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'Drug use is a health problem': inside one of the oldest legal consumption rooms

kranke155 3y ago
Its obviously a health problem. Portugal has one of the most successful drug programs in the world, and it was done through decriminalisation, support for drug users, and taking care of the pandemic of heavy drug usage as a health problem. Being Portuguese I've heard the people who were in charge of the decriminalisation program talk on podcasts. They directly talk about it as a "pandemic", and that they saw similar transmission profiles as a contagious disease when they studied the growth in users. Their solution was to decriminalise personal usage, support users to prevent HIV transmissions through needle reuse (one of the the biggest successes of the program was the enormous reduction in HIV transmission) and treat the issue as a public health problem - send addicts to psychiatrists, not jail. The result is Portugal, a middle-high income country is somewhere in the top 10 safest countries in the world, and drug usage is either same as its neighbours or lower.
- flappyeagle 3y ago
  Even Portugal seems to be having second thoughts on the matter.
  - deleted 3y ago
    [deleted]
  - kranke155 3y ago
    Where did you get this from? No one I know seriously considers changing the structure that's in place. Maybe some politician said something and it somehow reached your news feed.
    - sigzero 3y ago
      "The number of Portuguese adults who reported prior use of illicit adult drugs rose from 7.8% in 2001 to 12.8% in 2022 — still below European averages but a significant rise nonetheless. Overdose rates now stand at a 12-year high and have doubled in Lisbon since 2019." That is just the first Google hit. https://knowledge.wharton.upenn.edu/article/is-portugals-drug-decriminalization-a-failure-or-success-the-answer-isnt-so-simple/ https://knowledge.wharton.upenn.edu/article/is-portugals-dru...
      - kranke155 3y ago
        "still below European averages" being literally my point. The prediction (at the time) by those against the program was that Portugal would become a giant Amsterdam, and drug tourism would rise and the country would be awash in drugs and drug users. None of that happened. We are still around or below European averages.
      - kranke155 3y ago
        OP was saying this as if the Portuguese were having second thoughts, not a US institute report.
      - alistairSH 3y ago
        And those increases run in conjunction with decreased funding and outsourcing of the programs.
      - polygamous_bat 3y ago
        > The number of Portuguese adults who reported prior use of illicit adult drugs rose from 7.8% in 2001 to 12.8% in 2022 Isn’t this consistent with decriminalization that people aren’t afraid to talk about past drug use? You see similar statistics with, say, people coming out of the closet when homosexuality is decriminalized; which conservatives like to paint as “legalization making people gay”. The OD cases could also be from people more readily calling for help rather than trying to cover up.
    - twisteriffic 3y ago
      It's an evergreen topic on north american conservative talk radio. Our local right wing talking head brought it up this week as part of an effort to erode support for the existing supervised consumption site in our city. As evidenced by a few comments in this thread, a lot of people see drug use solely as a sign of moral failing on the part of the user and will refuse to accept any solutions that don't involve punishment.
      - throwuwu 3y ago
        They would likely accept it if it came with strict requirements that the addicts must also undergo counseling and engage in a job/housing search if they are currently unemployed or homeless. It’s not punishment that most people on the right want, it’s personal responsibility of which being punished for criminal activity is just a small component. If the addicts using these centres were demonstrated to be making real progress towards getting clean and reintegrated into society then the vast majority of conservatives would support them. The opposition is to a policy that is essentially no different from legalizing opium dens that support only the habit without requiring treatment.
        gaganyaan 3y ago
        The right wing people I know would never accept it, even if it came with counseling and all that. They have rejected Portugal's approach and said that that's just giving in to the druggies. There might be some conservative people that agree with you, but I think most strongly religious conservatives wouldn't. IMO it does come down to punishment. Druggies have sinned and must be punished, spare the rod and all that.
        kranke155 3y ago
        This is such a bizarre idea. Thanks to this thread, I learnt that the entire Portuguese drug program now costs something like 16€ million. The results for that is - top 10 country in safety in the world - pretty average results in drug usage in the population. For 16! Million! That's a preposterous result.
      - 3y ago
    - pcardoso 3y ago
      Portuguese here: I read that the current program is underfunded and having issues. https://www.publico.pt/2023/10/31/sociedade/noticia/consumo-droga-volta-ruas-nao-conseguir-dar-resposta-afluencia-2068368 https://www.publico.pt/2023/10/31/sociedade/noticia/consumo-...
      - HideousKojima 3y ago
        I don't know about Portuguese politics, but at least here in the US ~90% of the time when I hear that something is "underfunded" or "had funding cut" and look into it the reality ends up being "funding for the program was not increased at the rate at which advocates wanted" but actual funding levels stayed the same or continued to increase. Are there any hard numbers for actual past funding levels compared to the present?
        kranke155 3y ago
        I could try and find this if you're that interested. Likely I can find a portuguese level source for it.
        kranke155 3y ago
        "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. After years of economic crisis, Portugal decentralized its drug oversight operation in 2012. A funding drop from 76 million euros ($82.7 million) to 16 million euros ($17.4 million) forced Portugal’s main institution to outsource work previously done by the state to nonprofit groups, including the street teams that engage with people who use drugs." From the Washington Post article. https://web.archive.org/web/20230816172031/https://www.washingtonpost.com/world/2023/07/07/portugal-drugs-decriminalization-heroin-crack/ https://web.archive.org/web/20230816172031/https://www.washi...
      - kranke155 3y ago
        The commenters seem to me to be more saying that the program itself is somehow flawed. What flaws it has, of course, are always quite nebulous, and seem to apply more to US efforts than our own.
    - gruez 3y ago
      Not the guy you replied to but: https://news.ycombinator.com/item?id=36638752 https://news.ycombinator.com/item?id=36638752
      - samuelblum 3y ago
        sorry Gruez I don't know how to contact you. I am searching the ashley madison leak database. Do you know where I still could find it (piratebay links dont work anymore). Thank you !
        jimbob45 3y ago
        Stick an email in your profile if you want someone to contact you. Also, 4chan is probably a better forum for your question. Specifically, the torrents board.
        samuelblum 3y ago
        Thank you I did it !
        samuelblum 3y ago
        I mean I put an email adress on my profile !
        samuelblum 3y ago
        I asked the Ashley Madison files to you because you had them in 2015 https://news.ycombinator.com/item?id=10083708 https://news.ycombinator.com/item?id=10083708
      - kranke155 3y ago
        A paywalled article by the Washington Post. If you want to hear from the people who implemented the program itself, their thoughts and how successful they were, there are Portuguese language podcasts. Maybe OAI Whisper can translate them. There's plenty of coverage in local media about the issues with the program. Many related to underfunding. Something like 80% less than it was in previous years, according to the comments in your HN link. The points I made - focus on public health - psychiatrists instead of jail - HIV transmission massively reduced - remain.
    - thomastjeffery 3y ago
      > Maybe some politician said something and it somehow reached your news feed. Yes, except that instead of politicians, it's "police" (and statisticians); and instead of a news feed, it's literally the article we are commenting on.
      - kranke155 3y ago
        Please quote the part of the article that's being commented on that refers to the police being against decriminalisation in Portugal. All I found was "Crimes such as robbery in public spaces rose 14% from 2021 to 2022, which police have in part blamed on the rise in drug use." Are you American? Is this some point of pride for you to be agaisnt this kind of program?
        thomastjeffery 3y ago
        > Portugal decriminalised consumption of all drugs for personal use in 2001; it technically remains against the law, but instead of prison, users are registered by police and referred for help (attendance is voluntary). In the early days, it appeared to be an unequivocal success: HIV transmission rates via syringes dropped, as did the number of overdoses, and prison populations were down 16.5% by 2008. But a recent national survey shows illicit drug use up from 7.8% to 12.8% between 2001 and 2022; overdose rates are at a 12-year high, having nearly doubled in Lisbon between 2019 and 2023 (this is still below the European average). In Porto, there has been a 24% jump in drug paraphernalia being collected from city streets in the year to 2022, with this year set to outpace that. Crimes such as robbery in public spaces rose 14% from 2021 to 2022, which police have in part blamed on the rise in drug use. (italics for emphasis) > Are you American? Yes > Is this some point of pride for you to be agaisnt this kind of program? On the contrary! I am in favor of this kind of program. I am very critical of my country's war on drugs. It is a war with one singular belligerent: US.
        kranke155 3y ago
        There is no source for this, and it does not say the police want to change the program at all.
    - lossolo 3y ago
      https://www.washingtonpost.com/world/2023/07/07/portugal-drugs-decriminalization-heroin-crack/ https://www.washingtonpost.com/world/2023/07/07/portugal-dru...
      - kranke155 3y ago
        Are you happy to post this having read the whole thing or just the headline? I've read this article since everyone here kept quoting it. It contains two "criticisms". First Porto's well connected mayor, Rui Moreira, and his people, saying that the problem is out of control. It very likely is, in Porto. I live there and it's kind of shit since the pandemic. The second one (and in my view the only one that matters) is by the architect of the program Joao Goulao. "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. After years of economic crisis, Portugal decentralized its drug oversight operation in 2012. A funding drop from 76 million euros ($82.7 million) to 16 million euros ($17.4 million) forced Portugal’s main institution to outsource work previously done by the state to nonprofit groups, including the street teams that engage with people who use drugs." So yeah here's the thing. No one is having second thoughts about the program, they've just massively defunded it to the point its architect says it barely works, and the Porto mayor got to complain about it to the Washington Post, likely because he has a really good PR company. That's it. Rui Moreira is not even a part of any major party. No data on Portuguese support for the program is ever mentioned. No major politician is ever quoted. The statement that "the Portuguese are having second thoughts" remains unsourced, unless you are talking about Rui Moreira.
        lossolo 3y ago
        > Are you happy to post this having read the whole thing or just the headline? I've read it in July.
  - lossolo 3y ago
    Can anyone explain why this comment was downvoted? Multiple sources linked below provide justification for the commenter's statement. Meanwhile, the person claiming otherwise relies solely on personal opinion and attempts to discredit these sources, suggesting they have an ulterior motive. What has been happening lately on Hacker News?
    - kranke155 3y ago
      Because it's not true. The Portuguese are NOT having second thoughts on the matter. There is a poorly sourced, vague article on the Washington Post. I've just read this article. It contains two "criticisms". First Porto's well connected mayor, Rui Moreira, and his people, saying that the problem is out of control. It very likely is, in Porto. I live there and it's kind of shit since the pandemic. The second one (and in my view the only one that matters) is by the architect of the program Joao Goulao. "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. After years of economic crisis, Portugal decentralized its drug oversight operation in 2012. A funding drop from 76 million euros ($82.7 million) to 16 million euros ($17.4 million) forced Portugal’s main institution to outsource work previously done by the state to nonprofit groups, including the street teams that engage with people who use drugs." So yeah here's the thing. No one is having second thoughts about the program, they've just massively defunded it to the point its architect says it barely works, and the Porto mayor got to complain about it to the Washington Post, likely because he has a really good PR company. Rui Moreira is not part of any major political party. No major politician is ever quoted in the article. No data is shown on the topic showing that the Portuguese population is turning against the program. So the statement that "The Portuguese are having second thoughts on the matter" remains completely unsourced.
      - lossolo 3y ago
        Funding of a program is a problem but how funding explains this? The number of Portuguese adults who reported prior use of illicit adult drugs rose from 7.8% in 2001 to 12.8% in 2022 — still below European averages but a significant rise nonetheless. Overdose rates now stand at a 12-year high and have doubled in Lisbon since 2019. Crime, often seen as at least loosely related to illegal drug addiction, rose 14% just from 2021 to 2022. Sewage samples of cocaine and ketamine rank among the highest in Europe (with weekend spikes) and drug encampments have appeared along with a European rarity: private security forces.
- api 3y ago
  It's been far less successful in the USA, and I think the reason is probably that US governments don't know how to do anything except tax and police. So we decriminalize, which removes the law enforcement deterrent, but then we do little to nothing when it comes to treatment, counseling, rehabilitation, etc. We will pick up the body when they die on the street from an OD though, so that's something.
  - kranke155 3y ago
    As far as I know, the US decriminalised with little funding for the health programs that follow it. that's been the main criticism I've heard.
- vasco 3y ago
  I'm not sure how much to self-congratulate when Portugal has one of the highest rates of antidepressant usage in the world on the back of 20 years of also one of the highest rates of growth in consumption of ADs among all countries: https://www.statista.com/statistics/283072/antidepressant-consumption-in-selected-countries/ https://www.statista.com/statistics/283072/antidepressant-co... In my opinion people are just medicating in other ways, but life still sucks.
  - kranke155 3y ago
    What the heck makes you think that heroin and AD use is related? You could make the argument for it, but this seems completely out of left field.
    - vasco 3y ago
      The connection between depression, trauma, etc and substance abuse is widely documented. In tough times people drink more alcohol and do more drugs. https://americanaddictioncenters.org/treating-depression-substance-abuse https://americanaddictioncenters.org/treating-depression-sub... https://www.addictioncenter.com/addiction/depression-and-addiction/ https://www.addictioncenter.com/addiction/depression-and-add... > Depression can increase the risk of chronic illness, including the disease of substance abuse. Up to a third of clinically depressed people engage in drug or alcohol abuse. These chemical intoxicants can become a form of self-medication for soothing the feelings of low self-worth, hopelessness, and despair that characterize this mental health disorder. Perhaps I miss some nuance of what you're questioning because I find it surprising that my point was strange to you and now I'm confused.
      - kranke155 3y ago
        Sure, but the OP is about heavy drugs. Antidepressant use is not illegal.
        vasco 3y ago
        Your question was "What the heck makes you think that heroin and AD use is related?", and I answered. I didn't say they were illegal, I just showed that while some type of substance abuse went down, another type went up. Both related to mental health issues. I don't think this is some wild take.
- someonehere 3y ago
  Recently there’s been talk about how it isn’t working after all: https://archive.is/DmMeN https://archive.is/DmMeN I also work with someone from Portugal who says it isn’t all that it’s cracked up be. I know San Francisco has tried to pilot this but hasn’t been successful. I also know Vancouver has a problem with dealers fighting over turf near safe consumption sites. When NY opened up a safe consumption site, the same thing happened.
  - kranke155 3y ago
    I've just read this article. Have you? "not working at all" is an overstatement, but might be logical since they cut funding by 60-70% or so (news to me but helps explain recent issues). It contains two "criticisms". First Porto's well connected mayor, Rui Moreira, and his people, saying that the problem is out of control. It very likely is, in Porto. I live there and it's kind of shit since the pandemic. The second one (and in my view the only one that matters) is by the architect of the program Joao Goulao. "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. After years of economic crisis, Portugal decentralized its drug oversight operation in 2012. A funding drop from 76 million euros ($82.7 million) to 16 million euros ($17.4 million) forced Portugal’s main institution to outsource work previously done by the state to nonprofit groups, including the street teams that engage with people who use drugs." So yeah here's the thing. No one is having second thoughts about the program, they've just massively defunded it to the point its architect says it barely works, and the Porto mayor got to complain about it to the Washington Post, likely because he has a really good PR company. That's it. Rui Moreira is not even a part of any major party. No data on Portuguese support for the program is ever mentioned. No major politician is ever quoted.
acadapter 3y ago
Try telling that to Sweden. Some societies are really stubborn about punishing it as a crime against society and a lack of character, despite the harm it causes.
- kranke155 3y ago
  I've heard Sweden had a notorious doctor who had some public profile in the 1960s talk about horrible drugs are, and that stuck in the society. I'd like to know who the man is and what the story is about, tbh. This was just banter.
  - aredox 3y ago
    Isn't that Bejerot, the same scumbag who "invented" Stockholm Syndrome to silence a female hostage who criticised hs mishandling of an hostage situation?
    - Lexforce 3y ago
      Yes, Nils Bejerot was the guy. He saw drug addiction almost as a ”cultural virus” that needed to be stomped out of society. He educated the swedish police on these matters. Sometimes known as the ”father of swedish drug policy”. He has been discussed on some podcasts, but only in swedish afaik. (Yes I am a swede)
  - gerikson 3y ago
    Sweden has a long history where proponents of abstinence to alcohol have been influential in health care decisions and politics. This naturally extends to the view on drugs. Combine this with a historical Lutheran view of probity and personal responsibility, and it's easy to see why drugs have been branded as entirely detrimental. Sweden is a lot more liberal when it comes to the sale and promotion of alchohol nowadays, even if it's hard to believe. The view on recreational drugs is following, albeit slowly. It will be harder and harder to justify treating weed as akin to heroin as people are exposed to cultural norms in the US (where most popular culture comes from here) As an example, Sara Skyttedal, MEP for the Christian Democrats, has publicly advocated for legalization of certain drugs. Considering her party is part of the right-wing coalition in government, this is kinda big, especially as KD is historically full of teetotallers.
asylteltine 3y ago
[flagged]
- zaphar 3y ago
  It's conceptually that simple. But like many simple concepts implementation requires understanding and dealing with the rather more complex environment and circumstances around the problem in the first place.
  - asylteltine 3y ago
    As if that mindset has helped at all considering how bad drug problems continue to be and just get worse
    - zaphar 3y ago
      I would suggest that none of the current solutions actually take into account the complex environment and circumstances around the problem. We don't exactly create cultures of resiliency right now and most of the approaches on both the right and left sides don't tackle the problem of resiliency either. Advice to someone that they should "just not do that" aren't working either. There are no shortage of people who told and are telling addicts exactly that. What do you suppose would make them actually capable of following that advice?
- thomastjeffery 3y ago
  ...and if you already have? If your solution is to convince every single person in the world who hasn't used drugs to just not try them, then you still have to deal with the ones who have! That just ain't gonna work.
- deleted 3y ago
  [deleted]
- alistairSH 3y ago
  You do realize that many addicts (of opioids) got that way after using legitamely prescribed pain-killers? And many others have other underlying health problems (often mental)?
hanniabu 3y ago
[flagged]
- coffeebeqn 3y ago
  How so? No totalitarian government to execute you? I’m pretty sure people have been getting fucked up even before capitalism
- lacrimacida 3y ago
  Really? Tell that to Adganistan which has a huge drug problem. People get hooked on whatever is available, and there’s almost always something available, few exceptions are countries with capital punishment for this offense.
- andsoitis 3y ago
  > Drug use is a capitalism problem In what way?
CaptainZapp 3y ago
What the article doesn't mention that Switzerland also supplies hard drugs, including heroin to hard core addicts. That was and is an integral part of the harm reduction pillar besides the opportunity to use in a safe and clean environment.
thomastjeffery 3y ago
Drug use is a health problem that is resolved by decriminalization and treatment. That still leaves some closely related problems: * black market drug sales * people who would rather use drugs than do something else with their lives * a society that fails to present more attractive opportunities (to every person) than using drugs These problems need their own solutions. Some people think that criminalization is the solution to all of them. That solution has been tried in every extreme, and utterly failed every time.
- chpatrick 3y ago
  I think people often end up doing drugs rather than something else because they've fallen through the social safety net (if it even exists) and they don't have anything else to do. https://en.wikipedia.org/wiki/Rat_Park https://en.wikipedia.org/wiki/Rat_Park
- willsmith72 3y ago
  This is my problem with the Vancouver approach. Great, it's decriminalised. People will no longer have a record, can get out of the loop easier. But is anyone out there helping them? Otherwise, you're still getting nowhere
  - thomastjeffery 3y ago
    What I keep hearing from Canadians is that the healthcare system is systemically underfunded. This problem is not exclusive to addicts. Here in the US, we have a different version of the same problem.
  - AaronM 3y ago
    The longest journey starts with one step. Its a good first step and your right, more needs to be done than just decriminalizing it.
- deleted 3y ago
  [deleted]
- beaeglebeach 3y ago
4death4 3y ago
I would say drug addiction is partially a health problem. But, if you’re strung out on the streets then it’s also a different kind of problem. And what about before addiction or even first use? What kind of problem are drugs then? The fact that kids (16+) have easy access to drugs is yet another type of problem. The focus on decriminalization is misguided, in my opinion. Not because doing drugs as an addict is inherently a crime, but because addiction occurs way too late in the cycle to really do anything about.
- AaronM 3y ago
  Lots of studies about marijuana use after legalization. Many point to a reduction or no change in the use by teens. https://www.cnn.com/2019/07/08/health/recreational-marijuana-laws-teens-study/index.html https://www.cnn.com/2019/07/08/health/recreational-marijuana... One could also argue that removing blackmarket sources would make it more difficult to find drugs as an adolescent, as adults are less likely to buy for teenagers. This study seems to support that idea https://www.newscientist.com/article/2209053-us-teens-may-be-finding-it-harder-to-buy-cannabis-after-legalisation/ https://www.newscientist.com/article/2209053-us-teens-may-be...
  - 4death4 3y ago
    I’m not talking about marijuana. I’m talking about opiates. Often, initial exposure comes through entirely legal means, e.g. pain prescription for wisdom teeth removal. Certain classes of drugs are highly addictive. There is a major profit incentive to hook users on such drugs. This really doesn’t apply to marijuana because it’s not that addictive.
- jedrek 3y ago
  > Not because doing drugs as an addict is inherently a crime, but because addiction occurs way too late in the cycle to really do anything about. What's your source on this, or are you just going by vibes?

Its obviously a health problem. Portugal has one of the most successful drug programs in the world, and it was done through decriminalisation, support for drug users, and taking care of the pandemic of heavy drug usage as a health problem. Being Portuguese I've heard the people who were in charge of the decriminalisation program talk on podcasts. They directly talk about it as a "pandemic", and that they saw similar transmission profiles as a contagious disease when they studied the growth in users. Their solution was to decriminalise personal usage, support users to prevent HIV transmissions through needle reuse (one of the the biggest successes of the program was the enormous reduction in HIV transmission) and treat the issue as a public health problem - send addicts to psychiatrists, not jail. The result is Portugal, a middle-high income country is somewhere in the top 10 safest countries in the world, and drug usage is either same as its neighbours or lower.

flappyeagle 3y ago
Even Portugal seems to be having second thoughts on the matter.
- deleted 3y ago
  [deleted]
- kranke155 3y ago
  Where did you get this from? No one I know seriously considers changing the structure that's in place. Maybe some politician said something and it somehow reached your news feed.
  - sigzero 3y ago
    "The number of Portuguese adults who reported prior use of illicit adult drugs rose from 7.8% in 2001 to 12.8% in 2022 — still below European averages but a significant rise nonetheless. Overdose rates now stand at a 12-year high and have doubled in Lisbon since 2019." That is just the first Google hit. https://knowledge.wharton.upenn.edu/article/is-portugals-drug-decriminalization-a-failure-or-success-the-answer-isnt-so-simple/ https://knowledge.wharton.upenn.edu/article/is-portugals-dru...
    - kranke155 3y ago
      "still below European averages" being literally my point. The prediction (at the time) by those against the program was that Portugal would become a giant Amsterdam, and drug tourism would rise and the country would be awash in drugs and drug users. None of that happened. We are still around or below European averages.
    - kranke155 3y ago
      OP was saying this as if the Portuguese were having second thoughts, not a US institute report.
    - alistairSH 3y ago
      And those increases run in conjunction with decreased funding and outsourcing of the programs.
    - polygamous_bat 3y ago
      > The number of Portuguese adults who reported prior use of illicit adult drugs rose from 7.8% in 2001 to 12.8% in 2022 Isn’t this consistent with decriminalization that people aren’t afraid to talk about past drug use? You see similar statistics with, say, people coming out of the closet when homosexuality is decriminalized; which conservatives like to paint as “legalization making people gay”. The OD cases could also be from people more readily calling for help rather than trying to cover up.
  - twisteriffic 3y ago
    It's an evergreen topic on north american conservative talk radio. Our local right wing talking head brought it up this week as part of an effort to erode support for the existing supervised consumption site in our city. As evidenced by a few comments in this thread, a lot of people see drug use solely as a sign of moral failing on the part of the user and will refuse to accept any solutions that don't involve punishment.
    - throwuwu 3y ago
      They would likely accept it if it came with strict requirements that the addicts must also undergo counseling and engage in a job/housing search if they are currently unemployed or homeless. It’s not punishment that most people on the right want, it’s personal responsibility of which being punished for criminal activity is just a small component. If the addicts using these centres were demonstrated to be making real progress towards getting clean and reintegrated into society then the vast majority of conservatives would support them. The opposition is to a policy that is essentially no different from legalizing opium dens that support only the habit without requiring treatment.
      - gaganyaan 3y ago
        The right wing people I know would never accept it, even if it came with counseling and all that. They have rejected Portugal's approach and said that that's just giving in to the druggies. There might be some conservative people that agree with you, but I think most strongly religious conservatives wouldn't. IMO it does come down to punishment. Druggies have sinned and must be punished, spare the rod and all that.
        kranke155 3y ago
        This is such a bizarre idea. Thanks to this thread, I learnt that the entire Portuguese drug program now costs something like 16€ million. The results for that is - top 10 country in safety in the world - pretty average results in drug usage in the population. For 16! Million! That's a preposterous result.
    - 3y ago
  - pcardoso 3y ago
    Portuguese here: I read that the current program is underfunded and having issues. https://www.publico.pt/2023/10/31/sociedade/noticia/consumo-droga-volta-ruas-nao-conseguir-dar-resposta-afluencia-2068368 https://www.publico.pt/2023/10/31/sociedade/noticia/consumo-...
    - HideousKojima 3y ago
      I don't know about Portuguese politics, but at least here in the US ~90% of the time when I hear that something is "underfunded" or "had funding cut" and look into it the reality ends up being "funding for the program was not increased at the rate at which advocates wanted" but actual funding levels stayed the same or continued to increase. Are there any hard numbers for actual past funding levels compared to the present?
      - kranke155 3y ago
        I could try and find this if you're that interested. Likely I can find a portuguese level source for it.
      - kranke155 3y ago
        "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. After years of economic crisis, Portugal decentralized its drug oversight operation in 2012. A funding drop from 76 million euros ($82.7 million) to 16 million euros ($17.4 million) forced Portugal’s main institution to outsource work previously done by the state to nonprofit groups, including the street teams that engage with people who use drugs." From the Washington Post article. https://web.archive.org/web/20230816172031/https://www.washingtonpost.com/world/2023/07/07/portugal-drugs-decriminalization-heroin-crack/ https://web.archive.org/web/20230816172031/https://www.washi...
    - kranke155 3y ago
      The commenters seem to me to be more saying that the program itself is somehow flawed. What flaws it has, of course, are always quite nebulous, and seem to apply more to US efforts than our own.
  - gruez 3y ago
    Not the guy you replied to but: https://news.ycombinator.com/item?id=36638752 https://news.ycombinator.com/item?id=36638752
    - samuelblum 3y ago
      sorry Gruez I don't know how to contact you. I am searching the ashley madison leak database. Do you know where I still could find it (piratebay links dont work anymore). Thank you !
      - jimbob45 3y ago
        Stick an email in your profile if you want someone to contact you. Also, 4chan is probably a better forum for your question. Specifically, the torrents board.
        samuelblum 3y ago
        Thank you I did it !
        samuelblum 3y ago
        I mean I put an email adress on my profile !
        samuelblum 3y ago
        I asked the Ashley Madison files to you because you had them in 2015 https://news.ycombinator.com/item?id=10083708 https://news.ycombinator.com/item?id=10083708
    - kranke155 3y ago
      A paywalled article by the Washington Post. If you want to hear from the people who implemented the program itself, their thoughts and how successful they were, there are Portuguese language podcasts. Maybe OAI Whisper can translate them. There's plenty of coverage in local media about the issues with the program. Many related to underfunding. Something like 80% less than it was in previous years, according to the comments in your HN link. The points I made - focus on public health - psychiatrists instead of jail - HIV transmission massively reduced - remain.
  - thomastjeffery 3y ago
    > Maybe some politician said something and it somehow reached your news feed. Yes, except that instead of politicians, it's "police" (and statisticians); and instead of a news feed, it's literally the article we are commenting on.
    - kranke155 3y ago
      Please quote the part of the article that's being commented on that refers to the police being against decriminalisation in Portugal. All I found was "Crimes such as robbery in public spaces rose 14% from 2021 to 2022, which police have in part blamed on the rise in drug use." Are you American? Is this some point of pride for you to be agaisnt this kind of program?
      - thomastjeffery 3y ago
        > Portugal decriminalised consumption of all drugs for personal use in 2001; it technically remains against the law, but instead of prison, users are registered by police and referred for help (attendance is voluntary). In the early days, it appeared to be an unequivocal success: HIV transmission rates via syringes dropped, as did the number of overdoses, and prison populations were down 16.5% by 2008. But a recent national survey shows illicit drug use up from 7.8% to 12.8% between 2001 and 2022; overdose rates are at a 12-year high, having nearly doubled in Lisbon between 2019 and 2023 (this is still below the European average). In Porto, there has been a 24% jump in drug paraphernalia being collected from city streets in the year to 2022, with this year set to outpace that. Crimes such as robbery in public spaces rose 14% from 2021 to 2022, which police have in part blamed on the rise in drug use. (italics for emphasis) > Are you American? Yes > Is this some point of pride for you to be agaisnt this kind of program? On the contrary! I am in favor of this kind of program. I am very critical of my country's war on drugs. It is a war with one singular belligerent: US.
        kranke155 3y ago
        There is no source for this, and it does not say the police want to change the program at all.
  - lossolo 3y ago
    https://www.washingtonpost.com/world/2023/07/07/portugal-drugs-decriminalization-heroin-crack/ https://www.washingtonpost.com/world/2023/07/07/portugal-dru...
    - kranke155 3y ago
      Are you happy to post this having read the whole thing or just the headline? I've read this article since everyone here kept quoting it. It contains two "criticisms". First Porto's well connected mayor, Rui Moreira, and his people, saying that the problem is out of control. It very likely is, in Porto. I live there and it's kind of shit since the pandemic. The second one (and in my view the only one that matters) is by the architect of the program Joao Goulao. "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. After years of economic crisis, Portugal decentralized its drug oversight operation in 2012. A funding drop from 76 million euros ($82.7 million) to 16 million euros ($17.4 million) forced Portugal’s main institution to outsource work previously done by the state to nonprofit groups, including the street teams that engage with people who use drugs." So yeah here's the thing. No one is having second thoughts about the program, they've just massively defunded it to the point its architect says it barely works, and the Porto mayor got to complain about it to the Washington Post, likely because he has a really good PR company. That's it. Rui Moreira is not even a part of any major party. No data on Portuguese support for the program is ever mentioned. No major politician is ever quoted. The statement that "the Portuguese are having second thoughts" remains unsourced, unless you are talking about Rui Moreira.
      - lossolo 3y ago
        > Are you happy to post this having read the whole thing or just the headline? I've read it in July.
- lossolo 3y ago
  Can anyone explain why this comment was downvoted? Multiple sources linked below provide justification for the commenter's statement. Meanwhile, the person claiming otherwise relies solely on personal opinion and attempts to discredit these sources, suggesting they have an ulterior motive. What has been happening lately on Hacker News?
  - kranke155 3y ago
    Because it's not true. The Portuguese are NOT having second thoughts on the matter. There is a poorly sourced, vague article on the Washington Post. I've just read this article. It contains two "criticisms". First Porto's well connected mayor, Rui Moreira, and his people, saying that the problem is out of control. It very likely is, in Porto. I live there and it's kind of shit since the pandemic. The second one (and in my view the only one that matters) is by the architect of the program Joao Goulao. "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. After years of economic crisis, Portugal decentralized its drug oversight operation in 2012. A funding drop from 76 million euros ($82.7 million) to 16 million euros ($17.4 million) forced Portugal’s main institution to outsource work previously done by the state to nonprofit groups, including the street teams that engage with people who use drugs." So yeah here's the thing. No one is having second thoughts about the program, they've just massively defunded it to the point its architect says it barely works, and the Porto mayor got to complain about it to the Washington Post, likely because he has a really good PR company. Rui Moreira is not part of any major political party. No major politician is ever quoted in the article. No data is shown on the topic showing that the Portuguese population is turning against the program. So the statement that "The Portuguese are having second thoughts on the matter" remains completely unsourced.
    - lossolo 3y ago
      Funding of a program is a problem but how funding explains this? The number of Portuguese adults who reported prior use of illicit adult drugs rose from 7.8% in 2001 to 12.8% in 2022 — still below European averages but a significant rise nonetheless. Overdose rates now stand at a 12-year high and have doubled in Lisbon since 2019. Crime, often seen as at least loosely related to illegal drug addiction, rose 14% just from 2021 to 2022. Sewage samples of cocaine and ketamine rank among the highest in Europe (with weekend spikes) and drug encampments have appeared along with a European rarity: private security forces.
api 3y ago
It's been far less successful in the USA, and I think the reason is probably that US governments don't know how to do anything except tax and police. So we decriminalize, which removes the law enforcement deterrent, but then we do little to nothing when it comes to treatment, counseling, rehabilitation, etc. We will pick up the body when they die on the street from an OD though, so that's something.
- kranke155 3y ago
  As far as I know, the US decriminalised with little funding for the health programs that follow it. that's been the main criticism I've heard.
vasco 3y ago
I'm not sure how much to self-congratulate when Portugal has one of the highest rates of antidepressant usage in the world on the back of 20 years of also one of the highest rates of growth in consumption of ADs among all countries: https://www.statista.com/statistics/283072/antidepressant-consumption-in-selected-countries/ https://www.statista.com/statistics/283072/antidepressant-co... In my opinion people are just medicating in other ways, but life still sucks.
- kranke155 3y ago
  What the heck makes you think that heroin and AD use is related? You could make the argument for it, but this seems completely out of left field.
  - vasco 3y ago
    The connection between depression, trauma, etc and substance abuse is widely documented. In tough times people drink more alcohol and do more drugs. https://americanaddictioncenters.org/treating-depression-substance-abuse https://americanaddictioncenters.org/treating-depression-sub... https://www.addictioncenter.com/addiction/depression-and-addiction/ https://www.addictioncenter.com/addiction/depression-and-add... > Depression can increase the risk of chronic illness, including the disease of substance abuse. Up to a third of clinically depressed people engage in drug or alcohol abuse. These chemical intoxicants can become a form of self-medication for soothing the feelings of low self-worth, hopelessness, and despair that characterize this mental health disorder. Perhaps I miss some nuance of what you're questioning because I find it surprising that my point was strange to you and now I'm confused.
    - kranke155 3y ago
      Sure, but the OP is about heavy drugs. Antidepressant use is not illegal.
      - vasco 3y ago
        Your question was "What the heck makes you think that heroin and AD use is related?", and I answered. I didn't say they were illegal, I just showed that while some type of substance abuse went down, another type went up. Both related to mental health issues. I don't think this is some wild take.
someonehere 3y ago
Recently there’s been talk about how it isn’t working after all: https://archive.is/DmMeN https://archive.is/DmMeN I also work with someone from Portugal who says it isn’t all that it’s cracked up be. I know San Francisco has tried to pilot this but hasn’t been successful. I also know Vancouver has a problem with dealers fighting over turf near safe consumption sites. When NY opened up a safe consumption site, the same thing happened.
- kranke155 3y ago
  I've just read this article. Have you? "not working at all" is an overstatement, but might be logical since they cut funding by 60-70% or so (news to me but helps explain recent issues). It contains two "criticisms". First Porto's well connected mayor, Rui Moreira, and his people, saying that the problem is out of control. It very likely is, in Porto. I live there and it's kind of shit since the pandemic. The second one (and in my view the only one that matters) is by the architect of the program Joao Goulao. "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. After years of economic crisis, Portugal decentralized its drug oversight operation in 2012. A funding drop from 76 million euros ($82.7 million) to 16 million euros ($17.4 million) forced Portugal’s main institution to outsource work previously done by the state to nonprofit groups, including the street teams that engage with people who use drugs." So yeah here's the thing. No one is having second thoughts about the program, they've just massively defunded it to the point its architect says it barely works, and the Porto mayor got to complain about it to the Washington Post, likely because he has a really good PR company. That's it. Rui Moreira is not even a part of any major party. No data on Portuguese support for the program is ever mentioned. No major politician is ever quoted.

acadapter 3y ago

Try telling that to Sweden. Some societies are really stubborn about punishing it as a crime against society and a lack of character, despite the harm it causes.

kranke155 3y ago
I've heard Sweden had a notorious doctor who had some public profile in the 1960s talk about horrible drugs are, and that stuck in the society. I'd like to know who the man is and what the story is about, tbh. This was just banter.
- aredox 3y ago
  Isn't that Bejerot, the same scumbag who "invented" Stockholm Syndrome to silence a female hostage who criticised hs mishandling of an hostage situation?
  - Lexforce 3y ago
    Yes, Nils Bejerot was the guy. He saw drug addiction almost as a ”cultural virus” that needed to be stomped out of society. He educated the swedish police on these matters. Sometimes known as the ”father of swedish drug policy”. He has been discussed on some podcasts, but only in swedish afaik. (Yes I am a swede)
- gerikson 3y ago
  Sweden has a long history where proponents of abstinence to alcohol have been influential in health care decisions and politics. This naturally extends to the view on drugs. Combine this with a historical Lutheran view of probity and personal responsibility, and it's easy to see why drugs have been branded as entirely detrimental. Sweden is a lot more liberal when it comes to the sale and promotion of alchohol nowadays, even if it's hard to believe. The view on recreational drugs is following, albeit slowly. It will be harder and harder to justify treating weed as akin to heroin as people are exposed to cultural norms in the US (where most popular culture comes from here) As an example, Sara Skyttedal, MEP for the Christian Democrats, has publicly advocated for legalization of certain drugs. Considering her party is part of the right-wing coalition in government, this is kinda big, especially as KD is historically full of teetotallers.

asylteltine 3y ago

[flagged]

zaphar 3y ago
It's conceptually that simple. But like many simple concepts implementation requires understanding and dealing with the rather more complex environment and circumstances around the problem in the first place.
- asylteltine 3y ago
  As if that mindset has helped at all considering how bad drug problems continue to be and just get worse
  - zaphar 3y ago
    I would suggest that none of the current solutions actually take into account the complex environment and circumstances around the problem. We don't exactly create cultures of resiliency right now and most of the approaches on both the right and left sides don't tackle the problem of resiliency either. Advice to someone that they should "just not do that" aren't working either. There are no shortage of people who told and are telling addicts exactly that. What do you suppose would make them actually capable of following that advice?
thomastjeffery 3y ago
...and if you already have? If your solution is to convince every single person in the world who hasn't used drugs to just not try them, then you still have to deal with the ones who have! That just ain't gonna work.
deleted 3y ago
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alistairSH 3y ago
You do realize that many addicts (of opioids) got that way after using legitamely prescribed pain-killers? And many others have other underlying health problems (often mental)?

hanniabu 3y ago

[flagged]

coffeebeqn 3y ago
How so? No totalitarian government to execute you? I’m pretty sure people have been getting fucked up even before capitalism
lacrimacida 3y ago
Really? Tell that to Adganistan which has a huge drug problem. People get hooked on whatever is available, and there’s almost always something available, few exceptions are countries with capital punishment for this offense.
andsoitis 3y ago
> Drug use is a capitalism problem In what way?

CaptainZapp 3y ago

What the article doesn't mention that Switzerland also supplies hard drugs, including heroin to hard core addicts. That was and is an integral part of the harm reduction pillar besides the opportunity to use in a safe and clean environment.

thomastjeffery 3y ago

Drug use is a health problem that is resolved by decriminalization and treatment. That still leaves some closely related problems: * black market drug sales * people who would rather use drugs than do something else with their lives * a society that fails to present more attractive opportunities (to every person) than using drugs These problems need their own solutions. Some people think that criminalization is the solution to all of them. That solution has been tried in every extreme, and utterly failed every time.

chpatrick 3y ago
I think people often end up doing drugs rather than something else because they've fallen through the social safety net (if it even exists) and they don't have anything else to do. https://en.wikipedia.org/wiki/Rat_Park https://en.wikipedia.org/wiki/Rat_Park
willsmith72 3y ago
This is my problem with the Vancouver approach. Great, it's decriminalised. People will no longer have a record, can get out of the loop easier. But is anyone out there helping them? Otherwise, you're still getting nowhere
- thomastjeffery 3y ago
  What I keep hearing from Canadians is that the healthcare system is systemically underfunded. This problem is not exclusive to addicts. Here in the US, we have a different version of the same problem.
- AaronM 3y ago
  The longest journey starts with one step. Its a good first step and your right, more needs to be done than just decriminalizing it.
deleted 3y ago
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beaeglebeach 3y ago

4death4 3y ago

I would say drug addiction is partially a health problem. But, if you’re strung out on the streets then it’s also a different kind of problem. And what about before addiction or even first use? What kind of problem are drugs then? The fact that kids (16+) have easy access to drugs is yet another type of problem. The focus on decriminalization is misguided, in my opinion. Not because doing drugs as an addict is inherently a crime, but because addiction occurs way too late in the cycle to really do anything about.

AaronM 3y ago
Lots of studies about marijuana use after legalization. Many point to a reduction or no change in the use by teens. https://www.cnn.com/2019/07/08/health/recreational-marijuana-laws-teens-study/index.html https://www.cnn.com/2019/07/08/health/recreational-marijuana... One could also argue that removing blackmarket sources would make it more difficult to find drugs as an adolescent, as adults are less likely to buy for teenagers. This study seems to support that idea https://www.newscientist.com/article/2209053-us-teens-may-be-finding-it-harder-to-buy-cannabis-after-legalisation/ https://www.newscientist.com/article/2209053-us-teens-may-be...
- 4death4 3y ago
  I’m not talking about marijuana. I’m talking about opiates. Often, initial exposure comes through entirely legal means, e.g. pain prescription for wisdom teeth removal. Certain classes of drugs are highly addictive. There is a major profit incentive to hook users on such drugs. This really doesn’t apply to marijuana because it’s not that addictive.
jedrek 3y ago
> Not because doing drugs as an addict is inherently a crime, but because addiction occurs way too late in the cycle to really do anything about. What's your source on this, or are you just going by vibes?