Decriminalisation Policy and the role of the CDT Lisbon Addictions 2017 Américo Gegaloto Commissions for the Dissuasion of Drug Addiction

Declaration of interests I am President of the Commission for the Dissuasion of Drug Addiction of Setúbal since 2001 I work for SICAD – Portuguese Directorate for Intervention on Addictive Behaviours and Dependencies

1999 Portuguese Drug Strategy The strategy works as interrelated interventions: Prevention Dissuasion (new - Decriminalisation) Treatment Harm reduction Reintegration Portuguese National Strategy created: - New approach, “it is better to treat than to punish” - New structures and new answers - New holistic approach to the individual

Portugal Decriminalisation It aims to ban the consumption of illicit substances from the criminal field, which can either lead to non-sanction or to the imposition of an administrative sanction. Drug possession in Portugal is prohibited and considered an administrative offence, in line with the UN conventions rules.

Portuguese Legal Framework Decree-Law n. 130-A/2001 of 23 April Law n. 30/2000 of 29 November Defines the legal framework applicable to the consumption of narcotics and psychotropic substances, together with the medical and social welfare of the consumers of such substances without medical prescription. Decree-Law n. 130-A/2001 of 23 April Establishes the organization, process and operating system of the Commissions for the Dissuasion of Drug Addiction.

Dissuasion is a normative response based on values such as: - the humanist principle of respect for human dignity - innovation - pragmatism - multidisciplinary intervention and networking with local structures Its main objective is to offers the possibility of users to have an healthier lifestyle and changing their behavior The mission is to dissuade the use of drugs

Dissuasion aims to: - Discourage and making consumers aware of the harmful consequences - Create conditions for the individual to carry out the change - Confronting individuals with devaluing of their behavior - Commissions for the Dissuasion are light and multidisciplinary structures, guided by the principle of proximity

Global and Integrated Intervention Dissuasion is a global and integrated intervention, where the Commissions for the Dissuasion of Drug Addiction (CDT) guarantee the application of Law no. 30/2000 The Commissions are responsible for implementing the Law n. 30/2000, an important component of the intervention model, with: - prevention and promotion of healthier lifestyle - early detection of risk, consumption and public health situations - articulation with local responses

Commission as “referral platform": - Evaluate the relationship that the consumer establishes with drugs - Flag and forward to appropriate responses (health facilities) - Flag individuals with problematic situations of social integration or others In conclusion, the Commission try to bring consumers closer to the health and social services, with special emphasis on prevention, treatment, harm reduction and social reintegration, in order to obtain health gains

Commission for the Dissuasion of Drug Addiction Composition: Members (3 members / 2 make quorum) Legal Expert/Health Professional/Social Worker Multidisciplinary Team Technical team – Clinical Psychologists/Social Worker/Lawyer There are: 18 Commissions, one in each district of continental Portugal 4 Commissions, in the independent regions of Madeira and Azores

Security forces make the police report HOW IT WORKS - Identifies the consumer Other elements: - Circumstances of time and place - Type and quantity of illicit drugs - Send the report to the Commission - Notifies the consumer for hearing Security forces make the police report Hearing in the Commission - Evaluation interview - Motivational intervention - Opportunity to advise and to guide Establishing a relationship of trust Members Technical team - Confirm the identification - Explain the process and consequences - Accountability for future behaviors - Ask questions about the report - Inform, recommends and guide Show depreciation due to behavior Decision

Non-addicted consumer Non-addicted consumer (measures/penalties) Decision On first appearance On second appearance Addicted consumer Treatment Addicted consumer Non-addicted consumer Non-addicted consumer Provisional suspension of proceedings File the proceedings - Refuses treatment or - Interrupts treatment Sanctions (measures/penalties)

Sanctions (measures/penalties) Complies Does not comply - Fine (never to an addicted consumer) - Prohibition to exercise a profession or licensed activity - Prohibition of the frequency of certain places - Prohibition to accompany, house or receive People - Prohibition to travel abroad - Periodic presentation in a designated local (health and social services) - Seizure of objects - Deprivation of subsidy management Process follows for execution File the proceedings

Intervention in Dissuasion

Conclusions: - Decriminalisation did not led to an increase of drug use Decrease of recent users among general population Increase of treatment demand, also among cannabis users Decrease of problematic users Reduction of drug related deaths and infectious diseases Decrease of social stigma over drug users

Thank you for your attention Américo Gegaloto Lisbon Addictions 2017