The challenge
A heroin epidemic was driving HIV infections and filling prisons with people who used drugs.
The case
In July 2001, facing a heroin epidemic and one of Western Europe's highest rates of drug-related HIV, Portugal made possession of up to a 10-day supply of any drug an administrative offense instead of a crime. People caught with drugs went before 'dissuasion commissions' of health, legal and social professionals, which could refer them to treatment or impose fines. The change came with large investments in treatment and harm reduction. Over the following decade, drug-related HIV infections and overdose deaths fell substantially, fewer people were imprisoned for drug offenses, and drug use did not rise noticeably compared with neighboring countries. Between 2000 and 2008, the number of new HIV cases among drug users fell from 907 to 267, according to Portugal's drug institute data cited by Hughes and Stevens.
Why it worked
Decriminalization worked as part of a health package, not on its own. When funding was cut and the drug agency restructured after 2012, services weakened and some cities have reported strain.
Sources
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