João Goulão, MD Portuguese National Drugs Coordinator President, Institute on Drugs and Drug Addiction “Leaders Against Criminalization at AIDS 2010” Vienna, 22nd July 2010 DECRIMINALIZATION OF DRUG USE IN PORTUGAL

 It began much latter than in the other Western European Countries;  It happened with relevance only after the Portuguese Democratic Revolution (1974), when society was facing lots of deep and accelerated changes;  It developed very fast, and society was not able to answer in the right time and to face the “new needs” created by drug use; as a consequence, there was a gap between the appearance of the “needs” and the “answers” The history of Drug Use in Portugal

 Drug use spread under European average level;  But a considerable number of “problematic drug users” appeared and, during a long period of time, had no access to treatment;  By the end of the 20th Century, Portugal had one of the highest prevalence of Problematic Drug Use, at European Level;  At the same time the social burden, associated to drug use, was very relevant – top political concern As a consequence of that developmental pattern:

The complexity of the situation called for some measures expected to reverse that cycle  A new National Strategy was built (1999)  A new Legal Framework appeared (Law 30/2000)  A new institutional structure appeared to implement and coordinate an Integrated Approach to all the areas related to Drugs and Drug Use

Drug consumption: not a private choice, because of its social and sanitary effects Drug addiction: a disease Drug addict: a sick person The dissuasion intervention: Opportunity for early, specific and integrated interface with consumers Aimed and targeted to the consumers’ characteristics and individual needs Decriminalization in Short João Goulão 5

Challenges A new destination for drug tourism? Compliance with the UN Conventions? Drug use increase in younger groups? Administrative sanctions in line with UN Conventions – No, Portugal said. Positive references in: April 2004 International Narcotics Control Board Mission to Portugal. World Drug Report The Cato Institute Greenwald Report. The 2009 EMCDDA Annual Report. João Goulão 6

International References 7

New Patients by Main Drug Type in Public Ambulatory 2003 – 2007 Source: IDT, I. P.: DR / DMFRI – NE * Heroin and Heroin & Cocaine categories are not directly comparable with following years categories. 8 Treatment Demand by Drug Type

9 AIDS/HIV Notifications %: Drug Addicts and Non Drug Addicts, per Year of Diagnosis, In 2005, HIV infection was included in the mandatory diseases’ notification list. ** The possibility of ongoing updates due to previous years diagnosis’ late notifications make this data provisional. INSA, I. P.: CVEDT, (2008/03/31) / IDT, I. P.: DMFRI-NE Sanitary Evidence

10 AIDS/HIV Notifications: Drug Users and Non Drug Users, per Year of Diagnosis, In 2005, HIV infection was included in the mandatory diseases’ notification list. ** The possibility of ongoing updates due to previous years diagnosis’ late notifications make this data provisional. INSA, I. P. (2008/12/31) / IDT, I. P.: DMFRI-NE Sanitary Evidence

11 Source: IDDA,.P.I.: DR / DMFRI – NE Drug Injecting on the Previous 30 days before New Patients 1st Consultation - Public Treatment Network Sanitary Evidence

PORTUGAL 2001/2007 General Population ( years ) Source: Balsa, C. - INPP Drug Consumption Prevalences (any drug) 12

PORTUGAL 2001/2007 General Population ( years) Source: Balsa, C. - INPP Drug Consumption Prevalences (any drug) 13

There is a coherent articulation among ALL THE PORTUGUESE POLICY AND ACTIONS based on the idea that a DRUG ADDICT is a SICK PERSON with treatment needs instead of being addressed as a “CRIMINAL or a DELIQUENT”. Until now, the global drug situation in Portugal, seems to have a positive evolution in all the available indicators. CONCLUSIONS:

15 INSTITUTO DA DROGA E DA TOXICODEPENDÊNCIA, I.P. INSTITUTE ON DRUGS AND DRUG ADDICTION, P.I. Thank you for your attention

Ten Days Maximum Amount Allowed Illicit Substance Chart Illicit SubstanceGrams Heroin1 Methadone1 Morphine2 Opium10 Cocaine (hydrochloride)2 Cocaine (methyl ester benzoilegonine)0.3 Cannabis (leaves and flowers or fruited dons)25 Cannabis (resin)5 Cannabis (oil)2.5 LSD0.1 MDMA1 Amphetamine1 16

Annual Distribution of the Proceedings

Indiciados Primários 2009 Situação Face aos Consumos e Encaminhamento IDT, I. P.: GAD / DMFRI - NE Toxicodependentes778 ETC. SaúdeOutrosTotal Tratamento Voluntário Encaminhamento Reencaminhamento Continuação de Tratamento Não Toxicodependentes3911 Sem Diligências de Motivação1660 Apenas Diligências de Motivação771 Dilig. Motivação + Encaminhamento p/ Estruturas de Apoio522 Encaminhamento Directo para Estruturas de Apoio958 18