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 2001.
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
Figure 1: Lifetime prevalence of cannabis amongst Portuguese
school students, by year and survey
30
Prevalence of use
25
20
15
10
5
0
1998 2002 2006 1995 1999 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2003 2007 2001 2006 2001 2006
6, 8 & 10th grades
16 yrs
HBSC/OMS
ESPAD
13 yrs
14 yrs
15 yrs
16 yrs
ECTAD
17 yrs
18 yrs
7-9th grade 10-12th grade
INME
Source: Feijão (2008,
2009); and
Feijão
and Lavado (2003, 2004); Hibell et al. (2007); Matos et al. (2000, 2003, 2008). N.B. Only HSBC/OMS and ESPAD da
Evidence
policy
Evidence: drug related deaths
400
80
350
70
300
60
250
50
200
40
150
30
100
20
50
10
0
0
2000
2001
2002
2003
2004
2005
2006
2007
Year
Drug-related deaths - INML
Source: Institute da Droga e da Toxicodependência (2009, 2010).
Drug induced deaths - INE
2008
Drug-induced deaths (INE)
Drug-related deaths (INML)
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)
Evidence: Homicides
Homicide rate (deaths per 100,000 inhabitants)
1.8
1.6
1.4
1.2
1
0.8
0.6
0.4
0.2
0
2000
2001
Source: Eurostat
2002
2003
2004
2005
2006
2007
2008
2009
2010
Evidence: HIV
Incidence of HIV and AIDS among drug users, 2000-2008
1000
900
800
700
600
500
2000
400
2008
300
200
100
0
HIV
Source: Hughes and Stevens 2010
AIDS
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:
•
Email: a.w.stevens@kent.ac.uk
 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), 9991022
Conclusion on Portugal
“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.”
Source: Hughes and Stevens, 2012
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
14
12
Prevalence of use
10
8
6
4
2
0
15-64
Lifetime use
15-64
15-64
Recent use
Current use
2001
Source: Balsa et al. (2001; 2007).
2007
Evidence: prison population
Sentenced prisoners for drugs and other offences
12,000
10,000
8,000
6,000
Non-drug offences
Drug offences
4,000
2,000
0
Source: Council of Europe Annual Penal Statistics
Broader analysis: prison and problematic use