Portugal’s Lessons for the US
I’m based in California and many people who are in west coast cities often call me about their their concerns about drugs. Sometimes they’re elected officials, sometimes they’re just ordinary citizens who want to talk about it, and in a number of cities Los Angeles, San Francisco, Portland, Seattle are struggling right now but think they’re following the Portuguese model. I emphasize they think they’re following the Portuguese model, not that they actually are. And, it’s not going very well for them. You may have seen in the New York Times there’s a piece a few days ago on San Francisco’s overdose crisis–there’s open air drug dealing, there’s lots of crime, there’s lots of homelessness, there’s a horrifying number of overdose deaths. San Francisco lost more people to overdose than COVID-19 last year. So, when people call me and they say, “We don’t understand! We’re doing what Portugal did and we’re not getting Portuguese outcomes. What’s going on?”, I ask, “What what do you imagine Portugal, in fact, did?” and usually they say, “Well, I saw something on the internet and it said that Portugal had hundreds of thousands of people in prison for drug use, they let them all out, they now tolerate drug dealing, drug use is celebrated as an acceptable lifestyle, and the problem just kind of dissipated. We’re doing that, and it’s not working.”
Then I have to bring three pieces of bad news. First, they’ve completely misunderstood the history of drug policy in Portugal. Portugal never had a drug war at the scale the US did. The number of people in prison for drug use before the reforms was extremely small, relative to the US. So, when you change criminal penalties and a country that didn’t have severe penalties in the first place, it is not the same as doing it in the US, which has an extremely large… we have 2.2 million people behind bars, so it would be a different prospect here. Second, as you were just informed, it is not true that in Portugal that trafficking and drug dealing are legal. They’re illegal and there are extensive services and engagement with users. There are the dissuasion commissions with Dr. Goulão described. You have to build all that if you want to have a change. It’s not just a matter of getting the police out of the way and drugs disappear. You have to have something fill in that space to help people. The last thing, and perhaps the most challenging thing, and i’ll close with this, is that the culture around drug use is different in different parts of the world. So, it’s not necessarily true that San Francisco (a city I love!) would get the same outcomes as Lisbon from Portuguese drug policy. San Francisco is a highly individualistic city, a city of travelers, many people from other places, a city that has celebrated substance use for more than a century, it’s one of the heaviest drinking cities in the US, it’s been a center of cannabis culture, it was a center of the psychedelic movement. Those sorts of things matter in terms of how problems play out and whatever you do in that context is different than what will happen in Lisbon, which is a city and a country where it’s more communal, I think families are a bit stronger, people are a bit less mobile, and they have a reserved view of intoxication, there’s not a celebration of getting intoxicated. And, in that cultural surround ,this kind of policy may work better than it works in a place like San Francisco or Portland or Seattle.
So, just to underscore what what both the ambassador and Dr. Goulão said, we should learn from Portugal and at the same time have to remember that policy is always shaped by the cultural surroundings. So, what the US should do is apply what Portugal has learned to their own situation in light of the realities here, and find a solution that works for us, even if it’s not exactly the same as that which worked in it in Portugal.