Everybody Hurts: How Portugal Is Leading the Way in Addiction Treatment and Recovery

In 1999, there was no country on earth with a higher percentage of “hard” drug addicts than Portugal. A full one percent of its population had a drug abuse problem.

If that number doesn’t sound high, know this: in 2016, it is estimated that the combined number of Americans with a substance abuse disorderfor “hard” drugs – cocaine, heroin and opioids – was about 2.7 million. The total U.S. population in 2016 was 323.4 million. That equates to 0.008 percent of our population addicted to hard drugs.

Portugal had a problem, and that problem was killing its people. Dr. Joao Goulão, a public health official who is now Portugal’s drug czar, knew something had to be done, so he created an unprecedent drug strategy: decriminalize all drugs in Portugal, and put the power and the money behind rehabilitation.

The result? “A decade later, the number of addicts was halved and overdose deaths had dropped to just 30 a year for the entire country. The number has remained steady ever since. Europe’s drug-monitoring agency says Portugal’s mortality rate from drugs is now more than four times lower than the European average.”

How the country saved itself from self-destruction

The main shift was, of course, monetary: about 90% of public money goes towards healthcare, whereas only about 10% goes to enforcing the laws. (“Doing drugs” may not be illegal, but stealing someone’s wallet for drug money still is, so you cannot cut the police off entirely, of course.) Because drugs had been decriminalized, it became “far easier for a broad range of services (health, psychiatry, employment, housing etc) that had been struggling to pool their resources and expertise, to work together more effectively to serve their communities,” as a piece in The Guardianexplains.

But there was another shift, too – a cultural one. For example, “Those who had been referred to sneeringly as drogados(junkies) – became known more broadly, more sympathetically, and more accurately, as ‘people who use drugs’ or ‘people with addiction disorders.’”

How the healthcare professionals approached addiction treatment also changed. From The Guardian:

Portugal’s policy rests on three pillars: one, that there’s no such thing as a soft or hard drug, only healthy and unhealthy relationships with drugs; two, that an individual’s unhealthy relationship with drugs often conceals frayed relationships with loved ones, with the world around them, and with themselves; and three, that the eradication of all drugs is an impossible goal.

Dr. Goulão told the reporter that every person needed to be treated individually. “The secret,” he said, “is for us to be present.” (Sound familiar?)

The “war on drugs” is one part of a string of failures

Portugal’s response to its own deadly drug crisis is a complete 180° from America’s attempt to eradicate drugs(and therefore, drug abuse):

  • In 1920, the 18thAmendment bans alcohol.
  • In 1937, the Marihuana Tax Act started to tax cannabis (with the ultimate goal of ending the hemp industry).
  • In 1970, President Richard Nixon called drug abuse “public enemy number one,” and officially used the term “war on drugs.”
  • In 1981, the “Just Say No” campaign began.
  • In 1982, the US military and the CIA started getting heavily involved in fighting the sale of illegal drugs.
  • In 1986, the Anti-Drug Abuse Act installed tougher sentencing laws for crack-cocaine.

What each of these events have in common is an underlying goal of punishing people for using drugs. In America, we see drug abuse as an enemy to fight against, and we do that by creating stricter laws, steeper fines and penalties, and stronger rhetoric against not only the drugs themselves, but those who are addicted to them. We have spent the last century systematically attempting to shame and punish drug and alcohol users through legislation and anti-drug campaigns.

It doesn’t work.

A person with a substance abuse disorderneeds to want to change on his or her own. No amount of guilt or punishment is going to stop the addict from using.

That doesn’t mean we believe that drugs should be decriminalized. But what Portugal is doing – focusing its efforts on healthcare, on housing, on counseling, on re-engaging with the people around them – is, at its core, the same mission we have here at Little Creek Lodge. A person addicted to drugs or alcohol needs to be heard and seen. The deeper issues that have taken root need to be addressed. Threatening someone with punishment or pain isn’t effective – after all, how many children touch the hot stove even after being told not to do it?

If we want to put an end to the needless deaths and injuries that people throughout the country are suffering every day, then it’s time to try something radically new. Going to war against drugs and drug abuse hasn’t worked. Perhaps it’s time to try love, acceptance, vulnerability and hope, instead. That’s what we do every day, so we know that it can work. If you’d like to learn more about our services, or speak to someone about your loved one’s care, we’d be happy to schedule a tour of our home here in Eastern Pennsylvania. Please call 570-630-9354, or fill out this contact form, and start your journey to a healthy, sober lifestyle.


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