Europe Moves Drug War From Prisons to Clinics
Europe Moves Drug War From Prisons to Clinics
By T.R. Reid, Washington Post Foreign Service
Source: Washington Post
The last time the cops nabbed Miguel, he was carrying one
envelope with several grams of heroin and another with a slightly
smaller stash of cocaine. "I thought, 'Oh Lord, here we go again,' "
Miguel said, grimacing at the memory. "I figured I was headed straight
back to Leiria," the dank national prison where he has served two
terms on drug charges.
As it turned out, Miguel did not do another stretch behind bars -- not
because of a clever defense lawyer, but because of Portugal's
fundamentally new battle plan in the long-running war on drugs: This
nation of 10 million has decriminalized all drug use.
Today Miguel remains a free man, dividing his time between part-time
work as an auto mechanic and outpatient treatment at Lisbon's biggest
...
-------------------------------------------------------------------------------
Europe Moves Drug War From Prisons to Clinics
Europe Moves Drug War From Prisons to Clinics
By T.R. Reid, Washington Post Foreign Service
Source: Washington Post
The last time the cops nabbed Miguel, he was carrying one
envelope with several grams of heroin and another with a slightly
smaller stash of cocaine. "I thought, 'Oh Lord, here we go again,' "
Miguel said, grimacing at the memory. "I figured I was headed straight
back to Leiria," the dank national prison where he has served two
terms on drug charges.
As it turned out, Miguel did not do another stretch behind bars -- not
because of a clever defense lawyer, but because of Portugal's
fundamentally new battle plan in the long-running war on drugs: This
nation of 10 million has decriminalized all drug use.
Today Miguel remains a free man, dividing his time between part-time
work as an auto mechanic and outpatient treatment at Lisbon's biggest
drug treatment clinic.
"It's a good deal, because what I really want is to give up drugs,"
said the 29-year-old addict, who admitted that he has sold small
amounts of drugs on occasion to support his habit. "And I could never
do that in prison; in there, the dealers are living right next to
you."
The way Portugal has handled Miguel (under clinic rules, his full name
cannot be disclosed) and thousands of people like him reflects a
shifting attitude toward drugs in many West European countries.
Increasingly, drug users are viewed not as criminals, but as victims
of a drug culture that tough laws could not control.
Spain, Italy and Luxembourg have also decriminalized possession and
use of most drugs, and several other countries have effectively done
the same by waiving criminal penalties for addicts who are not found
to be dealing.
The director of the European Union's Monitoring Center for Drugs and
Drug Addiction, Georges Estievenart, noted that this more tolerant
stance applies not just to users of such "soft" drugs as marijuana,
but also to heroin and cocaine addicts. "The general trend across
Europe," Estievenart said, "is an approach that focuses on the
traffickers and does not pursue the drug user as a criminal. The
premise is that it is not in the interest of society to put these
people in jail, where they don't get treatment but do get fairly easy
access to all kinds of drugs.
"Some people refer to this as the 'pragmatic' approach," he said. "It
assumes that drug use is a fact of life that society can't stop, so
policymakers should try to control the damage. The U.S. perspective,
of course, is different. They seek to eliminate drug use by
prohibition."
Drug policy is not uniform across Europe. Some countries, notably
Sweden and Greece, have held fairly firmly to a U.S.-style,
"just-say-no" approach. But in most of Western Europe, said Jonathan
Cave, a drug policy expert at Warwick University in Britain, "the
general direction is harm reduction rather than use reduction."
"As the U.S. experience shows, people do obtain and use drugs, even if
you spend billions trying to stop them," Cave said. "So now the goal
[in Europe] is to have it happen without the risk of overdose, of HIV,
of random crime to support the habit."
The ethos of harm reduction was set forth succinctly by Vitalino
Canas, the former Portuguese government minister who has championed
the new approach here. "Of course our message is, 'Don't use drugs at
all,' " Canas said. "But people don't always listen. So then we say,
'If you use, do not use hard drugs. And if you use hard drugs, do not
inject them. And if you inject, do not share needles.' We think this
is more realistic than 'just say no' all by itself."
Europe's approach has drawn some sharp criticism, not least from the
International Narcotics Control Board, the U.N. agency set up to
enforce several international treaties that ban the sale or use of
narcotics.
The control board argues that uniform global prohibitions are
essential to stop the use and movement of drugs. Western Europe's
policy amounts to defeatism, said the board's president, Hamid Ghodse.
"It may not be possible to eliminate all forms of drug
experimentation, use and abuse," Ghodse said. "But the difficulty of
the challenge should not be used as an excuse not to take action."
U.S. drug enforcement officials have also sniped at European drug
policies, saying that legalization encourages use.
To date, there is little clear evidence as to the new policies'
impact. "We are eagerly awaiting studies," said the EU's Estievenart.
"But so far, we don't have the data to show whether or not the
pragmatic solution can reduce the use of drugs."
The shift toward tolerance began decades ago. In the 1970s, the
Netherlands was a leader, tolerating use of such so-called "soft
drugs" as marijuana, or cannabis, as it is generally known in Europe.
The famous "hash houses" that still draw a steady clientele of locals
and tourists opened along the old canals of Amsterdam.
Customers can order from two different menus. One has coffee --
espresso, cappuccino and the like. The other has an even wider
selection of hashish, a form of cannabis -- "Nepal," "Kashmir,"
"Thai," "Kabul." The barman will also roll joints, which cost about $3
each.
Contrary to Amsterdam's freewheeling reputation, the hash houses tend
to be quiet and controlled. At risk of police closure, the shops
strictly enforce the mandatory age limits -- customers have to be 18
to buy drugs there, two years older than the legal drinking age.
"Decriminalization has worked fairly well in the Netherlands," said
Cave, the drug policy expert at Warwick University, adding that few
hash-house customers have been found to move on to hard drugs.
Amsterdam's approach to cannabis spread widely through Europe. Today,
by statute or in practice, police officers in most European countries
ignore users of marijuana or so-called "recreational" drugs such as
amphetamines and ecstasy.
The latest convert is Britain, where the Home Office (roughly the
equivalent of the U.S. Justice Department) said in March that it would
downgrade cannabis from a "Class B" to "Class C" drug. This would
eliminate criminal penalties and treat possession or use like a
parking violation.
With the approval of the central government, some local police
departments in Britain have already taken that step in practice. In
the south London neighborhood Brixton, the local police commissioner
announced last year that his officers would no longer bother to arrest
pot smokers. Today it is commonplace to see young Londoners lighting a
"spliff" on the sidewalk outside Brixton's police station.
A recent study by the Joseph Rowntree Foundation, a London research
group, concluded that the Brixton experiment was a resounding success.
Ignoring marijuana offenses, the study concluded, allowed the police
to direct money and personnel to more serious crimes and "removed a
major source of friction between the police and the community." The
report said the more relaxed approach was "unlikely" to lead to
greater use of marijuana or more harmful drugs. It offered no data to
support this conclusion.
For the most part, the non-enforcement policy toward soft drugs has
gone over well with European voters. But Europe's new moves to
decriminalize such drugs as heroin and cocaine can be a tougher
political sell.
Nobody knows that better than Canas, an urbane, articulate former law
professor who was a Portugese government minister. It was Canas who
led this socially conservative, overwhelmingly Roman Catholic country
to abandon its long-standing prohibitionist policy toward hard drugs.
Canas spent a year or more discussing the plan with the Catholic
Church, the medical community and the police before introducing
legislation. The key political step, he said, was rejecting any
suggestion that decriminalization amounts to a stamp of approval for
drugs.
"You have to be very careful about the message you send," Canas
explained. "We do not say, we have never said, that it is good to use
heroin or cocaine. These drugs are still forbidden. What has changed
is the means we use to prevent their use."
Portugal's new drug law is so protective that it rejects terms such as
"addict" or "user." Rather, the person hooked on hard drugs is
referred to as a "consumer."
In the real world, the distinction between "consumer" and "dealer" is
not always clear, of course. To draw the line, Portugal has made rules
based on quantity. Anyone arrested with less than 10 days' personal
supply of each drug is considered to be in possession of the drugs for
personal use and is not prosecuted. Anyone arrested with more than 10
days' supply can be charged with dealing.
A drug user picked up by the police is initially sent to one of 18
civilian "drug commissions" around the country. The commission is
supposed to deal with each case individually, but users of cannabis or
amphetamines are generally given educational material and released,
while those using hard drugs are assigned to a treatment program.
A user who accepts treatment faces no further punishment, Canas said.
Those who duck out of treatment, or are caught offending again, face
administrative penalties similar to those for speeding or failing to
file a tax return. Initially, there are fines, beginning at about $22.
More serious violators can lose their driver's license or the right to
travel abroad, or be assigned to such public service Jobs as cleaning
graffiti off the city's walls.
Elza Pais, who runs the local drug commission for Lisbon, said most
consumers turned over by police say they want to break the drug habit
and that they readily accept treatment. A few would actually prefer to
go to prison, she said, perhaps because drugs tend to be easier to
obtain there. "But we no longer have that option."
Like most of the people arrested for drug use in Lisbon, Miguel was
dispatched to the sprawling four-story treatment center on Taipas
Street in Lisbon's Bairro Alto neighborhood. There he came under the
friendly but firm ministrations of the center's energetic director,
Luis D. Patricio.
"We have inpatients and outpatients here," Patricio said, leading a
tour of his center like a hotel manager showing off a fancy new
resort. "We have young mothers and aging pensioners. We have people
who genuinely want to end their addiction, and people who probably
just think it is easier to come here for methadone than to scratch up
the money for a fix on the street.
"But for all of them, we have the same message now: You are not a
criminal. You do not have to fear the government or the doctor. With
good treatment you can get over addiction, and we are going to help
you do it."
After two decades of treating Lisbon's drug problem, Patricio said he
is certain Portugal's new policy is the best course. "In prison, you
turn an amateur drug user into a professional," he said. "That's what
America is doing; in Europe, we are looking for other solutions."
Canas, the former government minister, acknowledges that the long-term
result of the policy is unclear. "We only put the law into effect last
July," he said. "Perhaps in a year or so, we will be able to draw some
conclusions about the impact.
"For now, the fact is that we are experimenting."
Source: Washington Post (DC)
Author: T.R. Reid, Washington Post Foreign Service
Published: Friday, May 3, 2002; Page A01
The Washington Post Company
Contact: letterstoed@washpost.com
Website: http://www.washingtonpost.com
-------------------------------------------------------------------------------
Europe Moves Drug War From Prisons to Clinics
Europe Moves Drug War From Prisons to Clinics
By T.R. Reid, Washington Post Foreign Service
Source: Washington Post
The last time the cops nabbed Miguel, he was carrying one
envelope with several grams of heroin and another with a slightly
smaller stash of cocaine. "I thought, 'Oh Lord, here we go again,' "
Miguel said, grimacing at the memory. "I figured I was headed straight
back to Leiria," the dank national prison where he has served two
terms on drug charges.
As it turned out, Miguel did not do another stretch behind bars -- not
because of a clever defense lawyer, but because of Portugal's
fundamentally new battle plan in the long-running war on drugs: This
nation of 10 million has decriminalized all drug use.
Today Miguel remains a free man, dividing his time between part-time
work as an auto mechanic and outpatient treatment at Lisbon's biggest
drug treatment clinic.
"It's a good deal, because what I really want is to give up drugs,"
said the 29-year-old addict, who admitted that he has sold small
amounts of drugs on occasion to support his habit. "And I could never
do that in prison; in there, the dealers are living right next to
you."
The way Portugal has handled Miguel (under clinic rules, his full name
cannot be disclosed) and thousands of people like him reflects a
shifting attitude toward drugs in many West European countries.
Increasingly, drug users are viewed not as criminals, but as victims
of a drug culture that tough laws could not control.
Spain, Italy and Luxembourg have also decriminalized possession and
use of most drugs, and several other countries have effectively done
the same by waiving criminal penalties for addicts who are not found
to be dealing.
The director of the European Union's Monitoring Center for Drugs and
Drug Addiction, Georges Estievenart, noted that this more tolerant
stance applies not just to users of such "soft" drugs as marijuana,
but also to heroin and cocaine addicts. "The general trend across
Europe," Estievenart said, "is an approach that focuses on the
traffickers and does not pursue the drug user as a criminal. The
premise is that it is not in the interest of society to put these
people in jail, where they don't get treatment but do get fairly easy
access to all kinds of drugs.
"Some people refer to this as the 'pragmatic' approach," he said. "It
assumes that drug use is a fact of life that society can't stop, so
policymakers should try to control the damage. The U.S. perspective,
of course, is different. They seek to eliminate drug use by
prohibition."
Drug policy is not uniform across Europe. Some countries, notably
Sweden and Greece, have held fairly firmly to a U.S.-style,
"just-say-no" approach. But in most of Western Europe, said Jonathan
Cave, a drug policy expert at Warwick University in Britain, "the
general direction is harm reduction rather than use reduction."
"As the U.S. experience shows, people do obtain and use drugs, even if
you spend billions trying to stop them," Cave said. "So now the goal
[in Europe] is to have it happen without the risk of overdose, of HIV,
of random crime to support the habit."
The ethos of harm reduction was set forth succinctly by Vitalino
Canas, the former Portuguese government minister who has championed
the new approach here. "Of course our message is, 'Don't use drugs at
all,' " Canas said. "But people don't always listen. So then we say,
'If you use, do not use hard drugs. And if you use hard drugs, do not
inject them. And if you inject, do not share needles.' We think this
is more realistic than 'just say no' all by itself."
Europe's approach has drawn some sharp criticism, not least from the
International Narcotics Control Board, the U.N. agency set up to
enforce several international treaties that ban the sale or use of
narcotics.
The control board argues that uniform global prohibitions are
essential to stop the use and movement of drugs. Western Europe's
policy amounts to defeatism, said the board's president, Hamid Ghodse.
"It may not be possible to eliminate all forms of drug
experimentation, use and abuse," Ghodse said. "But the difficulty of
the challenge should not be used as an excuse not to take action."
U.S. drug enforcement officials have also sniped at European drug
policies, saying that legalization encourages use.
To date, there is little clear evidence as to the new policies'
impact. "We are eagerly awaiting studies," said the EU's Estievenart.
"But so far, we don't have the data to show whether or not the
pragmatic solution can reduce the use of drugs."
The shift toward tolerance began decades ago. In the 1970s, the
Netherlands was a leader, tolerating use of such so-called "soft
drugs" as marijuana, or cannabis, as it is generally known in Europe.
The famous "hash houses" that still draw a steady clientele of locals
and tourists opened along the old canals of Amsterdam.
Customers can order from two different menus. One has coffee --
espresso, cappuccino and the like. The other has an even wider
selection of hashish, a form of cannabis -- "Nepal," "Kashmir,"
"Thai," "Kabul." The barman will also roll joints, which cost about $3
each.
Contrary to Amsterdam's freewheeling reputation, the hash houses tend
to be quiet and controlled. At risk of police closure, the shops
strictly enforce the mandatory age limits -- customers have to be 18
to buy drugs there, two years older than the legal drinking age.
"Decriminalization has worked fairly well in the Netherlands," said
Cave, the drug policy expert at Warwick University, adding that few
hash-house customers have been found to move on to hard drugs.
Amsterdam's approach to cannabis spread widely through Europe. Today,
by statute or in practice, police officers in most European countries
ignore users of marijuana or so-called "recreational" drugs such as
amphetamines and ecstasy.
The latest convert is Britain, where the Home Office (roughly the
equivalent of the U.S. Justice Department) said in March that it would
downgrade cannabis from a "Class B" to "Class C" drug. This would
eliminate criminal penalties and treat possession or use like a
parking violation.
With the approval of the central government, some local police
departments in Britain have already taken that step in practice. In
the south London neighborhood Brixton, the local police commissioner
announced last year that his officers would no longer bother to arrest
pot smokers. Today it is commonplace to see young Londoners lighting a
"spliff" on the sidewalk outside Brixton's police station.
A recent study by the Joseph Rowntree Foundation, a London research
group, concluded that the Brixton experiment was a resounding success.
Ignoring marijuana offenses, the study concluded, allowed the police
to direct money and personnel to more serious crimes and "removed a
major source of friction between the police and the community." The
report said the more relaxed approach was "unlikely" to lead to
greater use of marijuana or more harmful drugs. It offered no data to
support this conclusion.
For the most part, the non-enforcement policy toward soft drugs has
gone over well with European voters. But Europe's new moves to
decriminalize such drugs as heroin and cocaine can be a tougher
political sell.
Nobody knows that better than Canas, an urbane, articulate former law
professor who was a Portugese government minister. It was Canas who
led this socially conservative, overwhelmingly Roman Catholic country
to abandon its long-standing prohibitionist policy toward hard drugs.
Canas spent a year or more discussing the plan with the Catholic
Church, the medical community and the police before introducing
legislation. The key political step, he said, was rejecting any
suggestion that decriminalization amounts to a stamp of approval for
drugs.
"You have to be very careful about the message you send," Canas
explained. "We do not say, we have never said, that it is good to use
heroin or cocaine. These drugs are still forbidden. What has changed
is the means we use to prevent their use."
Portugal's new drug law is so protective that it rejects terms such as
"addict" or "user." Rather, the person hooked on hard drugs is
referred to as a "consumer."
In the real world, the distinction between "consumer" and "dealer" is
not always clear, of course. To draw the line, Portugal has made rules
based on quantity. Anyone arrested with less than 10 days' personal
supply of each drug is considered to be in possession of the drugs for
personal use and is not prosecuted. Anyone arrested with more than 10
days' supply can be charged with dealing.
A drug user picked up by the police is initially sent to one of 18
civilian "drug commissions" around the country. The commission is
supposed to deal with each case individually, but users of cannabis or
amphetamines are generally given educational material and released,
while those using hard drugs are assigned to a treatment program.
A user who accepts treatment faces no further punishment, Canas said.
Those who duck out of treatment, or are caught offending again, face
administrative penalties similar to those for speeding or failing to
file a tax return. Initially, there are fines, beginning at about $22.
More serious violators can lose their driver's license or the right to
travel abroad, or be assigned to such public service jobs as cleaning
graffiti off the city's walls.
Elza Pais, who runs the local drug commission for Lisbon, said most
consumers turned over by police say they want to break the drug habit
and that they readily accept treatment. A few would actually prefer to
go to prison, she said, perhaps because drugs tend to be easier to
obtain there. "But we no longer have that option."
Like most of the people arrested for drug use in Lisbon, Miguel was
dispatched to the sprawling four-story treatment center on Taipas
Street in Lisbon's Bairro Alto neighborhood. There he came under the
friendly but firm ministrations of the center's energetic director,
Luis D. Patricio.
"We have inpatients and outpatients here," Patricio said, leading a
tour of his center like a hotel manager showing off a fancy new
resort. "We have young mothers and aging pensioners. We have people
who genuinely want to end their addiction, and people who probably
just think it is easier to come here for methadone than to scratch up
the money for a fix on the street.
"But for all of them, we have the same message now: You are not a
criminal. You do not have to fear the government or the doctor. With
good treatment you can get over addiction, and we are going to help
you do it."
After two decades of treating Lisbon's drug problem, Patricio said he
is certain Portugal's new policy is the best course. "In prison, you
turn an amateur drug user into a professional," he said. "That's what
America is doing; in Europe, we are looking for other solutions."
Canas, the former government minister, acknowledges that the long-term
result of the policy is unclear. "We only put the law into effect last
July," he said. "Perhaps in a year or so, we will be able to draw some
conclusions about the impact.
"For now, the fact is that we are experimenting."
Source: Washington Post (DC)
Author: T.R. Reid, Washington Post Foreign Service
Published: Friday, May 3, 2002; Page A01
The Washington Post Company
Contact: letterstoed@washpost.com
Website: http://www.washingtonpost.com
