of it impacts the usage though. There is not reason to take the result beyond what it indicates.

[toyg]

You cannot realistically get one without the other. Treatment often cannot be cold turkey, which means the addict will have to keep consuming (and hence carrying and buying) for a period; if that's illegal, treatment is not going to work. And no, methadone is not the same.

Taking Sweden as control, for example, they spend loads on health services and treatment; but without decriminalisation, their numbers are still terrible.

[usrusr]

Sure you can. Restrict illegality to use/possession outside of a treatment program. There already are many things pharmacists are not allowed to sell without a doctor's prescription, including strong opoids.

You would probably not want this kind of prescription to be signable by just any MD though, but that's another story.

[syshum]

>That is separate from saying that changing the legality of it impacts the usage though

You can not before treatment and for keeping it illegal.

These are mutually exclusive, as treatment for drug addiction has to be voluntary on the part of the user, and often time criminal convictions, and stress of legal issues are what drive people to use drugs.

[lm2s]

It's not really misleading if you know the how and why. For the addicts to accept health services help (like clean needles or getting off heroin) they could not be under threat of going to jail.

So you decriminalise to allow addicts to come forth and accept clean needles and other help, while simultaneously investing more money to provide that help.

It's a two prong "attack" and it's pretty simple actually.

[jdmoreira]

Exactly. Also, decriminalizing sends a message to the population that addicts are not criminals but people that by a series of mistakes and bad decisions are currently in a bad situation and in need of help.

[Kurtz79]

It's hard to decouple decriminalization (which is not legalization) with simply investing in better treatment for addicts.

If to get treatment they basically have to turn themselves in, and are liable to go to jail, I doubt many would make that choice.

[Radle]

Well, but it clearly shows that making drugs illegal, does not help at all to keep people save.

[seanhandley]

What about all the criminals that can no longer make money selling on the black market? Killing unregulated production allows for cleaner, safer substances to be created with known strength and purity.

After decades of prohibition, we can conclude the "War On Drugs" is a lost cause and people will always seek out drugs. If people are going to take drugs regardless, let's make sure they're clean and the profits of sale don't fund criminal gangs.

[thatswrong0]

Exactly.

Beyond removing the criminal element, the fentanyl epidemic should make the destructive nature of our current policy so obvious as to warrant the complete legalization (and regulation) of heroin. People are dying at incredibly high rates because they are not getting pure substances - they are receiving substances cut with something that can kill at tiny doses. Not only do heroin addicts have to deal with heroin overdoses (which are still quite possible), but they have to deal with fentanyl overdoses. Every time they use unregulated product, they are gambling with their lives. Our drug policy in America is completely ignorant of this reality.

[vidarh]

I keep saying that the evidence on the danger of the current drug policy is so clear that I refuse to see this as a subjective issue where a politician is justified to be of the opinion current policy is ok anymore.

I can understand "ordinary people" not reading up on it, but at this point I personally consider politicians who continue to oppose large scale drug reform to be morally responsible for contributing to mass murder.

I accept they're not legally responsible, but I genuinely believe most of them should be in prison on murder charges for their parts in perpetuating these violent policies unless they've at the very least voted in opposition to these policies if/when they've had the chance.

[gehwartzen]

Just want to point out that the two don't necessarily have to go hand in hand as often portraid in the US. Things can be legalized without being regulated.

[MadSax]

Herbs should be treated like speech, freely available with education and stipulation that they be used wisely.

[woodandsteel]

Well, yes and no. You are right that it is essential to spend a whole lot of money on health services. But if drugs are illegal then a great deal of those limited funds go instead to policing.

Besides that, people are a whole lot more likely to voluntarily go for help if they know they won't be arrested for what they have been doing.

[anigbrowl]

They shifted a significant chunk of money to health services.

But everyone knows this, it's the obvious corollary of decriminalization and has been stated over and over.

[Spooky23]

If you live in the United States, a significant number of people believe that getting sick is a moral failure. Drug use? Forget it.

[bdamm]

How? It's entirely possible to decriminalize and simply move law enforcement monies to other efforts, leaving nothing for health services.

[TulliusCicero]

It's technically possible yes, but decriminalization is generally proposed as a component of a larger strategy called "treating addiction as a health issue rather than a criminal one".

[bdamm]

Your belief in functional, rational government is encouraging.

[TulliusCicero]

I think it's possible, although sometimes it doesn't feel so. :)

[anigbrowl]

Why do you think that is relevant to anything since it's not what actually happened? It seems like you want all the content of every article shoehorned into the few words of the headline. That's not going to happen.

[cvsh]

>I get that some folks want to legalize drugs, but make an argument for it that doesn't involve this twisting of results to match the desired outcome.

Criminalizing drugs has negative externalities like boosting the profits of organized crime, but is often argued to outweigh those side effects by suppressing drug use, which is harmful.

If we found a way to make drug use much less harmful, then why would we not decriminalize drugs concurrently, given that its positives are negated so there's no argument remaining that they outweigh its negatives?

Even if the critical factor in reducing drug use harms was health services, the argument for concurrent decriminalization is overwhelming.

[libertine]

You've got a point there.

I think one of the main things is that people stopped being considered criminals to being considered "sick" - they have addiction, they need help, so they require health care.

If the police catches you with weed - you'll need to go psychological counseling for example.

[EGO_DEATH]

Actually, you can say that people are scared to seek help because of the stigma. In a country with a judgemental culture of shame like Sweden you're in between a rock and a hard place. Because anyone with a credit card can access your legal history and see if you have been convicted for something, it's a pretty self destructive choice to make, and leads to unnecessary suffering.

[jdavis703]

There's a bill in California to de-criminalize drugs (AB 186) -- provided you use them in purpose built medical facility. Right now no serious (i.e. elected) politicians are discussing a totally deregulated drug market as far as I know.

[mmjaa]

> decriminalization

Criminalization means, they send the police to address the issue.

De-criminalizaton means, they no longer send the police to address the issue.

This isn't hand-waving, the term really means what has happened: since people are no longer treated as criminals, humanity has been added to the mix - and, appears to be helping solve the problem.

I think you maybe just don't understand the term. Yes, in fact, de-criminalization is the key issue: patients, not criminals.