On July 7, the Washington Post ran a story by Anthony Faiola and Catarina Fernandes Martins with the headline, “Once Hailed for Decriminalizing Drugs, Portugal is Now Having Doubts.” The authors report that Portuguese policymakers are beginning to doubt the country’s landmark drug decriminalization program that began in 2001. Glenn Greenwald profiled Portugal’s reform in a 2009 Cato Institute white paper.
The reporters note that drug use, overdoses, and drug‐related crime have increased from 2019–2023. They report that the percentage of adults reported to have used illicit drugs was 12.8 percent in 2022, compared to 7.8 percent in 2001. Yet, as they point out, Portugal’s adult drug use still remains lower than the European average.
In my letter to the editor, I argue that the article’s tone suggests the expectation that decriminalization would lead to a drop in illicit drug use. While it did, that was always a secondary goal. The primary goal was to reduce drug overdose deaths by redirecting resources from incarceration to harm reduction. I pointed out that Portugal’s harm reduction efforts have greatly succeeded.
I also pointed out that while overdose deaths increased between 2019 and 2023, for most of those years anxiety, despair, and isolation resulting from pandemic‐related policies caused a worldwide increase in drug use—including alcohol consumption—and sparked overdose deaths. The authors of the Post article didn’t take this into account in their reporting.
Pundits and policymakers seek simple explanations for the rise in drug use and drug overdoses. For the past several years, they have blamed it mostly on doctors prescribing opioids too liberally to their patients in pain. But the evidence shows no correlation between prescription volume and the nonmedical use or addiction to opioids. And the National Survey on Drug Use and Health shows that the addiction rate of adults aged 18 or over to prescription opioids has remained at or below 0.7 percent since the survey began in 2002. Besides, doctors prescribing opioids can’t explain the surge in the use of and overdose deaths related to cocaine, methamphetamine, and other stimulants.
The evidence shows that a growing number of people are engaging in illicit drug use. Many might be self‐medicating to treat psychogenic pain. Researchers at the University of Pittsburgh showed that overdose deaths in the U.S. have been increasing exponentially since at least the late 1970s. And Cicero et al. found that the percentage of heroin addicts who initiated drug use with heroin—heroin was their gateway drug—went from 8.9 percent in 2005 to 33.3 percent in 2015. The worldwide increase in drug use has psychosocial and sociocultural origins. The pandemic and pandemic policies only served to accelerate drug use.
The Post article features Portuguese police venting their frustration that many drug users they encounter on the streets turn down offers to enter rehab. But not every recreational drug user has an addiction problem, so no one should be surprised if not all users accept offers to enter rehab.
The reporters describe people in Portugal openly using drugs on the streets, with congregations of drug users in residential neighborhoods disturbing residents. In the interest of brevity, I did not address this in my letter to the editor. But libertarian philosophy professor Daniel Shapiro made the following valid point in an email correspondence we had about this:
The illicit drug users are clearly causing significant externality/nuisance problems, and that is something it is legitimate to use the law to combat (not jail except in extreme cases, but certain fines and some kind of sanctions) Consider alcohol as a comparison: if a group of people are intoxicated and vomiting on public streets, are rowdy, and littering the street with bottles, it is legitimate to call the cops or some kind of enforcement authority to combat it. There is a quote in the article where someone said (correctly) that it was a human right to use–yes but not everywhere and anytime in public.
The worldwide trend suggests that non‐medical drug use will continue to increase. Portugal’s policymakers were right in 2001 when they shifted the emphasis from punishment and incarceration to harm reduction. The ultimate form of harm reduction would be to end prohibition—as we did in 1933 with the drug alcohol—which will make drug users safer because the drugs they use will be legal and regulated.
You can read my letter to the editor here.