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13 June 2018
Portuguese drug policy changes save lives wholesale. Sydney meeting.
Big turn-out on rainy Sydney evening for drug law reform meeting.Tuesday 5th June 2018. St
Stephen’s Church, Macquarie Street, Sydney.
“An evening with Manuel
Cardoso the man who helped reform Portugal’s drug policy”.
Take-home message to get
through to our politicians: decriminalisation is now proven to save lives,
money and much more.
The most impressive part of
this evening was actually the audience, all like me, frustrated supporters of
drug law reform, some for up to 40 years.And I estimate that there were over 1000 in attendance on a cold wet
winter evening.An email blitz had
offered a free umbrella for the first 250 to attend.
The evening consisted of a
fireside chat type presentation – no power-point slides, etc.Will Tregoning PhD was a whippy and
knowledgeable compere with his three guests on a couch up front with
microphones and cameras for live-stream on FaceBook.
Dr Manuel Cardoso said that
he was an optimist and did not recall anything bad, just the good.So when people asked what were the triggers
for the move to decriminalization in 2001 in his country he said he could not
recall that far back.His CV seems to
indicate that he was not involved in the drug field in 2001 so the title of the
evening’s talk seems a little odd.He
explained that he was the deputy and was modest about the dramatic changes in
his country following decriminalisation.
Other information indicates
very serious drug-related events in his country with some of the worst stats in
Europe for a number of major outcomes such as overdose deaths, HIV
transmission, incarceration, etc.Also
the economy was in the doldrums.I
understand that there was a coming together of three great minds being a
politician, a radio host and a law professor.And an opposition in parliament which was also on-side or at least on
the same page, partly due to so many overdose deaths, some children of
prominent citizens.The entire story is
carefully described in an excellent report by the CATO Institute (G. Greenwald,
2009) as quoted by one speaker (see links below).
Dr Cardoso was also giving
talks in Hong Kong, Argentina, Luxembourg, Norway and elsewhere on this trip,
seemingly in great demand.We were told
that only Norway is in any political place to introduce decriminalisation, in
great distinction from Sweden which has long had a zero tolerance approach
despite their poor outcomes of drug related morbidities in such an
environment.Only America has a worse
system and even the current unprecedented overdose crisis seems unable to move
the prohibition monster.
During the talk I realised
that decriminalization brings out those who really DO have problems with drugs
as distinct from those who like using their drugs, finding they can get on with
their lives, work, raise families, pay tax, etc without problems.This became clear as Dr Cardoso was talking
about alcohol which some people use quite seriously but without apparent harm
while others get into trouble with excess use and serious social/medical
consequences.This latter group needs
help in numerous ways, just like others with disabilities or illness.Indeed, the evening has taught me to be more
tolerant of illicit drug use in my methadone patients when it is clearly low-risk
and in some cases may even be quasi-therapeutic.
Three of the best comments of
the night came from the floor after the main interviews were over.Marion Mc’Connell who co-founded Family and
Friends for Drug Law Reform spoke about her frustration at seeing so little
progress since the death of her son over 20 years ago.This was then reflected by Rev Bill Crewes
who dated his first meeting on the subject to the 1970s.He also mourned the lack of serious moves
away from the failed policies of prohibition and harm maximization.Then an articulate young lady introduced
herself as the new Labor candidate for Balmain in State Parliament, saying much
work needed to be done by and within political parties.She promised to push the issue as best she
could but added that politicians can only act when they know what their
constituents want and/or what expert opinion is suggesting.Why are we still locking up drug users?
This latter was taken up by
ex-Premier Geoff Gallop whose government in WA virtually decriminalised
cannabis.He pointed out that two
factors were crucial to successful change: bipartisan support as well as public
forums with expert evidence pointing to a need for change.Even some of his own (Labor) government’s
easing of cannabis restrictions in WA were rolled back by a subsequent (Liberal
Dr Marianne Jauncey spoke
briefly about her experience as director of the Medically Supervised Injecting
Centre in Kings Cross.This is the only
place in Australia where it is legal to possess illicit drugs.Despite its success clinically over 17 years
(no deaths after up to a million injecting episodes) and public acceptance, it
has not been duplicated by the NSW Health Department, which is
regrettable.After numerous false starts
it appears that Melbourne may soon have an injecting centre.
Others had particular
questions for Dr Cardoso about the situation in Portugal and how that might be
relevant to other jurisdictions.His
answers while direct were generic.I asked
him if there were any moves in Portugal to return to old policies such as from
the Catholic Church, older citizens or conservative forces.He replied that he knew of no such moves and
would be surprised if there were any.The Church, he said, was wholly supportive.It seems that the benefits have been so
widespread and so obvious that the entire population, not just drug users, can
see the benefits.There may be similarities
to the lifting of alcohol prohibitions in America 90 years ago.
There was a great deal of
camaraderie in the foyers afterward with nice mingling over savouries and
drinks with many old colleagues, some I had not seen for ages.It was also nice to see a younger generation
of health professionals, advocates, researchers, etc in attendance at such a
My summation of the event was
that there is a groundswell of keen support for total decriminalisation of
personal drug use and that the Portuguese experience was one of the largest
social experiments of our time … and every indication is that it has proven
beyond any doubt that prohibition has failed and removing it along with
increasing access to treatment and harm reduction is successful.This ‘experiment’ (my colleagues say I should
not call it an experiment) was so large and so successful in a country with
many similarities to our own that it places our system of prohibitions of drugs
as being out-dated, counter-productive, wasteful and inhumane.
If everyone at this meeting
made an appointment to see their local member of parliament with their views we
may see the start of something big.It
took the ‘Mothers of America’ to start the moves against prohibition in that
country … maybe we need a similar movement here.The rationale is compelling … and in America
with the overdose crisis the case is overwhelming.
Written by Andrew Byrne,
Redfern Addiction Physician.