zaterdag 20 oktober 2012

Drugs - without the hot air: Minimising the harms of legal and illegal drugs (David Nutt) [4]

In 1999, the Portuguese parliament approved a new National Strategy, which came into effect in 2001. Under this new strategy, drugs covered by the UN International Conventions remain illegal, but the penalties for personal use are no longer dealt with through the criminal justice system. Anyone caught with less than 10 days’ average supply of a drug (5 g of cannabis, 1 g of heroin) has it confiscated by the police and they are given a ticket, requiring them to appear before a “dissuasion board” within 72 hours. The board is normally made up of two psychiatrists and a legal specialist, who ask about their drug use, categorise them as a recreational user or regular user or addict, warn them of the risks they are taking, and offer treatment if appropriate. There are a range of potential sanctions, from a fine, to having social-security benefits cut or being forced to go to rehab. 

In practice though, about 85% of those sent to the board get a suspension with no sanctions, and most of the rest are given treatment. Supplying drugs is still penalised: if you’re caught with more than 10 days’ personal supply you still have to go to court and could face prison. A good comparison is with traffic offences: dangerous driving might land you in jail, but failing to wear a seat belt or cycling through a red light is more likely to result in a fine or having to go on a road-safety course. 

Despite fears from some conservative politicians that decriminalisation would lead to a large increase in drug use, with Portugal becoming a site of “drug tourism”, this has not happened and the policy has been highly successful at reducing harm, and has had few negative consequences: The number of heroin addicts in treatment increased from 23,500 in 1998 to over 40,000 in 2010, partly due to the fact that they no longer have to fear criminal sanctions if they come forward. 

The number of new HIV cases among injecting drug users has reduced from 430 in 2000, to 352 in 2008. Halving the number of people injecting in the last month. Freeing up existing resources, which instead can be used to treat addiction and make larger seizures further up the supply chain. 19Up to  400 million a year being taken out of the hands of criminals through decreased use. Although there has been a slight increase in drug use among adults, there has been 20a decrease among 15 to 19-year-olds, indicating lower levels of experimentation. 

This is very positive, because this was smaller than in neighbouring countries – Spain, for example – and drug behaviour in teenage years has a strong relationship with drug use later in life. Nor has Portugal become a destination for foreign drug users; 95% of those caught since the strategy was introduced have been Portuguese. The most significant change, however, has been in the social attitude towards drug addiction. It is now seen primarily as a medical and social problem rather than a moral or criminal one. 

And far from the Portuguese state being “soft on drugs”, they are intervening more than ever, taking steps to deter people from progressing from recreational use to addiction, and heavily encouraging people into treatment. There is also a recognition that a response which might work well for one person would be less effective for another, and that addicts respond to different sorts of incentives than non-addicts. Fines are specifically not recommended as a punishment for addicts, for example, lest they commit crimes to get the money to pay the fine.

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