Although Fonseca says centers still lack adequate funding, two state-sponsored outreach teams—made up of psychologists, social workers and nurses—continue to travel each day to find addicts and get them the treatment they need. Portugal still has a way to go, with some people continuing to use drugs in terrible conditions. But to do so, it will have to stop treating them like criminals. Follow him on Instagram goncalo. Follow him on Twitter paulmoakley. Write to Naina Bajekal at naina.
Portugal Might Have the Answer. At the height of the heroin crisis in the 90's as many as 5, drug users lived on the streets of the Casal Ventoso neighborhood shown here, January 12, Portugal made history by becoming the first country in the world to abolish criminal penalties for consumption and possession of all drugs.
She and Rita, a psychologist, are a part of the first line of help in the Portuguese Harm Reduction Policy. They trade used needles for clean ones, offer tinfoil for those who smoke, and psychological and social support to almost 1, users every year. A site near Bairro da Cruz, Lisbon February 6, The kit the outreach workers give out consists of two syringes and drug paraphernalia, a condom, citric acid, distilled water and sanitation wipes.
But we do not advocate consumption. We try to talk to them, help them improve their lives. The outreach team on their daily route, which include these abandoned swimming pools near Casal Ventoso, Lisbon, February 3, It is operated by the Ares do Pinhal Association, and has existed since the Casal Ventoso neighborhood was demolished. The two vans administer methadone maintenance therapy to more than 1, people every day.
Opioid users who receive this treatment on the street are healthier and safer than those who do not. Paulo Lopes, the president of this NGO. Recommended reads:. You might also be interested in one of the following sections:. Related information Key populations. If drugs are sold openly on a commercial basis and prices are close to production and distribution costs, opportunities for illicit undercutting would appear to be rather small.
Under a more restrictive regime, such as government-controlled outlets or medical prescription schemes, illicit sources of supply would be more likely to remain or evolve to satisfy the legally unfulfilled demand.
In short, the desire to control access to stem consumption has to be balanced against the black market opportunities that would arise. Schemes that risk a continuing black market require more questions—about the new black markets operation over time, whether it is likely to be more benign than existing ones, and more broadly whether the trade-off with other benefits still makes the effort worthwhile.
The most obvious case is regulating access to drugs by adolescents and young adults. Under any regime, it is hard to imagine that drugs that are now prohibited would become more readily available than alcohol and tobacco are today.
Would a black market in drugs for teenagers emerge, or would the regulatory regime be as leaky as the present one for alcohol and tobacco?
Not surprisingly, the wider international ramifications of drug legalization have also gone largely unremarked. Here too a long set of questions remains to be addressed. Given the longstanding U. What would become of the extensive regime of multilateral conventions and bilateral agreements?
Would every nation have to conform to a new set of rules? If not, what would happen? Would more permissive countries be suddenly swamped by drugs and drug consumers, or would traffickers focus on the countries where tighter restrictions kept profits higher? This is not an abstract question. Finally, what would happen to the principal suppliers of illicit drugs if restrictions on the commercial sale of these drugs were lifted in some or all of the main markets?
Would the trafficking organizations adapt and become legal businesses or turn to other illicit enterprises? What would happen to the source countries? Would they benefit or would new producers and manufacturers suddenly spring up elsewhere? Such questions have not even been posed in a systematic way, let alone seriously studied. Although greater precision in defining more permissive regulatory regimes is critical to evaluating their potential costs and benefits, it will not resolve the uncertainties that exist.
Only implementation will do that. Yet jettisoning nearly a century of prohibition when the putative benefits remain so uncertain and the potential costs are so high would require a herculean leap of faith. Only an extremely severe and widespread deterioration of the current drug situation, nationally and internationally—is likely to produce the consensus—again, nationally and internationally that could impel such a leap. Even then the legislative challenge would be stupendous.
The debate over how to set the conditions for controlling access to each of a dozen popular drugs could consume the legislatures of the major industrial countries for years. None of this should deter further analysis of drug legalization. In particular, a rigorous assessment of a range of hypothetical regulatory regimes according to a common set of variables would clarify their potential costs, benefits, and trade- offs.
Besides instilling much-needed rigor into any further discussion of the legalization alternative, such analysis could encourage the same level of scrutiny of current drug control programs and policies. With the situation apparently deteriorating in the United States as well as abroad, there is no better time for a fundamental reassessment of whether our existing responses to this problem are sufficient to meet the likely challenges ahead.
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