In
the 1980s and 1990s, Portugal also had a terrible drug problem, one of the
worst in Europe, and lawmakers there, too, debated how to respond. In the end,
the two countries took precisely opposite paths. The United States doubled down
on the war on drugs and "zero tolerance" criminal justice approaches.
In contrast, Portugal convened a commission and ended up adopting - under then
prime minister Antonio Guterres, now the secretary general of the United
Nations - a public health approach instead. Portugal treated drug addiction
like a disease, rather than a crime. It decriminalized possession of all drugs,
even heroin and cocaine, and focused on prevention through public education, as
well as treatment of those with addictions to try to wean them of substance
abuse.
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Many
people around the world were horrified that a major nation like Portugal was
abandoning the war on drugs and decriminalizing drug use. There was legitimate
concern that this would lead to soaring use of hard drugs. We now have almost
two decades of experience with these two diametrically opposite approaches, and
it's clear which worked better.
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In
the United States, drug use and fatalities have soared, thanks partly to street
fentanyl. There were 6,100 deaths from illegal drugs in 1980, compared to
68,000 in 2018. Every fifteen minutes in America, another child is born with an
opioid addiction. In contrast, Portugal's experiment proved a huge success. The
number of people with addictions has fallen by about two-thirds, and its rate
of drug-related deaths is now the lowest in Western Europe. In Portugal, 6
persons die of drug-related causes per million people between the ages of
fifteen and sixty-four. In the United States, the figure is 348.
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Crackdowns
on small-time drug offenders in the United States devastated many low-income
families, especially in African-American communities, and the resulting felony
records left black men in particular less employable and less marriageable. The
United States has spent more than $1 trillion on the war on drugs, money spent
locking up two-bit users rather than educating children. The war on drugs has
been perhaps the worst single policy mistake of the last half century.
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One
legacy of this policy blunder is that 70 million Americans now have a criminal
record, according to the Brennan Center for Justice. That's slightly more than
the number of Americans with a college degree, and we have more jails and
prisons than four-year colleges. The war on drugs even reached into schools. In
Ohio, a fourteen-year-old girl named Kimberly Smartt was suspended from a
public junior high school for four months in 1996 after she gave a
thirteen-year-old girlfriend a Midol tablet for menstrual cramps (Midol is a
mild over-the-counter pain reliever).
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Portugal's
experience helped convince us that the United States and other countries should
try the public health approach, too, and it's encouraging that more localities
are moving in that direction. One reason is simply that the opioid crisis,
while still disproportionately affecting low-income families, increasingly is
striking middle-class communities as well. In Ohio, the lieutenant governor
discovered that both her sons were wrestling with addictions. The public is
showing far more sympathy to middle-class white kids struggling than it ever
showed to blacks like Geneva Cooley. The mantra moved from "lock 'em
up" to "treat addiction like a disease." The recent emphasis on
treatment rather than punishment, now that white kids are overdosing in large
numbers, is welcome and long overdue, but those in the black community have
reason to see it also as hypocritical.
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Nicholas Kristoff "Tightrope:
Americans Reaching for Hope" (2020)
