What goes in must come out. Science has given us a new(er) way of finding out what drugs you (or someone you know) took to get high. Mass spectrometric wastewater analysis of illicit substances shows that some people are less than truthful when surveyed about why they were in such a good mood.
In case you haven't heard, the newest way to measure our drug habits is on the tail end of consumption. City sewer systems reveal our innermost secrets using high-tech, mass-spectrum chromatography. And it would seem that all of Western Europe is awash in a wave of intoxication.
Condolences, not congratulations, are in order for Porto, Portugal. The beautiful, historic port city was recently declared the cocaine capital of Portugal. The city's wastewater measures some of the highest levels in Western Europe of cocaine, ecstasy, ketamine, and cannabis.
Porto's mayor claims the drug problem in the city is worse than at the height of the 2008 crisis. Catarina Martins, a Washington Post writer, described the situation in Porto this way: "Addiction haunts the recesses of the city as gaunt, clumsy hands lift crack pipes to lips, syringes to veins. Authorities are sealing off warren-like alleyways with iron bars and park fencing to halt encampment spread. A siege mentality is taking root in nearby enclaves of pricey condos and multimillion-euro homes."
The city council and mayor called for new penalties for taking drugs in public places, especially near hospitals and schools. According to the Portugal Country Drug Report, 8% of adults smoke cannabis, 0.2% consume MDMA, 0.3% cocaine, and 5.2% heroin. But that's just what people will tell you. The truth is in the pudding poop.
All this is happening in a country that has been held up as the shining example of enlightened illegal drug policy reform. This stems from the common misconception that Portugal "legalized" drugs or, at least, '"decriminalized" all drugs in 2001, but that is not entirely true. Drugs were and are still illegal, but the status of violations was changed from criminal to administrative. Harm reduction and treatment became the priorities, with extensive country-wide social support systems. The key to the early success of those programs was funding. Portugal's experiment became the world's poster child for an enlightened, practical approach to the drug epidemic.
Two decades later, the edges of the picture have frayed; the system is fatigued. The country's drug czar, João Goulão, says: "What we have today no longer serves as an example to anyone. Decriminalization is not the silver bullet … if you decriminalize and do nothing else, things will get worse. This is not a phenomenon only in Portugal; all of Europe is facing a huge availability of drugs, new and old. We are trying to put together again the means to counter this."
The financial crises of 2008 -2011 resulted in a "disinvestment" in Portugal's support programs in 2012. The resulting fragmented system for dealing with drugs is underfunded as the budget was cut from 76 million euros to 16 million. Now, addicts are on waiting lists for treatment, and there is a shortage of professionals to provide addiction treatment. The Portuguese health system is under strain, partly due to the emigration of health professionals to other countries for better pay. Portuguese Doctors are the lowest paid in Western Europe, making one-third as much as M.D.s in Germany, Denmark, and Belgium and only half as much as those in Spain.
Recent data shows the weakness of Portugal's experiment. Another national survey shows illicit drug use has increased by 12.8% in 2022, with overdoses in Lisbon hitting 12-year highs and nearly doubling from 2019 to 2023, as the Wall Street Journal reported earlier this year. Drug-related debris littered on the city streets of Porto surged 24% between 2021 and 2022. Admittedly, Portugal's numbers (74 deaths in 2021) are small compared to 1,197 deaths in Scotland (a country with half the population of Portugal) or 96,000 in the United States. But the trend is real in a country that was supposed to have the answers. Many European countries followed Portugal's lead, prioritizing harm reduction over criminal enforcement.
Oregon is the only state in the United States to embrace Portugal's model. Nearly 60% of the state's voters were in favor of making small amounts of all drugs legal in a 2020 referendum. But the devil was in the details, as the legislature failed to adequately fund new treatment services for a long 18 months after the law passed. There was also a failure to train police on a new approach to address addiction and no place to send drug users to treatment. After an alleged surge in fentanyl use and a spike in opioid-related deaths, a legislative committee on addiction proposed reversing the policy. Now, Oregon's governor Kotek is poised to sign a new law to re-criminalize most hard drugs.
Back in Portugal, André Ventura, the leader of the far-right Chega party, characterized a new law decriminalizing synthetic drugs as "a disaster … designed by the left." He said, at the time: "We do not need to be softer on drugs. We need a war." The out-in-public use of hard drugs is changing the direction of public opinion; gang violence fighting over drug turf is making headlines in Northern Europe. So now, many right-wing politicians are calling for tougher law enforcement. However, Mr. Ventura and others may want to read up on the "War on Drugs" in the United States, where the annual cost of those programs currently runs $51 billion annually and totals well over a trillion dollars.1
The drug crisis was at the top of public concerns in Portugal back in the 1990s, but the issue has slipped to 13th or 14th place, according to drug czar Goulão. He also sees social prejudices towards drug users resurfacing. "Today, the problem is mostly limited to people living in very difficult circumstances. It's easy for certain political groups to exploit fears towards them as being different and problematic."
The Center for American Progress has noted that people of color are six times as likely to be incarcerated for drug offenses than their white counterparts despite equal use of illegal substances. Eighty percent of people serving time for federal drug offenses are black or Latino; in state prisons, it is sixty percent.
Clearly, the appetite for illegal drugs in the United States is unique, where a country with less than five percent of the world's population consumes 80% of all the opioids produced globally. Drugs and guns, we're number 1.
In Portugal, the challenges include alcohol, illicit synthetic drugs, and prescription drugs. Portugal leads the E.U. in the prescribing of legal mood drugs like antidepressants and benzodiazepines like Valium. It also leads Europe in wine consumption (51.9 liters per person), recently overtaking France.
Despite the most restrictive drug laws in the E.U., France is also drowning in drugs. An estimated €3 billion is generated illegally every year. In the port city of Marseille, a turf war among drug gangs killed 73 people in 2023. Despite strict French gun laws prohibiting automatic weapons, the Kalashnikov is the weapon of choice in gang skirmishes. Most of those killed are under 25. The government, which routinely boasts of large drug hauls they have made, cannot explain why the price and availability of drugs on the street keep going down. French police officers on the street and even judges say all these efforts are like trying to empty the ocean with a teaspoon. France leads Europe in cannabis consumption, and the courts were so backed up they instituted on-the-spot fines of €200 to help alleviate the backlog.
France has long called for a uniform drug code in Europe, but it appears to be swimming against the tide. Many of their neighbors are going the other way, recently not only decriminalizing but also legalizing cannabis: Malta, Switzerland, Luxembourg, the Netherlands, and, recently, Germany. But now France is announcing a new nationwide crackdown.
Even in the Netherlands, many have decided drug tourism is a plague. Amsterdam banned smoking marijuana on the street in its red-light district. The number of coffee shops selling weed was decreased by 40%. Several cities are limiting sales to Dutch citizens, which boosts the market for illegal dealers.
Trying to control and limit the influx of illegal drugs is like a game of whack-a-mole. Despite enormous sums of money being spent to control drugs, the street price of getting high is going lower. Paul Griffiths, the science director at the European Union's drug-monitoring agency, says that too much focus is on criminal policy alone. For an example of how global factors affect the drug trade, the Taliban's suppression of opium-poppy production affects European heroin supplies. This gave incentive to drug syndicates to develop home-brewed ultra-potent synthetic opioids, nitazenes, which have caused a surge of deaths in Estonia and Latvia. Nitazenes are considered to be 10 to 40 times more potent than the fentanyl ravishing the U.S. and distressingly easy to make. They were recently found in two overdose autopsies in Boulder, Colorado, a community frequently listed as one of the best places to live in the United States.
So what is this all about? Why do I think it is vital for me to write about this and for you to read it? Am I promoting decriminalization of all drugs or calling for a new "drug war" to get things back in control, a clean sweep of these addictive poisons from our streets, our schools, and our homes?
For a moment, let's try to reverse-engineer the problem. Is it possible to define what success would look like if we "fixed" society's drug problem? Can we agree on whether these outcomes are positive?
Reduce drug overdose deaths to zero or as close as possible.
Eliminate the significant source of money going to gangs and organized crime.
Providing healthy alternatives for people feeling dis-ease = addiction.
In Portugal and many European countries, the best results come from joining health care, housing, public education, and other services. Europe features strong welfare states, the big reason 6,000-7,000 die of overdoses there each year, compared with around 100,000 in America with a similar population.
The "war on drugs" started with President Richard Nixon in 1971 in the United States. It morphed into a global campaign and has been a miserable failure. The revelations of Nixon's advisor, John Ehrlichman, point to a political scheme to disenfranchise people of color and the "Hippies" of the counter-culture movement.
“We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.”
If for no other reason than simple economics, it would make sense to treat drug addiction as an illness and stop putting people in jail. The average cost of incarcerating a federal inmate in the U.S.is over $42,000 a year. If that money was redirected to help people, to provide the basic needs of food and shelter, there would still be money available to help those who want to heal from their addiction.
Yes, there will still be some people who stay stoned and high, who will be unproductive. Still, even here, it would be both cost-effective and humane to provide free needles and even safe drugs rather than spend the money and resources on emergency room visits, jails, and prisons. Many claim the Los Angeles County jail system was the largest mental health provider in the country, with 39% of inmates (out of 15,000) needing mental health services when surveyed in 2022. A support system for the addicted won't bring everybody out of the swamp, but they will have better options.
The prohibition of alcohol in 1920 gave rise to the American gangster syndicates and the Mafia in America. That colossal failure fueled an empire of crime that lasted decades and was never entirely eradicated. The rise in gang violence now happening across the globe is primarily driven by supplying drugs to people who want to take them. Decriminalizing drugs will at least stop the pouring gasoline on the fire.
It's a bitter pill to swallow, but some people will fall into addiction no matter what policy is pursued. Obviously, fifty years of the drug wars have failed. The time has come to stop the madness of punitive drug laws and offer people help and support. "The definition of insanity is doing the same thing over and over and expecting different results." - Albert Einstein
Depending on who you ask, estimates vary widely, according to the U.N., the Human Rights Foundation, the Cato Institute, and Wikipedia. They range from about $600 billion to 1 trillion, and since we are talking about getting high, I rounded up.
Excellent article. One comment: "The Center for American Progress has noted that people of color are six times as likely to be incarcerated for drug offenses than their white counterparts" My guess is people of color are six times as likely to be low income. Criminality can be seen most clearly through income, not race.
I am discouraged to learn about these trends in Portugal. Losses for everyone. I appreciate the facts you provide along with the broad view of a complex social and medical problem. Thank you for including the HUGE disparities in US incarceration rates: "...people of color are six times as likely to be incarcerated for drug offenses than their white counterparts despite equal use of illegal substances." To some people, this is just another form of institutionalized racism rooted in slavery.