From crime to health: civil commissions help redefine drug use

Published: 11 Feb 2016

From crime to health: civil commissions help redefine drug use

Ahead of a UN landmark meeting this April, a new report shows how an integrated national system can effectively deal with drug use as a health issue.

In Portugal, people stopped with up to a certain amount of any type of illegal substances are not arrested and do not receive a criminal record. Instead, the police refer them to the Commissions for Dissuasion from Drug Abuse (CDTs), civil bodies operating under the Ministry of Health.

Gateways from Crime to Health is the first study to examine in detail how the Portuguese Drug Commissions work with people abusing drugs or at risk of doing so. The Commissions, made up of panel members and staff with a legal, psychological, sociological and social work background, assess the mental, physical and social wellbeing of every person that comes before them. They provide tailor-suited information and advice and have a range of measures at their disposal, with sanctions only used in the last instance. They direct users to a variety of support structures, from health clinics to psychological assistance, to housing and employment help, to treatment for problematic users.

The report was written as the result of a Winston Churchill Memorial Trust Fellowship in partnership with the Prison Reform Trust. It unveils a complex, multi-faceted and well co-ordinated web of integrated medical and psycho-social interventions, based on the key national aims of dissuasion, prevention, treatment, harm reduction and reintegration.

The Portuguese Drug Commissions are unique civil institutions; there is nothing comparable to them in the field of drugs worldwide.They are gateways into a capillary system of intervention, taking drug users away from criminal justice. I was impressed with their person-centred, non-punitive approach, the holistic way the Commissions consider the individuals before them and their humane yet robust attitudes.

- Arianna Silvestri, author of Gateways from Crime to Health

Sofia Almeida, President of the Aveiro Drugs Commission, said: ‘Our motto is ‘tratar, não punir’ – treatment, not punishment. We aim to understand each person in their own right, and to address the problems they face. We are here to help, not to judge. The results, 15 years on, show that our approach is working’.

Since 2001, when this system was introduced, Portugal has not seen increases in use or social problems related to drugs. Instead, the study shows that, having redirected resources from criminal justice, the country has experienced positive outcomes, including health improvements (e.g. steep declines in HIV incidence among injecting drug users), the freeing up of police and court time, and fewer users in prison.

The social and financial gains related to this innovative approach run counter to the notion that punitiveness is the only or best way to deter consumption and contain harm. The Portuguese experience strongly indicates the possibility of good returns in terms of public health, recidivism and public expenditure.

In advance of the United Nations General Assembly Special Session (UNGASS), such measurable indicators constitute a sound base for considering alternatives to criminalising drug users. 

Contact Arianna:  asilvestri@alumni.lse.ac.uk

Arianna's blog: http://asilvest.weebly.com/