A victory in the war on drugs may now be exported from Europe to America Between 1995 and 2019, the estimated number of addicts fell from 100,000 to 50,000, of whom 30,000 are receiving treatment

In his early twenties, João Goulão was offered heroin by a friend, but turned it down. It is tempting to wonder what might have happened had he tried the drug; quite possibly, the history of his own country might have been very different.

Dr Goulão went on to become Portugal’s drugs tsar, spearheading a revolutionary policy of decriminalisation of illicit substances which is admired around the world. Fate was not so kind to his friend.

“He became addicted to heroin and died from [an] Aids[-related illness],” recalls Dr Goulão now. As Britain and the US continue to lose the war against drugs, and the death toll rises from opiate epidemics, one of Europe’s smallest countries has shown another way out of the morass.

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In November, Portugal will celebrate the 20th anniversary of the passing of a law which decriminalised all illicit substances. Now Dr Goulão believes the US and other countries that are ravaged by drugs are finally ready to follow his country’s example.

The doctor smiles patiently when he explains that most misunderstand what happened in this deeply conservative Catholic state. Portugal did not legalise drugs. In fact, Portugal made possession of small amounts of narcotics an administrative rather than a criminal offence, like the small fine one might receive for failing to put on a seat belt.

Improve lives, reduce consumption

Those caught with less than 10 doses of any drug – defined as the amount which they would be using only for personal use – can attend the Commission for the Dissuasion of Drug Use rather than appear before a court.

They are seen by a psychologist, a social worker and a lawyer, and advised about treatment, harm reduction and support services. Users may face small fines, do community service or – more likely – be advised on the drug’s effect.

“We took drugs out of the criminal system and into the health system. We want to see how we can give people a chance to improve their lives – not necessarily quit drugs, just reduce consumption,” says Dr Goulão.

In the 80s, he was a family GP in the Algarve in southern Portugal when the country was ravaged by a heroin epidemic very like the opioid crises in the US, Scotland and elsewhere.

During the long dictatorship of António de Oliveira Salazar, Portugal was closed off from the world. Drugs were unheard of. Even Coca-Cola was banned and licences were necessary to have a cigarette lighter.

When democracy finally arrived in Portugal in 1974, so did drugs. At first, they were a novelty – until the death toll mounted. “Nobody was spared. All the social groups were affected. About 1 per cent of the population – or 100,000 – died,” remembers Dr Goulão, 65, who started to specialise in addictions.

Dispelling the doubts

Portugal had no drugs policy except to lock up users with dealers, but it was not working. Amid a clamour for action from all corners of society, including the Roman Catholic Church, Portugal’s left-wing government assembled a group of experts to come up with a solution.

“We had freedom to do anything within the United Nations statutes on drugs, which means do anything except legalising drugs,” Dr Goulão says. “In the end, we went as far as we could.”

Despite opposition from right-wing parties, the law to decriminalise drugs was passed. The results have dispelled the doubts of the doomsayers, who claimed that Portugal would turn into a “paradise for drug tourists” and give the young easy access to narcotics.

Between 1995 and 2019, the estimated number of addicts fell from 100,000 to 50,000, of whom 30,000 are receiving treatment, according to the Portuguese government.

Other problems associated with drug addiction such as HIV infection plummeted, from 104.2 new cases per million in 2000 to 4.2 in 2015.

Under a motorway bridge in a run-down Lisbon suburb, the reality of the Portuguese approach plays out every day. Here addicts, who include doctors and former politicians, queue at the methadone bus for their daily dose of an alternate opiate to heroin. Clean needles are offered and blood tests for illness are carried out by an NGO called Ares do Pinhal.

‘Quality of life’

“We want to do what we can to improve their quality of life,” says Nuno Capaz, a social worker.

Antonio Gago, 51, is proof of how the system has worked. His gaunt features bear witness to how heroin and cocaine pushed him almost to death. Now clear of drugs for a decade, he lectures in schools on drugs and helps assess users.

“I knew Dr Goulão when he was a doctor in Faro. He always had time for people. I was going to kill myself and rang him and he told me: ‘You are not alone’. I will never forget that,” he says.

The doctor and his patient are now old friends. “There are many Antonios across Portugal, who are either still struggling with drugs or who, like him, have overcome them,” says Dr Goulão.

Having just returned from Rhode Island in the US, he believes America’s smallest state is about to follow Portugal’s example. “I really get the feeling this time that Rhode Island may decriminalise drugs. They are going through a terrible opioid crisis. If they do it, then other states across the US could follow,” says the doctor.