Transcript Diapositivo 1

Decriminalisation: Definitions and
models of delivery
14th March 2013
International Drug Policy Consortium
João Goulão, MD
Portuguese National Coordinator for Drug Problems, Drug Addictions
and the Harmful Use of Alcohol
General-Director of the Intervention on Addictive Behaviours
and Dependencies DG
Chairman, European Monitoring Center on Drugs and Drug Addiction
(EMCDDA)
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 Resident population
10 627 250
 North/South territorial units
maximum length
652 km
East/West territorial units maximum
length
218 km
Surface
92 090 Km2
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The history of Drug Use in Portugal
 It began much latter than in the other Western
European Countries;
 It happened with relevance only after the Portuguese
Democratic Revolution (1974), when society was facing
lots of deep and accelerated changes;
- society unprepared to new phenomenon;
- closed and isolated country;
- return of soldiers and colons from ancient colonies
 It developed very fast; society was not able to answer
in the right time and to face the “new needs” created by
drug use; as a consequence, there was a gap between the
appearance of the “needs” and the “answers”
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As a consequence:
Drug use spread under European average level;
But a considerable number of “problematic drug users”
appeared and, during a long period of time, had no access to
treatment (small gap between “total” and “problematic” drug
users);
By the end of the 20th Century, Portugal had one of the
highest prevalence of Problematic Drug Use, at European
Level
(1% -100 000 problematic drug users);
At the same time, the social burden, associated to drug use,
was very relevant – top political concern
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The complexity of the situation called for some
measures expected to reverse that cycle
A new National Strategy was built, recommended by an
expert group (1999)
A new Legal Framework was approved by the Parliament
(Law 30/2000); good social acceptance; huge political debate
A new institutional structure was created to implement and
coordinate an Integrated Approach to all the areas related to
Drugs and Drug Use – IDT (Institute on Drugs and Drug
Addiction)
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A New Paradigm
 The Portuguese Drugs Strategy elaborated on the past
policy consumption’s criminalization and on the need to
liberate resources for the fight against drug trafficking:
 Imprisonment or fee (the most common sentence imposed
on 1st time offenders) didn’t solve drug abuse;
 In the case of 1st time offenders or occasional users,
imprisonment is likely to produce counterproductive
effects;
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1999 National Drugs Strategy
• Established 8 Principles, among which the Humanistic
Principle:
– Recognition of the human person’s full dignity;
– Understanding the human person’s life, clinical record
and social environment;
– Assumption that the drug user is a diseased person
endowed with the constitutional right to health;
– Offender’s full responsibility.
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Challenges
A new destination for drug tourism?
Compliance with the UN Conventions?
Increase of drug use in younger groups?
 Administrative sanctions in line with UN Conventions
Positive references in:
 April 2004 International Narcotics Control Board Mission to
Portugal;
 World Drug Report 2009;
 The Cato Institute Greenwald Report – April 2009;
 The 2009 EMCDDA Annual Report;
 The British Journal of Criminology, Caitlin Hughes and Alex
Stevens – November 2010;
 Drug Policy in Portugal, The Benefits of Decriminalizing
Drug Use – Open Society Institute, June 2011.
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The Dissuasion Model
Law No. 30/2000: the consumption, acquisition and possession
for own consumption of plants, substances or preparations
constitute an administrative offence and can not exceed the
quantity previewed for individual use for a 10 days period.
Exceeding this quantity, criminal procedures take place.
• The drug addict is viewed as a sick person in need of health
care;
• The dissuasion intervention provides an opportunity for an
early, specific and integrated interface with drug users;
• The dissuasion intervention is aimed and targeted to the drug
users’ characteristics and individual needs.
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Ten Days Maximum Amount Allowed Illicit Substance Chart
Illicit Substance
Grams
Heroin
1
Methadone
1
Morphine
2
Opium
10
Cocaine (hydrochloride)
2
Cocaine (methyl ester benzoilegonine)
0.3
Cannabis (leaves and flowers or fruited dons)
25
Cannabis (resin)
5
Cannabis (oil)
2.5
LSD
0.1
MDMA
1
Amphetamine
1
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Dissuasion Objectives
• To dissuade consumption – a “second line” of preventive
intervention – the “yellow card”;
• To prevent and reduce drug use and abuse;
• To ensure the sanitary protection of users and the
community;
• To liberate resources for the fight against drugs trafficking
and crime related, such as the small crime to acquire drugs
for one’s own consumption.
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Dissuasion Tools
• Users’ information and awareness to drug consumption
risks;
• Promotion of health in global terms;
• Promotion of users’ social reintegration;
• Drug addicts motivation and referral to treatment;
• Signalization of situations that, thought not characterized
as drug addiction, need to be specifically addressed.
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Composition of the Commissions
President and two
other members
Appointed by the
Minister of
Justice and by
the Minister of
Health
Multidisciplinary technical unit support –
Psychologists, social service workers, lawyers
and administrative workers
Prepare all facts and make previous evaluation
that supports the decision
Motivation of the user to undergo for treatment
Guarantee the function of network
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Procedure
•A person is found at a public
place in possession or using
drugs
Police
Authority
•Occurrence police report
Commission
•Psychological and social evaluation
•Hearing the user
•Decision
•The user is brought to the
commission in a maximum delay
of 72h
Motivation work
Situation regarding drug
use
Execution of
penalties
File Proceedings
Psychosocial situation
Previous register
When the suspension period expires and
the user stopped to use drugs without
record of relapse, or if penalties were
carried out
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Network
Employment and
Training Services
Treatment Addicts
Centre
Police
Authorities
Coordination between services
with responsibilities in this area
Health Centre
Schools
Primary Prevention
Activities
Welfare
Services
Prisons
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Decisions and Sanctions
• Provisional Process Suspension;
• Periodic Presentation to the Drug Addiction Dissuasion
Commissions;
• Admonition, Warning;
• Community Service;
• Forbiddance of attending certain places;
• Periodic presentation to Drug Addiction Dissuasion
Commissions;
• Apprehension of objects;
• Interdiction to travel;
• Interdiction of receiving subsidies or other monetary social
grants;
• Monetary fee.
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•Some Results
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Annual Distribution of processes
CDT 2001-2011
8.441
9,000
7.870
7.365
8,000
6.025
7.342
6.972
6.785
7,000
7.432
7,388
5.900
6,000
5,000
4,000
3,000
2.246
2,000
1,000
2001*
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
Source: IDT, I.P.
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Type of administrative sanctions by year
4000
3500
3719
3000
3259
Processes
2880
2765
2500
2000
1892
2010
1778
1500
829
1000
683
500
476
597
516
61 68
69 72
2005
2006
Prov. Susp. Non Addict
571
623
46
88
2007
Prov. Susp. With Treatment
875
825
745
768
670
121 102
2008
634
78
2009
Susp. Of the rulling/execution
217
99
70
740
62
2010
Punitive
72
2011
Aquittal
Source: IDT, I.P./ DMFRI – NE
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Type of drug involved in administrative
sanctions by year
6000
5429
4920
4934
5000
4015
4104
4043
4163
Processes
4000
3000
2000
1089
864
789
1000
628
362
2005
526
395
2006
Heroin
841
959
803
610
625
580
484
460
2007
2008
Cocaine
438
424
2009
Cannabis
506
468
2010
461
429
2011
Polydrugs
Source: IDT, I.P./ DMFRI – NE
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Treatment Public
Network
22 CRI– Integrated Units
(Treatment, Harm Reduction,
Prevention and Reintegration)
45 Drug Treatment Teams
(and more 32 outpatient units)
3 Therapeutic Communities
4 Detoxification Units
2 Day Centres
Source: IDT, I.P./ DMFRI – NE
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Outpatients Clients in the Public Network
40 000
38 875
38 532
34 266
31 822
38 292
616 658
600 000
32 460
614 213
30 000
500 000
Clients
25 000
20 000
700 000
467 789
406 410
469 678
458 987
400 000
428 855
300 000
15 000
200 000
10 000
5 000
Treatment Episodes
35 000
37 983
7019
4844
2005
Clients Total
4745
2006
7643
8444
8492
5124
2007
100 000
2008
Clients First Treatment Demands
2009
2010
2011
Follow-up treatment episodes
Source: IDT, I.P./ DMFRI – NE
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Average age evolution of the IDT first
clients, users of other psychoactive
substances
35%
30%
25%
1995
20%
1998
2001
2004
15%
2007
2010
10%
5%
0%
-14
15 - 19
20 - 24
25 - 29
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
55 - 59
60 - 64
65 - 69
Source: IDT, I.P.
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Clients distribution by Year and Main Drug
120%
100%
80%
Cannabis
60%
Cocaína
Heroína
40%
20%
0%
1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Source: IDT, I.P.
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Drug Injecting on the Previous 30 days before New Patients 1st
Consultation - Public Treatment Network 2000 - 2010
30
28
25
25
21
20
20
%
17
14
15
10
11
11
10
5
0
2003
2004
2005
2006
2007
2008
2009
2010*
2011*
Source: IDT, I.P./ DMFRI – NE
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Diagnosis of HIV infection by characteristics
of sampled population
Portugal 1983-2009
Users in Therapeutic Programs with Opiate Agonists
2005-2011
Number of diagnosis
30,000
27,392
25,000
25,808
22,922
Utentes
20,000
27,031
26,351
24,312
21,054
15,000
10,000
5,000
Year of diagnosis
2005
2006
2007
2008
2009
2010
2011
Source: National Coordination for HIV/AIDS Infection
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Trends since 2001
 Small increases in reported illicit drug use amongst adults
 Reduced illicit drug use among adolescents, at least since
2003
 Reduced burden of drug offenders on the criminal justice
system
 Reduction in the prevalence of injecting drug use
 Reduction in opiate-related deaths and infectious diseases
 Reduced stigmatization of drug users
 Increases in the amounts of drugs seized by the authorities
 Reductions in the retail prices of drugs
 Increased efficiency of Police and Customs forces.
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Final Remarks
 We do not establish a causal effect of
decriminalisation to the results
 Comprehensive responses as a whole
But, for sure,
 Decriminalisation did not affect negatively
the evolution of the phenomenon
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CONCLUSIONS:
There is a coherent articulation among
ALL THE PORTUGUESE POLICY AND ACTIONS
based on the idea that DRUG ADDICT is a SICK PERSON
with treatment needs
instead of being addressed as a
“CRIMINAL or a DELIQUENT”.
Until now, the global drug situation in Portugal seems to
have a positive evolution in all the available indicators.
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Prevention
Treatment
Dissuasion
Harm
Reduction
Reinsertion
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General-Directorate for Intervention on
Addictive Behaviours and
Dependencies
Thank you for your attention
[email protected]
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