4 ms·

I'm Portuguese and I grew up watching the heroin epidemic we had in Portugal. It was horrible, like the article mentions 1% of the population was addicted to he

I'm Portuguese and I grew up watching the heroin epidemic we had in Portugal. It was horrible, like the article mentions 1% of the population was addicted to heroin. Curiously I now live in Sweden, but I lived in Portugal for the first 11 years of the decriminalization. And the solution actually started years before, in the early 90s. It's a bit like you said, it was an huge investment in public health - the first success was that you could get a kit to inject heroin for free in any pharmacy, paid by the state, no questions asked! It was a huge win against the spread of HIV. The biggest difference I see comparing the Portuguese reality to the Swedish one is the lack of social stigma regarding drugs. Drugs are just openly discussed in Portugal and addicts are well integrated in society. I have friends whose parents are heroin addicts and for the most part they are a normal family with jobs and responsabilities. Sometimes they relapse but it's not a big deal because they have a network and feel safe to get help quickly and the state sponsors replacement therapies in the meanwhile. These are people that started doing heroin in the late 80s and for the most part still raised a family and are good parents and neighbors. It's just a disease like any other and Portuguese people see addiction that way.

CamelCaseName 9y ago
I don't have much to say other than that I really admire that sense of thinking, and I hope more countries can adopt a similar vision.
bjelkeman-again 9y ago
I wish we could get the same attitude in Sweden. What do you think is the main barrier in Sweden?
- vidarh 9y ago
  I'm Norwegian, not Swedish, but there is this lutheran/protestant culture that's very deeply embedded in the Scandinavian/Nordic countries that have one hand contributed to the success of things like criminal reform and welfare, because those areas happened to unite a lot of Christians and a lot of liberals and left wing people around a shared belief of how to treat people with decency and compassion, but which at the same time can be very paternalistic when applied to other areas. You see this in terms of policies on things like alcohol and drugs in particular, but also areas like prostitution, where the attitude is often that the people involved are sinners who both need help and punishment, and where there is an attitude of "we know best" about legislation and treatment options. The Nordic countries often looks liberal on the surface, but while they have secularised rapidly there is still an undercurrent of Christian moralistic ideas that have had a very firm grip in many areas, aided by the long lasting state churches (e.g. the Norwegian Lutheran church was a state church with the government appointing key people until 2012).
  - rasjani 9y ago
    I can echo the same is very valid in Finland. Certain behaviors that are very stereotypical here are Protestant/Lutheran by nature. It's also a bit amuzing as mostly people don't recognize that and are typically very anti religion or atheist.
- kpil 9y ago
  Here are some topics that have actively not been a topic for political discussions for at least the last 15 years: The immigration, the housing bubble, the failed city planning on all scales, the inefficient patchwork of regional authorities (Kommuner) in the large regions, the overinflated financial system, the deindustrialization, and the drug politics. All of them are rather urgent, but instead we get virtue signalling and distancing from the nationalist party, pseudo debates about tax-levels (55% or 54%) and endless mantras regarding "healthcare" and "schools" while ironically those systems are still good but are slowly deteriorating due to New Public Management, unhinged privatisation and a good deal of incompetence. None of which is discussed except maybe the last few weeks when a properly virtue-signalling but spectacularly incompetent General Director managed to outsource classified information to Serbia of all places. It's obvious that the drug politics has failed. The only thing we need to do is to look at the facts (almost worst in EU), think and discuss, and then modify. But no. Right now we are just feeding the criminal gangs earning money on lighter drugs such as cannabis where there is an unstoppable demand, while coming down so hard on the heavier users that they literally die on the streets. One mistake or relapse while on a program - and they are kicked out on the street again. But why? I honestly don't know. Swedish government bodies seems to have a very hard time changing their position, especially when it involves admitting that they have been wrong. Swedes are also very conformist - almost like a big insecure high school class where everyone say the same thing, wear the same things, and bully anyone that sticks out even just a little bit, so it could be hard to discuss sensitive topics.
rwnspace 9y ago
It's peculiar how reports of sensible policy make me feel Portugal is adorned in rubies and roses. Here in the UK the Home Office recently said they have no plans to look at even the classification of cannabis. Despite most local police forces not bothering with anything but factories, a majority of population supporting legalisation/decriminalisation, and global trends. We are comparatively medieval but for a few smart initiatives. I have heard that Germany and Norway/Sweden also have some very similar attitudes: I blame Calvinism. I could rant for hours on alcohol and tobacco policy in the UK. A little knowledge of the field of Harm Reduction opens a lot of avenues for criticism. Particularly increasing taxation, which extracts most from the working class and is effective in few use-cases. The UK isn't alone: look up the EU's May 2017 'Tobacco Product Directive' regarding E-cigs. Read: lobbying from groups that are responsible for millions of deaths and public cost are strangling and monopolising a market and technology that is an incredible source of harm reduction... I'm struggling to hold my tongue at this point. We have a large problem with a political class who don't listen to reason or evidence, simply an innately conservative discourse makes the problem look smaller than it really is. It's fantastic to read a positive outlook on Portugal's policy - it has been smeared countless times here.
- libertine 9y ago
  Here in Portugal I think there's still quite a path to go to legalize some drugs honestly - some country's are jumping right into it, heads first, but they are forgetting precisely the addiction factor and what health care structures and mindset are required to deal with this. No matter how harmless a drug is, there are always inherent issues bound to it's consumption.
  - rwnspace 9y ago
    I am not entirely sure that legalisation alone increases unhealthy usage. I think people that fit profiles which make substance addiction a significant risk, are mostly the same profiles that don't respect 'the law because it's law'. At the same time, I know of plenty of people who drink dangerously but don't touch other substances. The comparison is difficult because of all the factors that promote drinking in society. Mindset/cultural attitudes are the central question. Say if the UK's binge-drinking culture transposes to binge-consumption, and introducing legality is considered an opened door, then the healthcare structures are critical. It's also probably quite hard to educate GPs - who seem to be big on drinking away their stresses at uni but avoiding other drugs - into an open mindset that identifies the right problems. The pros and cons seem to accommodate a careful optimism and evolution-of-culture outlook. Not necessarily sweeping reforms. The problem for this view is that those with vested interests support sweeping anti-reform, whatever way you want to look at it.
alkonaut 9y ago
What most keeps me away from hard drugs isn't that the addiction is similar to a horrible disease, but to 99% that it (society's stigma) would cost me my job and my family. I admire the way in which Portugal removed the stigma of existing addicts and how it's considered a disease and not as stigmatized as here (Sweden) but I can't say the "threat of being stigmatized" is 100% negative. You can't have it both ways I guess.

CamelCaseName 9y ago

I don't have much to say other than that I really admire that sense of thinking, and I hope more countries can adopt a similar vision.

bjelkeman-again 9y ago

I wish we could get the same attitude in Sweden. What do you think is the main barrier in Sweden?

vidarh 9y ago
I'm Norwegian, not Swedish, but there is this lutheran/protestant culture that's very deeply embedded in the Scandinavian/Nordic countries that have one hand contributed to the success of things like criminal reform and welfare, because those areas happened to unite a lot of Christians and a lot of liberals and left wing people around a shared belief of how to treat people with decency and compassion, but which at the same time can be very paternalistic when applied to other areas. You see this in terms of policies on things like alcohol and drugs in particular, but also areas like prostitution, where the attitude is often that the people involved are sinners who both need help and punishment, and where there is an attitude of "we know best" about legislation and treatment options. The Nordic countries often looks liberal on the surface, but while they have secularised rapidly there is still an undercurrent of Christian moralistic ideas that have had a very firm grip in many areas, aided by the long lasting state churches (e.g. the Norwegian Lutheran church was a state church with the government appointing key people until 2012).
- rasjani 9y ago
  I can echo the same is very valid in Finland. Certain behaviors that are very stereotypical here are Protestant/Lutheran by nature. It's also a bit amuzing as mostly people don't recognize that and are typically very anti religion or atheist.
kpil 9y ago
Here are some topics that have actively not been a topic for political discussions for at least the last 15 years: The immigration, the housing bubble, the failed city planning on all scales, the inefficient patchwork of regional authorities (Kommuner) in the large regions, the overinflated financial system, the deindustrialization, and the drug politics. All of them are rather urgent, but instead we get virtue signalling and distancing from the nationalist party, pseudo debates about tax-levels (55% or 54%) and endless mantras regarding "healthcare" and "schools" while ironically those systems are still good but are slowly deteriorating due to New Public Management, unhinged privatisation and a good deal of incompetence. None of which is discussed except maybe the last few weeks when a properly virtue-signalling but spectacularly incompetent General Director managed to outsource classified information to Serbia of all places. It's obvious that the drug politics has failed. The only thing we need to do is to look at the facts (almost worst in EU), think and discuss, and then modify. But no. Right now we are just feeding the criminal gangs earning money on lighter drugs such as cannabis where there is an unstoppable demand, while coming down so hard on the heavier users that they literally die on the streets. One mistake or relapse while on a program - and they are kicked out on the street again. But why? I honestly don't know. Swedish government bodies seems to have a very hard time changing their position, especially when it involves admitting that they have been wrong. Swedes are also very conformist - almost like a big insecure high school class where everyone say the same thing, wear the same things, and bully anyone that sticks out even just a little bit, so it could be hard to discuss sensitive topics.

rwnspace 9y ago

It's peculiar how reports of sensible policy make me feel Portugal is adorned in rubies and roses. Here in the UK the Home Office recently said they have no plans to look at even the classification of cannabis. Despite most local police forces not bothering with anything but factories, a majority of population supporting legalisation/decriminalisation, and global trends. We are comparatively medieval but for a few smart initiatives. I have heard that Germany and Norway/Sweden also have some very similar attitudes: I blame Calvinism. I could rant for hours on alcohol and tobacco policy in the UK. A little knowledge of the field of Harm Reduction opens a lot of avenues for criticism. Particularly increasing taxation, which extracts most from the working class and is effective in few use-cases. The UK isn't alone: look up the EU's May 2017 'Tobacco Product Directive' regarding E-cigs. Read: lobbying from groups that are responsible for millions of deaths and public cost are strangling and monopolising a market and technology that is an incredible source of harm reduction... I'm struggling to hold my tongue at this point. We have a large problem with a political class who don't listen to reason or evidence, simply an innately conservative discourse makes the problem look smaller than it really is. It's fantastic to read a positive outlook on Portugal's policy - it has been smeared countless times here.

libertine 9y ago
Here in Portugal I think there's still quite a path to go to legalize some drugs honestly - some country's are jumping right into it, heads first, but they are forgetting precisely the addiction factor and what health care structures and mindset are required to deal with this. No matter how harmless a drug is, there are always inherent issues bound to it's consumption.
- rwnspace 9y ago
  I am not entirely sure that legalisation alone increases unhealthy usage. I think people that fit profiles which make substance addiction a significant risk, are mostly the same profiles that don't respect 'the law because it's law'. At the same time, I know of plenty of people who drink dangerously but don't touch other substances. The comparison is difficult because of all the factors that promote drinking in society. Mindset/cultural attitudes are the central question. Say if the UK's binge-drinking culture transposes to binge-consumption, and introducing legality is considered an opened door, then the healthcare structures are critical. It's also probably quite hard to educate GPs - who seem to be big on drinking away their stresses at uni but avoiding other drugs - into an open mindset that identifies the right problems. The pros and cons seem to accommodate a careful optimism and evolution-of-culture outlook. Not necessarily sweeping reforms. The problem for this view is that those with vested interests support sweeping anti-reform, whatever way you want to look at it.

alkonaut 9y ago

What most keeps me away from hard drugs isn't that the addiction is similar to a horrible disease, but to 99% that it (society's stigma) would cost me my job and my family. I admire the way in which Portugal removed the stigma of existing addicts and how it's considered a disease and not as stigmatized as here (Sweden) but I can't say the "threat of being stigmatized" is 100% negative. You can't have it both ways I guess.