A tale of two drug policies:Portugal and Sweden

Alex Stevens, PhDProfessor in Criminal Justice

Content

• Key features of Portuguese and Swedish drug policies

• Narratives of success (and failure)

• Portugal: Trends since decriminalisation

• Sweden Trends in drug use and harms

• Need for broader analysis

Key features of Portuguese policy

• Decriminalisation of personal possession of all illicit drugs since 2001.

But also:

• Referral to CDTs.

• Continued prosecution of dealers and traffickers.

• Expansion of treatment and harm reduction.

• Introduction of guaranteed minimum income.

Portugal: Narrative of success (e.g. Greenwald 2009)

• Drug use declined.

• Reduction in drug deaths.

• Lower prevalence of drug use in Portugal than other EU countries.

• [Little emphasis placed on treatment expansion, or lifetime drug use in adults.]

• Policy a ‘resounding success’.

Portugal: Narrative of failure (e.g. Pinto Coelho 2010)

• Drug use went up.

• Drug deaths went up.

• Drug related homicides went up.

• Portugal has highest rate of HIV in injecting drug users in the EU.

• Policy a ‘disastrous failure’

Evidence: drug use by young people

Evidence and policy

Figure 1: Lifetime prevalence of cannabis amongst Portuguese school students, by year and survey

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5

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30

1998 2002 2006 1995 1999 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2001 2006 2001 2006

Prev

alen

ce o

f use

I NMEECTADHBSC/ OMS ESPAD

7-9th grade 10-12th grade13 yrs 17 yrs14 yrs 15 yrs 16 yrs 18 yrs16 yrs6, 8 & 10th grades

Source: Feijão (2008, 2009); Feijão and Lavado (2003, 2004); Hibell et al. (2007); Matos et al. (2000, 2003, 2008). N.B. Only HSBC/OMS and ESPAD data were collected pre and post reform.

Evidence: drug related deathsFigure 4: Drug related deaths in Portugal between 2000 and 2008 using INML definition (positive post-mortem toxicological test for drugs) and INE definition (determination by physician according to ICD criteria)

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2000 2001 2002 2003 2004 2005 2006 2007 2008

Dru

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INE)

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Year

Drug-related deaths - INML Drug induced deaths - INE

Source: Institute da Droga e da Toxicodependência (2009, 2010).

Evidence: Homicides

Source: Eurostat

Evidence: HIV

Source: Hughes and Stevens 2010

Sweden: key features of drug policy

• Aim for a ‘drug free society’.

• Restrictive approach to drugs: Use of drugs criminalised (police testing) High rate of conviction of arrestees for drug

possession. Use of compulsory treatment.

• But relatively low maximum prison sentences: 10 years for first offence (even large scale trafficking)

• Limited availability of harm reduction services.

Sweden: Narratives of success?

• UNODC 2007: ‘Countries get the drug problem they deserve’ Sweden has low prevalence of drug use, due to

rigorous policy against drugs since the 1970s.

• Counter-argument (Cohen, Olsson) UNODC conclusions not supported by

evidence. Recent data shows worrying increase in drug

related deaths and HIV in IDU.

Sweden: historical drug use trends

Source: UNODC 2007 (citing Olsson 1994)

Sweden: drug related deaths

Source: EMCDDA 2011

Sweden: IDUs testing positive for HIV

Source: EMCDDA 2011

Broader analysis: welfare and youth drug use

Conclusions:

• Decriminalisation in Portugal did not lead to an explosion in drug use.

• Restrictive policies in Sweden did not cause the reduction in drug use.

• Treatment and harm reduction services are associated with reductions in deaths and HIV incidence.

• Broader policies of welfare and imprisonment are associated with drug policy outcomes.

More information

• Publications: Hughes, C., & Stevens, A. (2012) A resounding

success or a disastrous failure: Re-examining the interpretation of evidence on the Portuguese decriminalisation of illicit drugs, Drug and Alcohol Review, 31(1) 101—113.

Stevens, A. (2011), Drugs Crime and Public Health: The Political Economy of Drug Policy. Abingdon: Routledge

Hughes, C., & Stevens, A. (2010). What can we learn from the Portuguese decriminalisation of illicit drugs? British Journal of Criminology, 50(6), 999-1022

• Email: a.w.stevens@kent.ac.uk

Conclusion on Portugal

Source: Hughes and Stevens, 2012

“Considered analysis of the two most divergent accounts reveals that the Portuguese reform warrants neither the praise nor the condemnation of being a ‘resounding success’ or a ‘disastrous failure’, and that these divergent policy conclusions were derived from selective use of the evidence base that belie the nuanced, albeit largely positive, implications from this reform.”

Evidence: drug useFigure 2: Prevalence of lifetime, recent (last 12 month) and current (last month) use of any illicit drug in Portugal amongst individuals aged 15-64, 2001 and 2007

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2

4

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15-64 15-64 15-64

Pre

vale

nce o

f use

2001 2007

Lifetime use Recent use Current use

Source: Balsa et al. (2001; 2007).

Evidence: prison population

Source: Council of Europe Annual Penal Statistics

Broader analysis: prison and problematic use