How Portugal became a world leader in fighting drug addiction

Tiago Gomes is a man on the mend, determined to renounce cocaine and heroin. It’s been two months since the last use, a feat he credits to the nonprofit Crescer, which moved him off the streets into housing during the pandemic. Initially, he slept on the floor because he had to relearn the habits of being indoors. Now, he is focused on getting a job and reconnecting with his daughter.

Since Portugal decriminalized drugs in 2001, its strategy is credited with reversing the drug addiction explosion of the 1980s and 1990s and halting the HIV/AIDS pandemic. Across the Atlantic, it has inspired policymakers in British Columbia, Canada, and in Oregon. In Europe, the Czech Republic has decriminalized drugs, and Ireland is considering that step.

Drug consumption is not legal in Portugal. What the 2001 reform changed is that it is no longer a criminal offense. Possession for individual use may lead to administrative penalties, such as fines or community service.

“There is a clear decrease,” says João Goulão, the national drug coordinator. “We estimate that we have half the problematic users that we had in the beginning of the century.”

Nuno and Mariana are on a first-name basis with everyone in the grip of drug addiction they encounter while crisscrossing Lisbon. They know those who reside in tents on littered, suburban hillsides just as well as those who consume drugs in bustling neighborhoods at the heart of the Portuguese capital.

They know their stories – like that of the university professor-turned-police spotter for drug traffickers, or the migrant from India struggling to navigate health services. And, most importantly, they care about everybody’s immediate and future needs.

“Our priority is to make relationships with people,” says Mariana Gomes, a bubbly social worker who methodically jots down whom she meets and what they need in a giant binder. “When we say, ‘Do you need anything?’ we really are asking.

“We try to promote an honest relationship, a horizontal conversation,” she continues. “It seems small, but it makes all the difference in building trust.”

The pair walk in thick-soled shoes while distributing silver foils and safer drug-use kits. Their eyes are trained to recognize health issues. They handle the basics on the spot and organize follow-ups for harder cases.

“Most of the job we do is about creating goodwill, because we don’t have all that much to give,” says Nuno Maneta, a peer educator who overcame drug addiction himself. “It helps a lot if you understand the point of view of the person.”