LISBON — On a broken-down set of steps, a 37-year-old fisherman named Mario mixed heroin and cocaine and carefully prepared a hypodermic needle. “It’s hard to find a vein,” he said, but he finally found one in his forearm and injected himself with the brown liquid. Blood trickled from his arm and pooled on the step, but he was oblivious.
“Are you O.K.?” Rita Lopes, a psychologist working for an outreach program called Crescer, asked him. “You’re not taking too much?” Lopes monitors Portuguese heroin users like Mario, gently encourages them to try to quit and gives them clean hypodermics to prevent the spread of AIDS.
Decades ago, the United States and Portugal both struggled with illicit drugs and took decisive action — in diametrically opposite directions. The U.S. cracked down vigorously, spending billions of dollars incarcerating drug users. In contrast, Portugal undertook a monumental experiment: It decriminalized the use of all drugs in 2001, even heroin and cocaine, and unleashed a major public health campaign to tackle addiction. Ever since in Portugal, drug addiction has been treated more as a medical challenge than as a criminal justice issue.
After more than 15 years, it’s clear which approach worked better. The United States drug policy failed spectacularly, with about as many Americans dying last year of overdoses — around 64,000 — as were killed in the Vietnam, Afghanistan and Iraq Wars combined.
