Since 1996, when California voters approved the medical use of marijuana, most of the high-profile political progress that has been made towards legalizing marijuana has been made in the United States. And starting with Colorado and Washington, all of the full legalization experiments have been homegrown.

But that does not mean we should not be looking to other countries for successful experiments and policies. Drug use and abuse is worldwide, so the solution to the destructive war on drug users must also be worldwide.

The Portugal Experiment

In 2001, the Portugal legislature bravely enacted a comprehensive form of drug decriminalization, in which all criminal penalties were removed for personal drug possession and use offenses — reclassifying them as administrative violations. Instead of arresting individuals in possession of personal-use amounts of any drug, defined as less than a ten-day supply of any drug — a gram of heroin, ecstasy, or amphetamine; two-grams of cocaine; or 25 grams of marijuana — they are now given a violation and ordered to appear before a rather ominous sounding “dissuasion commission.”

The possession of larger amounts of drugs and drug sales continue to be criminal matters for which an offender is subject to arrest and prosecution.

The “dissuasion commission,” which is comprised of one local legal official and two health and social service professionals, first determines whether the individual is addicted, and if so to what degree. It then determines whether the individual is referred to a voluntary treatment program, given a fine, or receives other administrative sanctions. The majority of cases are simply suspended, and the violator receives no sanction. According to Nuno Capaz, a sociologist who serves on the Lisbon “dissuasion panel,” between 80 and 85 percent of the people who are referred to the panels today are caught with hashish or cannabis.

For persistent offenders, or those identified as addicts, these panels can order sanctions or treatment, and recreational users may face fines or community service. If an addict refuses treatment, they are required to check in regularly with their family doctor (Portugal has a free national healthcare program), and if they fail, the local police remind them of their obligation. And those running the Portuguese system attribute this close working relationship between the police and the public health officials as crucial to their success. “This small change actually makes a huge change in terms of police officers’ work,” says Capaz. “Of course, every policy officer knows where people hang out to smoke joints. If they wanted to they would just go there and pick up the same guy over and over. That doesn’t happen.”

Flying in the face of the more prevalent “lock-em-up and throw-away-the-key” anti-drug policies popular at the time in most countries, especially the United States, there were initially fears that Portugal would become overrun with heroin addicts from all over Europe, and the government received a lot of criticism for their experimental policy from such staid groups as the International Narcotics Control Board – part of the UN drug convention system.

What Decriminalization Really Means

Decriminalization was a half-way measure originally recommended for marijuana policy in the U.S. by the National Commission on Marijuana and Drug Abuse in 1972. It says consumers, who generally comprise up to 90 percent of the marijuana arrests, should be removed from the criminal justice system, but that commercial sales of marijuana should remain illegal. While that is obviously an improvement over total prohibition, where users are also subject to arrest and jail, it generally is thought to lead to an increase in demand without any legal supply — a boon to the illegal black market and those willing to take the risk to sell to the newly legal consumers.

Seventeen states in the U.S. have enacted a version of marijuana decriminalization (some have eliminated all penalties for minor possession offenses; others have reduced the penalty to a fine-only). But more recently states that wish to end prohibition have looked toward full legalization, where the commercial market is regulated and taxed. Nonetheless, decriminalization remains an option for those states that no longer wish to treat smokers as criminals, but do not yet feel politically comfortable with full legalization.

Not The Results In Portugal That Were Expected

But the results from Portugal seem to dispel those initial fears that decriminalizing drugs would result in an increase in dangerous drug use, especially among addicts.

First, and most importantly, decriminalization in Portugal for a decade and a half has not led to any major increases in the rate of drug use. There were minor increases in drug use during the initial year (2001), but the rates of drug use after that have not changed significantly, or, in some cases, have actually declined since 2001, and remain below the average rates in both Europe and the United States. And importantly, adolescent use, and use by people who are deemed “dependent” or who inject drugs, has decreased in Portugal since 2003.

So decriminalization may yet prove to be an attractive alternative to prohibition for the more dangerous drugs in the United States. No one wants to see a cocaine store on the corner, but neither do most people want to ruin an individual’s life with a long prison sentence for the use of cocaine. If it is a problem, it is a medical one, not a criminal justice problem.

And Portugal has experienced more than a 60 percent decrease in the number of people arrested and prosecuted for drug offenses. More than 80 percent of the cases coming before the “dissuasion commissions” are perceived to have no problems and receive no sanction.

The percentage of prisoners in Portuguese prisons for drug offenses has been reduced from a high of 44 percent to the current rate of 13 percent. And drug overdose deaths have decreased from 80 in 2001 to 16 in 2012. In the U.S., for comparison, more than 14,000 people died from prescription opioid overdoses alone each year.

“There is no doubt that the phenomenon of addiction is in decline in Portugal,” Portugal’s Drug Czar Dr. Joao Goulão explained, according to Drug Policy Alliance. He attributed this shift to “a set of policies that target reduction of both supply and demand, including measures of prevention, treatment, harm reduction and social reinsertion.” Adding that, “[t]he biggest effect has been to allow the stigma of drug addiction to fall, to let people speak clearly and to pursue professional help without fear.”

And he strongly favors a policy of harm reduction. “I think harm reduction is not giving up on people,” Dr. Goulão said, according to Vice, “…assuming that even if someone is still using drugs, that person deserves the investment of the state in order to have a better and longer life.”

And even the United Nations Office on Drugs and Crime has concluded that “Portugal’s policy has reportedly not led to an increase in drug tourism. It also appears that a number of drug-related problems has decreased.” And some leading independent researchers investigating the Portugal experiment wrote in the British Journal of Criminology in 2010 that “contrary to predictions, the Portuguese decriminalization did not lead to major increases in drug use. Indeed, evidence indicates reductions in problematic use drug-related harms and criminal justice overcrowding.”

So What Can We Learn From Portugal

First, we can begin to stop treating so harshly illicit drug users, who use something other than marijuana. Sure heroin and cocaine and methamphetamine are more potentially dangerous than marijuana; but that does not mean those drug users should be treated like criminals. If, like Portugal, we can minimize abuse, greatly reduce the number of people arrested on drug charges, reduce overdose deaths, reduce adolescent drug use and problematic drug abuse, greatly reduce our prison population, and still maintain a safe, free and open society, then why would we not want to begin to move in that direction?

Also, we can learn from Portugal the importance of adopting a policy of harm reduction that recognizes the value of all lives, including those who may, for a time, use dangerous drugs, and to provide needed mental health services to those whom we can identify as problem drug abusers. Portugal seems to make it clear that their success simply could not have been possible without making health care professionals available to those who will avail themselves of that help.

And third, we can and should learn that the stigma of drug use or abuse — regardless of the drug involved — needs to be eliminated, to create an environment in which individuals feel free to seek help without fear of being labeled a bad person. It’s time to treat drug abuse as a medical issue, not primarily a criminal justice issue.

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