A tale of two drug policies: Portugal and Sweden Alex Stevens, PhD Professor 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 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 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 deaths Figure 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) 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),

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

Evidence: prison population Source: Council of Europe Annual Penal Statistics

Broader analysis: prison and problematic use