• Ok so first, my biases. I’m going to write my best guess and then I’ll read the article. So… is it that Portugal helped people instead of simply trying to arrest them or put up anti-homeless architecture so that those better off wouldn’t have to see addicts in the streets? Let’s go and read now…

    WELL. I’m shocked!

    "Portugal’s leaders responded by pivoting away from the U.S. drug war model, which prioritized narcotics seizures, arrests and lengthy prison sentences for drug offenders.

    Instead, Portugal focused scarce public dollars on health care, drug treatment, job training and housing. The system, integrated into the country’s taxpayer-funded national health care system, is free and relatively easy to navigate. "

    Ok, I’m not that shocked.

    • As a Portuguese who was alive (albeit a kid) in the 90s, I can summarize this as we didn’t have enough resources (both human and monetary) to keep enforcing the U.S. drug war model. Since it wasn’t working and we were reaching a critical situation (like half of Lisbon in particular was filled with drug addicts shooting heroin up their veins), we turned to the experts.

      The article implies this was a decision made from the beginning of this epidemic, but it was pretty much a last resort because the other model was unsustainable for the government. Not sure if we would’ve adopted it if we had US’ resources.

      Also, just giving context here, not trying to diminish this accomplishment.

  • Yeah, this was an easy one to call. It’s repeated in other countries as well.

    One other factor that they don’t mention is that the surge in street opioids corresponded to a crackdown on doctors writing opioid prescriptions. I saw this coming when I was doing policy analysis and looking at unintended consequences in complex systems. I don’t remember much about what degree of a surge we saw in prescriptions, but I do remember all of those “pill mill” headlines. That always struck me as a pretty manufactured crisis - but even if not, the crackdown certainly didn’t improve the situation.

  • Portugal also doesn’t ban the use of Metamizole, an analgesic halfway between Paracetamol/acetaminophen and opioids.

    In the US, it’s considered a “dangerous horse tranquilizer” with a 1.1 per million mortality rate. Meanwhile, opioids only have a 320 per million mortality… which apparently is just fine.