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From the article you linked: > João Goulão — head of Portugal’s national institute on drug use and the architect of decriminalization — admitted to the local p

From the article you linked: > João Goulão — head of Portugal’s national institute on drug use and the architect of decriminalization — admitted to the local press in December that “what we have today no longer serves as an example to anyone.” Rather than fault the policy, however, he blames a lack of funding. > Twenty years ago, “we were quite successful in dealing with the big problem, the epidemic of heroin use and all the related effects,” Goulão said in an interview with The Washington Post. “But we have had a kind of disinvestment, a freezing in our response … and we lost some efficacy.” The story turns out to be much the same as a common trope for those who wish to undo successful policies here in the US: under-fund them as sabotage, and then call them failed when the lack of funding causes lower efficacy. Additionally, prohibitionist policies and the policing drug use has been rising (see 24,25,26 at https://substanceabusepolicy.biomedcentral.com/articles/10.1186/s13011-021-00394-7 https://substanceabusepolicy.biomedcentral.com/articles/10.1...) over the second half of the time drugs have been decriminalized, so the rollbacks in societal gains need to be taken with a grain of salt.

itsoktocry 3y ago
So it's not solved? Perpetually spending more and more money is not a solution. I'm also not surprised to see the architect blame funding as opposed to admitting their policy failed. Again, we are trying to do the same in Canada, and while overdoses are decreasing, these policies are not solving the crisis. In some places they are making it worse.
- kristopolous 3y ago
  > Perpetually spending more and more money is not a solution. That's how running a society works. The criminalize and lockup method isn't free of cost Are you expecting biological addiction to be like breeded out of the gene pool? How would a $0 cost solution eventually happen?
  - happytiger 3y ago
    I feel like many of these solutions are fueled first by ideology, and only then by the evidence. On the right, people criticize and blame the users, rant about personal responsibility, and try to lock drug users and the mentally ill up and throw away the keys. This is failed policy. On the left, people invest in legalization and treatment as a personal ideology and don’t seem to be willing to admit when their policies fail. It almost seems like a failed policy conflates to some kind of personal failure that cannot be examined or criticized. And instead of policy failure, it’s always a funding issue, no matter how many times consistent results emerge. This is looking more and more like failed policy too. I’ve seen it in Van, Portland, Sacramento, Seattle, San Francisco and LA, and it’s pretty consistently not only not getting better but getting much worse. Ultimately, neither approach seems to be working very well. And in the meantime people are living lives of hopelessness and despair in tremendously awful conditions. Are there no other options available than these two counter positions? I think we should be having more of an open dialogue about how to solve the problem and be more ready to examine the evidence, even when it doesn’t support our positions, for the greater good of those suffering, and I often see conversations on the topic break down into the tit for tat I’m seeing here. These kinds of conversations are the default, and solve nothing.
    - nullindividual 3y ago
      Neither Portland nor Seattle have received funding to tamper drug addiction to the necessary degree to provide indication that such a policy would work or not, which leads me to believe your other examples also did not get such funding, thus negating your entire argument, sans the failure of the lock em up policy, of course.
      - happytiger 3y ago
        But in doing so you’re doing precisely what I’ve referenced as leading with ideology. You are making assumptions about funding being the issue based on what you think should work and then attacking my argument by justifying your belief with assumptions to support the conclusion you want instead of letting the data and the facts lead.
    - 3y ago
- huytersd 3y ago
  You’re going to perpetually spend on crime caused by junkies, it’s serious financial burden on the healthcare system and a social burden on families. You’re much better off spending a fraction of that money on rehab.
  - ddd00001 3y ago
    [dead]
  - trogdor 3y ago
    Treatment works best when people are motivated to get clean. It doesn’t work when they are not. Moreover, the likelihood of good long-term outcomes decreases dramatically when addiction is comorbid with other serious mental illness. Sadly, I don’t believe that most mentally ill, homeless addicts are going to get better. It’s a terrible situation, and I don’t know of a solution. I don’t think anyone does. I would also note that most rehab facilities for substance use disorders espouse an abstinence-based approach to treatment. That approach simply doesn’t work. The standard of care for opioid use disorder is medication assisted treatment, which is both evidence-based and far more effective than abstinence-based programs. The difference in outcomes is stark, particularly since dropout often results in death. Bottom line, though, from my perspective: you can’t effectively treat people unless and until they are motivated to enter into and engage with a treatment program. “Junkies” of the type you describe rarely fit that bill. Drug courts are a good step in the right direction, but they need to take a more evidence-based approach to their operations. I wish there was an easy solution to this problem, but there isn’t.
turquoisevar 3y ago
To add to that, while Portugal is now often brought forward as the “poster child” now that efficacy stats benefit the “law & order” types, a lot of Western European countries have way more compassionate laws and regulations on drugs and far outperform the US both in stats as well as the boots in the ground situation on the streets. As per usual this is presented as a “uniquely American” issue, when in reality many other countries have found solutions to mitigate the issue.
- ddd00001 3y ago
  [dead]

itsoktocry 3y ago

So it's not solved? Perpetually spending more and more money is not a solution. I'm also not surprised to see the architect blame funding as opposed to admitting their policy failed. Again, we are trying to do the same in Canada, and while overdoses are decreasing, these policies are not solving the crisis. In some places they are making it worse.

kristopolous 3y ago
> Perpetually spending more and more money is not a solution. That's how running a society works. The criminalize and lockup method isn't free of cost Are you expecting biological addiction to be like breeded out of the gene pool? How would a $0 cost solution eventually happen?
- happytiger 3y ago
  I feel like many of these solutions are fueled first by ideology, and only then by the evidence. On the right, people criticize and blame the users, rant about personal responsibility, and try to lock drug users and the mentally ill up and throw away the keys. This is failed policy. On the left, people invest in legalization and treatment as a personal ideology and don’t seem to be willing to admit when their policies fail. It almost seems like a failed policy conflates to some kind of personal failure that cannot be examined or criticized. And instead of policy failure, it’s always a funding issue, no matter how many times consistent results emerge. This is looking more and more like failed policy too. I’ve seen it in Van, Portland, Sacramento, Seattle, San Francisco and LA, and it’s pretty consistently not only not getting better but getting much worse. Ultimately, neither approach seems to be working very well. And in the meantime people are living lives of hopelessness and despair in tremendously awful conditions. Are there no other options available than these two counter positions? I think we should be having more of an open dialogue about how to solve the problem and be more ready to examine the evidence, even when it doesn’t support our positions, for the greater good of those suffering, and I often see conversations on the topic break down into the tit for tat I’m seeing here. These kinds of conversations are the default, and solve nothing.
  - nullindividual 3y ago
    Neither Portland nor Seattle have received funding to tamper drug addiction to the necessary degree to provide indication that such a policy would work or not, which leads me to believe your other examples also did not get such funding, thus negating your entire argument, sans the failure of the lock em up policy, of course.
    - happytiger 3y ago
      But in doing so you’re doing precisely what I’ve referenced as leading with ideology. You are making assumptions about funding being the issue based on what you think should work and then attacking my argument by justifying your belief with assumptions to support the conclusion you want instead of letting the data and the facts lead.
  - 3y ago
huytersd 3y ago
You’re going to perpetually spend on crime caused by junkies, it’s serious financial burden on the healthcare system and a social burden on families. You’re much better off spending a fraction of that money on rehab.
- ddd00001 3y ago
  [dead]
- trogdor 3y ago
  Treatment works best when people are motivated to get clean. It doesn’t work when they are not. Moreover, the likelihood of good long-term outcomes decreases dramatically when addiction is comorbid with other serious mental illness. Sadly, I don’t believe that most mentally ill, homeless addicts are going to get better. It’s a terrible situation, and I don’t know of a solution. I don’t think anyone does. I would also note that most rehab facilities for substance use disorders espouse an abstinence-based approach to treatment. That approach simply doesn’t work. The standard of care for opioid use disorder is medication assisted treatment, which is both evidence-based and far more effective than abstinence-based programs. The difference in outcomes is stark, particularly since dropout often results in death. Bottom line, though, from my perspective: you can’t effectively treat people unless and until they are motivated to enter into and engage with a treatment program. “Junkies” of the type you describe rarely fit that bill. Drug courts are a good step in the right direction, but they need to take a more evidence-based approach to their operations. I wish there was an easy solution to this problem, but there isn’t.

turquoisevar 3y ago

To add to that, while Portugal is now often brought forward as the “poster child” now that efficacy stats benefit the “law & order” types, a lot of Western European countries have way more compassionate laws and regulations on drugs and far outperform the US both in stats as well as the boots in the ground situation on the streets. As per usual this is presented as a “uniquely American” issue, when in reality many other countries have found solutions to mitigate the issue.

ddd00001 3y ago
[dead]