Public Health Public Policy

Does drug decriminalization work? The Portugal case study

In 2001, Portugal decriminalized drugs. What does that mean? How did it health outcomes, incarcerations, drug trafficking and other outcomes? A post by Liam Bendicksen at Incidental Economist reviews the literature.

The first thing to understand is what decriminalization in Portugal did and did not do.

…drug reforms decriminalized possession up to “the quantity required for an average individual consumption during a period of 10 days” of all psychoactive drugs as well as public and private drug use. Quantities exceeding that threshold are considered evidence of drug trafficking.

The decriminalization of drug use and possession is distinct from drug legalization, which would sanction the legal sale and distribution of previously-llicit drugs under government supervision. This is not the case in Portugal, where drug trafficking remains a crime…Portugal does not incarcerate individuals for using drugs, but people who use drugs still purchase those drugs from illicit markets.

Note that before de jure decriminalization took place, Portugal already largely had a de facto decriminalization before the law was passed.

Well before the 2001 law, people convicted of drug use were primarily punished with administrative fines. From 1993 to 2000, the total number of people incarcerated for drug consumption alone ranged from 4 to 42. (For scale, the population of Portugal over this period ranged from about 9.9 million to 10.3 million people.)

What were some behavioral responses to the new law? First, the number of outpatient drug treamtent centers rose by nearly 50% between 1998 and 2010 (from 53 to 79) and there was a large increase (~15,000 people) in the number of people receiving treatment for drug addiction in this time span.

As the reformers hoped, drug use-associated diseases and complications declined after the law was passed. For instance, the number of opioid-related overdose deaths and the number of new cases of infectious diseases (e.g., hepatitis C, HIV) declined. Prison overcrowding also fell.

Not all the news was good however.

…there was a substantial and temporary increase in experimental illicit drug use after the law took effect. For the most part, this experimentation did not translate into more regular use in the years following the reforms. The number of people ages 15-24 who reported regular (past 30 days) and recent (past 12 months) drug use declined significantly, while that number rose for people above the age of 24…

…the number of murders in Portugal increased by 41% in the first five years post-reform, and cocaine seizures increased by 700% over the same period, raising concerns about the policies’ effects on drug trafficking patterns. As Stanford Professor Keith Humphreys put it, “transnational criminal organizations may have taken the new policy as a sign that Portugal would be a safer, lower-enforcement venue in which to operate.”

So was decriminalization a good thing? Despite a short-term spike in drug use and the potential for increased trafficking activity, I would still largely say that ‘yes’, decriminalization was a success. However without more detailed, long-run data, this is a very cautious ‘yes’ at best.

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