What was done in Oregon, based on the successful policy in Portugal, was decriminalising use and possession of very small quantities. Distribution and sale are still just as illegal as before.
Basically I think this is the right approach. Drug use at low levels in endemic. I don't think it makes sense for huge swathes of otherwise law abiding citizens to be technically criminals. It ends up with grossly distorted demographic distributions of those that suffer legal consequences in deeply unfair ways. Criminalisation on use also aligns the interests of users with those of dealers, where differences in criminal liability help drive a wedge between them.
The 3 year old policy in Oregon looks like it was fumbled. They didn’t put in place essential social and health care support services that a policy like this relies on for 2 years. Portugal has a national health care service, so a co-ordinated approach seems like it was far easier to implement and co-ordinate. Still, Oregon seems to have made much needed improvements in this area.
Policies like this are not silver bullets. Drug abuse is a severe issue with deep roots in individual lives and society, and manifests differently in different societies. I hope Oregon sticks with it and works on trying to get this policy to work, and tailor their response to their needs. 50 years of the war on drugs has failed utterly, let’s give an alternative a chance.
How are you defining successful? The linked article links to a recent wapo article from last week "Once hailed for decriminalizing drugs, Portugal is now having doubts". I don't know one way or the other, I'm just trying to collect more data points. Didn't Vancouver BC try something similar?
(Seems a little odd that this Atlantic article, the Wapo article questioning Portugal's policy, and yesterday's Times article about weed addiction have all appeared in a week's span. Since none of them seems triggered by an external reporting event.)
Beyond the headline Portugal is having doubts because they decided to gut funding. Where it was seen as promising or successful, now it's basically decriminalized drug use and no treatment or enforcement. Which kinda sounds like what Oregon is doing now and what Reagan did with mental health care in California.
Could you (or anyone else reading this) define "gut funding" in quantitative terms?
I'm asking because I've noticed newspapers have somehow acquired the ability to imply that spending on this or that program is being cut, when in fact it isn't. Often simply refusing to let a program grow at an exponential rate is supposed to be a "spending cut". And sometimes mere exponential growth is not enough.
To give an example, if one trusts the newspapers of the United Kingdom, the NHS is supposed to have been "underfunded" ever since Cameron became prime minister in 2010. The reality is that expenditures on that system have remained at around 9.7% of GDP until COVID when they rose to 12%, remaining at that level since then. And GDP is a quantity that's growing every year.
If "properly funding" hard drug legalization would require expenditures on rehab programs that steadily grow until they reach a third of all government revenues, that in and of itself makes legalization a horrible policy.
> After years of economic crisis, Portugal decentralized its drug oversight operation in 2012. A funding drop from 76 million euros ($82.7 million) to 16 million euros ($17.4 million) forced Portugal’s main institution to outsource work previously done by the state to nonprofit groups, including the street teams that engage with people who use drugs.
Yes. That is the definition of the nonprofit structure. These entities don't exist if they actually solve the problems that they pretend to try to solve. If some nonprofit came up with a magical solution to the opioid crisis, that ended it tomorrow, the grants would dry up and they'd all be out of work. Perhaps you pretend that everyone who works for nonprofits are completely altruistic in nature, and if that's the case may I suggest that you have not met enough of these people.
Yes. if a non-profit receives most of its finding to end homelessness for example, the last thing they want to actually do is end homelessness, because their funding then goes away. What they want is homelessness to remain somewhat constant and claim reduction in growth, or appearance as a success.
Cameron effectively cut £500 million from the NHS budget by redefining what the budget was and then claiming the budget increased. The result is that Cameron was ordered to stop claiming that he increased NHS funding.
Good links thanks, and I'll add: the % of NHS's budget being pushed to private providers has been steadily increasing every year for over a decade. If you have £x to pay nurses (or CT scanning machine operating costs, or cleaning crews, or...) and nurses typical pay is £y, and your budget goes up to £2x but you also switch to using agency nurses who charge £3y while paying the nurses £1.5y, the nurses have had a 50% pay rise, but the NHS budget is effectively worth 2/3rds what it was before despite being technically double.
Obviously it's not as simple as X and 2X, but constant real-term pay drops have led to lower staff levels leading to more agency staffing (where a private company takes a tidy slice of profit for every hour worked), policies such as selling off NHS buildings for NHS Trusts to have to rent them back have been put in place, and shit like that has happened across the board.
Ultimately, the tory party hates that the NHS is public not privately run, have gradually been pushing to change that, and have excellent PR that's persuaded many people that it's the useless NHS's fault for all of this. Those pesky doctors who don't care about people!
>To give an example, if one trusts the newspapers of the United Kingdom, the NHS is supposed to have been "underfunded" ever since Cameron became prime minister in 2010. The reality is that expenditures on that system have remained at around 9.7% of GDP until COVID when they rose to 12%, remaining at that level since then. And GDP is a quantity that's growing every year.
The reality is that they cut the things that add cumulative pressure to the NHS itself. E.g - social care cuts meant that thousands of beds occupied by medically fit people were occupied because they had nowhere to send those people to. The "underfunded" thing is a simplistic and borderline misleading way of phrasing it but with the attention economy that we're in I can see why they'd phrase it that way
Your UK example doesnt include the denominator -- the number of people needing care. GDP growth is not correlated to the number of people needing care, so using it to normalize spend isn't right. The %GDP needs to be going up to maintain funding levels
In addition, the policy in Portugal was to radically increase funding for community health and other programs as well as decriminalize drugs. I’m not sure that has been replicated in Oregon or San Francisco.
I live right across the border from Vancouver BC. Whatever they're doing to solve the addiction problem isn't working terribly well either. There's lots of places in the PNW that look downright utopian from a distance, but when you go and live hereabouts, only then do you see the problems. Portland is getting the flak here and everyone knows about SF because it's the worst by long shot, but even in smaller towns on both sides of the border, there are problems.
We need a hard look at this problem because particularly on the West Coast of US and Canada, and particularly SF and northward, it is making a mockery out of the free-spiritedness and open-mindedness that folks here would espouse. We don't set boundaries on detrimental behavior. The way people OD in the streets here is not okay. The violent behavior of addicts on the BART is not okay. Then on the other end of the spectrum, when someone "important" in the community does something awful around here, other people will try to encourage reconciliation by taking on smaller doses of that bad thing. As if that makes it less bad. It's absolutely insane. It's like this whole place has given up on trying to do better, societally. It is radically individualistic, and yet, personal accountability has broadly flipped on its head. The folks who have chosen addiction and homelessness over getting clean / sanity / whatever are really just the tip of the iceberg.
Unfortunately, what you are describing is incredibly common. Issue A gets some funding to try a New Approach because nothing else has worked. New Approach sees some positive results. New Approach gets some more funding. People working on New Approach say hey to scale this effectively we will need significantly more funding. They receive some funding or no funding. New Approach continues to work to some extent, but without additional funding is not scalable.
Issue A gets some funding to try a New Approach... and so on.
One of the worst parts about this cycle is that people will point to Issue A and say, "We've been throwing money at the problem for years and nothing works!" and give up and/or decide that they are now against funding Issue A.
On the other hand, it is extremely difficult for an outside observer, looking at the results of the New Approach, to judge whether it is not scaling well because of a lack of funding or because it fundamentally does not scale well. It can also be challenging for the people involved to realize that their approach isn't working (cf. "sunk cost fallacy", "it is difficult to get a man to understand a point when his salary depends on him not understanding it", "confirmation bias"). Often, the approaches are not necessarily poorly funded but rather inefficiently managed - education and healthcare would be the prime examples in the US context. The US spends a roughly approximate amount of its public budget on healthcare as the UK does. At other times, advocates for an approach to solving a social issue are ideologically motivated more than results-oriented. A case in point is the difference between LA's approach to the homelessness crisis and NYC's take (https://public.substack.com/p/three-times-more-homeless-die-...)
> Basically I think this is the right approach. Drug use at low levels in endemic. I don't think it makes sense for huge swathes of otherwise law abiding citizens to be technically criminals.
While I do agree that prohibition is probably not the answer, calling the Portuguese policy a "success" kind of misses the forest for the trees[1]. The most obvious problem is funding (which Porto is running out of): life-long support for a drug addict is going to be significantly more expensive than throwing them in jail for a few years. Not to mention that the latter is also more popular with voters.
>life-long support for a drug addict is going to be significantly more expensive than throwing them in jail for a few years
Citation needed, you might be underestimating how much it costs to jail someone.
If a drug user actually manages to get clean (which with proper support, most can) then the cost of support is basically checking up on them a couple of times a year. Meanwhile they can hold down a job and live a normal life.
That's as opposed to the significant costs of keeping someone in prison, which is significantly more than they would be earning if they were free.
> That's as opposed to the significant costs of keeping someone in prison, which is significantly more than they would be earning if they were free.
It's worse than that. If someone is working a productive job, even if they don't make much, they're doing something useful. Someone has their dishes washed or their floors swept and there is a surplus that accrues not only to the worker but also the rest of society.
If someone is in prison, not only do you lose that surplus, you have to extract tax dollars from some other productive activity and use it to pay prison guards and consume real estate, which money could have been used by the government to do something useful, or to lower taxes so the taxpayer can do something useful.
> even if they don't make much, they're doing something useful.
While I agree that the prison-scenario costs are probably underestimated and underappreciated... If we're going to try to measure the "doing something useful" part, we should also consider the other side of "doing something destructive to other people and property" part.
Someone could hold down a job and be cutting catalytic converters out of other people's cars.
The underlying assumption being that the only alternatives are prison and crime.
Suppose nonviolent criminals get sentenced to restitution and community service and only go to prison if they fail to complete their community service. Now you want to go out stealing catalytic converters and you're going to find that doing a bunch of free labor while giving half the wages from your paid labor to your victims is a lot less profitable than just doing honest work.
Ah, I was assuming the drug addict (or at least a signification portion) wouldn't be getting clean. A large part of Portugal's policy is focused on safe drug use (decriminalization, clean needles, drug dispensaries, etc.).
The primary purpose of these policies is that they actually do help people get clean. It's harder to fix up your life when you're also going through the criminal justice system, or otherwise trying to avoid all forms of authority.
Consider this: if drug use is criminalised, then seeking help increases your risk of getting arrested!
True, though I suspect most people do this calculus: would I rather want a drug addict to be on the streets or in jail? (Especially if the crime is violent.)
Keep in mind that I have no idea how to "fix" this, and it's a very complicated issue, so I'm just trying to spark conversation. If we look at historical examples (e.g. opium dens), it's rarely these societal issues fixed themselves with more lenient social policies (they often, in fact, got worse).
The counter-example is Prohibition (which was an abject failure), but maybe this is (at least in part) due to the cultural importance of alcohol of so many people. I don't really think cocaine or meth are such cultural lynchpins.
Prohibition wasn't an abject failure. The most pessimistic reading is that its results were mixed, with many scholars believing it was a success. (There was a reason it took 14 years to repeal and not because people thought it was an abject failure.)
Copied & pasted from Wikipedia:
"Alcohol consumption declined dramatically during Prohibition. Cirrhosis death rates for men were 29.5 per 100,000 in 1911 and 10.7 in 1929. Admissions to state mental hospitals for alcoholic psychosis declined from 10.1 per 100,000 in 1919 to 4.7 in 1928. Arrests for public drunkenness and disorderly conduct declined 50 percent between 1916 and 1922. For the population as a whole, the best estimates are that consumption of alcohol declined by 30 percent to 50 percent.[7]
Specifically, "rates for cirrhosis of the liver fell by 50 percent early in Prohibition and recovered promptly after Repeal in 1933."[4] Moore also found that contrary to popular opinion, "violent crime did not increase dramatically during Prohibition" and that organized crime "existed before and after" Prohibition.[7] The historian Jack S. Blocker Jr. stated that "Death rates from cirrhosis and alcoholism, alcoholic psychosis hospital admissions, and drunkenness arrests all declined steeply during the latter years of the 1910s, when both the cultural and the legal climate were increasingly inhospitable to drink, and in the early years after National Prohibition went into effect."[8] In addition, "once Prohibition became the law of the land, many citizens decided to obey it".[8] During the Prohibition era, rates of absenteeism decreased from 10% to 3%.[9] In Michigan, the Ford Motor Company documented "a decrease in absenteeism from 2,620 in April 1918 to 1,628 in May 1918."[6]
It took that long to repeal because it was an amendment (and thus needed another amendment to repeal it). The rest of your post basically says people drank less therefore less people drank (it's obvious that if less people drink, less people will have alcohol problems). I'm not sure if the academic consensus is that it was "mixed," most top search results seem to agree that it was kind of a failure[1][2], but to be fair I never studied it in depth and Google can be biased.
> I'm not really clear what you're trying to argue here.
Prohibition fell out of popularity, so to me it seems like it was a failure because it didn't significantly impact domestic policy in the long-term. As opposed to something like women's suffrage.
> it's rarely these societal issues fixed themselves with more lenient social policies (they often, in fact, got worse).
Opium was prohibited even after the opium wars. That's not a good example of non-prohibition but instead the knockon effects of worst of both worlds informal, capricious quasi-legality.
> The counter-example is Prohibition (which was an abject failure), but maybe this is (at least in part) due to the cultural importance of alcohol of so many people. I don't really think cocaine or meth are such cultural lynchpins.
I mean, people haven't really stopped doing Cocaine or Meth, and the most negative effects of prohibition (extremely violent organized crime) still seem to be present.
Yep, which is why I used the term "more lenient policies," not necessarily non-prohibition. Opium dens were getting more and more problematic in San Francisco[1] until they were criminalized in the late 19th century.
> I mean, people haven't really stopped doing Cocaine or Meth
I don't think the end goal of prohibition is zero use of said substance, but rather its control as to prevent large-scale societal disruption.
> Yep, which is why I used the term "more lenient policies," not necessarily non-prohibition. Opium dens were getting more and more problematic in San Francisco[1] until they were criminalized in the late 19th century.
The point is that prohibition the issue. Being more lenient while still keeping prohibition isn't a half way point, but still keeps the most harmful elements intact.
> I don't think the end goal of prohibition is zero use of said substance, but rather its control as to prevent large-scale societal disruption.
Do you think that prohibition is effectively preventing large scale societal disruption?
Sure, and if you're ideologically opposed to a policy you can make a comment like this. What's needed is data on many alternative approaches, what policies _and_ executions taken as one promote better outcomes? Over what timeframes? Otherwise it's just all shouting into a windstorm.
That’s… what I’m arguing? There’s a hard problem to be solved with uncertain paths toward a solution — or uncertainty of what “solved” means in this case, maybe, depending on whether endemic is an acceptable outcome — and every attempt at a solution that doesn’t work out, or doesn’t work out sufficiently well, is data added to the project of getting better outcomes for all. I’m not entirely sure what you’ve read in my comment but I’m certainly not saying we shouldn’t view things plainly.
I would also challenge your implicit notion here that there is a binary pass/fail solution to societal levels of drug addiction. Like any seriously hard problem there are policies that have been proposed and implemented around that world that have some positive outcomes in some regards and negatives in others. Incarceration (the Drug War) theoretically makes serious drug addiction absent from public life, a positive, but with the result of growing the police state, a negative. Vice versa for Oregon’s policy, now that it’s run for a while. I think we’re recently finding that Portugal’s approach which Oregon based their policy on also does not have better than expected outcomes, although the data is early yet.
> What's needed is data on many alternative approaches, what policies _and_ executions taken as one promote better outcomes?
> Over what timeframes?
This is where the goalpost shifting happens.
I can not think of a single instance in recent history where a political leader has admitted that a policy they like has failed because it was fundamentally a bad idea.
Not PP, but the onus is always on the person or group making the affirmative claim. It _might_ be that the policy is sound but the execution is in error, but we should not _assume_ that the policy is sound.
> Not PP, but the onus is always on the person or group making the affirmative claim.
But they're both making an affirmative claim. One says that legalization is better and all these addicts are an error in execution. The other says that criminalization is better and all this widespread disrespect for the law and erosion of civil liberties and mass incarceration and cartel murder squads are an error in execution.
In general the burden should be on the party who wants make something illegal.
I’m kind of of the opinion that we shouldn’t hold addicts to account for their addictions. By the time they’re addicted they’re not rational actors any more.
By the same count we don’t judge the mentally unwell and children as if they’re well-functioning adults.
OK, so what does that concretely mean as a policy? "Not judge", fine - does that mean no arrests, no involuntary holds, not touching them? We used to take the view that we could confine people for things that weren't their fault when there was an overwhelming public interest (e.g. people with infectious diseases).
I don't think it's that simple. No one acts 100% rationally all of the time. In this respect, addicts, children, and the mentally unwell differ from the rest of us by degree - they may have diminished responsibility for their own actions, but I don't think it makes sense to try to draw a sharp line where you're either responsible for your own actions or you're not. Recovery from addiction requires assuming responsibility for one's actions.
By the same count we don’t judge the mentally unwell and children
as if they’re well-functioning adults.
Sure we do (or we did up until recently). Bill Clinton famously presided over the execution of a man missing a chunk of his brain to appear tough on crime during his presidential campaign.
Looking on from the UK, the only answer American liberals seem to have for the failures of American liberalism is that America just wasn't liberal enough.
The UK that dismisses or suppresses its own reports into drug policy and fires its leading experts because their views are not politically expedient, that UK?
I think even if we don't know what is the right way to go about drug policy, we can probably agree that sticking your head in the sand and pretending there's no debate to be had is probably not the best approach.
Portugal also forces people into treatment if they can’t function as a member if society. Oregon will never do that. The treatment is there but people won’t voluntarily go to it. If they continue this policy they’ll see the same degradation of public spaces that I’ve seen living in Portland since this was enacted.
Portugal's program is very different than Oregon's. It's "decriminalized," sure... But with nonetheless strong state-enforced repercussions for doing hard drugs. From Wikipedia (https://en.wikipedia.org/wiki/Drug_policy_of_Portugal):
The [Portugese drug offense] committees have a broad range of sanctions available to them when ruling on the drug use offence. These include:
Fines, ranging from €25 to €150. These figures are based on the Portuguese minimum wage of about €485 (Banco de Portugal, 2001) and translate into hours of work lost.
Suspension of the right to practice if the user has a licensed profession (e.g. medical doctor, taxi driver) and may endanger another person or someone's possessions.
Ban on visiting certain places (e.g. specific clubbing venues).
Ban on associating with specific other persons.
Foreign travel ban.
Requirement to report periodically to the committee.
Withdrawal of the right to carry a gun.
Confiscation of personal possessions.
Cessation of subsidies or allowances that a person receives from a public agency.
Meanwhile Oregon's (and much of the West Coast's) idea of "decriminalization" is just... No consequences for doing hard drugs! Here's Oregon's law, from the article:
To achieve this goal, Measure 110 enacted two major changes to Oregon’s drug laws. First, minor drug possession was downgraded from a misdemeanor to a violation, similar to a traffic ticket. Under the new law, users caught with up to 1 gram of heroin or methamphetamine, or up to 40 oxycodone pills, are charged a $100 fine, which can be waived if they call a treatment-referral hotline. Second, the law set aside a portion of state cannabis tax revenue every two years to fund a statewide network of harm-reduction and other services.
You don't even have to pay the fine! You can just call a hotline. No follow up, no ensuring that you go to treatment... Just a phone call.
The idea that you can have no consequences for hard drug use, and that people will just voluntarily check themselves into "services" (or that "harm reduction" services will dissuade people from using hard drugs) is I think at this point dead in the water.
I used to be in favor of broad drug decriminalization. But the opioid epidemic changed my mind: some drugs are so bad that even when administered by a regulated medical system, large numbers of people's lives can be ruined simply by giving them access to the drug. Allowing street usage of similar drugs like heroin, fentanyl, etc can't be safer than that. I don't necessarily think jail is the best option, but zero-consequence + entirely-optional treatment for opiate abuse is not a working policy, and IMO jail is actually a better policy than that: at least in jail you have a chance at forcing them off the drug. My preferred policy at this point would probably look more like mandatory state-enforced rehab in a confined setting without long-term legal implications like a criminal record, though.
Less-addictive drugs like marijuana, ketamine, MDMA, etc I think probably should be legal for adults, with some guardrails around access similar to e.g. Sudafed. But effectively having an open season for using opiates is asking for trouble.
Tolerating use but keeping sale / production illegal means you are creating a billion dollar market that by default can only be serviced by criminal organizations.
Legalize and harm reduction have been the tenets for so so long. No one does it.
What is harm reduction though? The catch with severe addiction is that those suffering actively fight against treatment as a result of the disease. Is there a point of functioning at which we can force an opioid addict into treatment? Or is harm reduction just to let those folks live in oblivion indefinitely?
I'm genuinely asking because I've mostly thought of "harm reduction" as actions to prevent issues like the spread of disease through needles or the lacing of street drugs. Which are important no doubt, and perhaps legalization (w/ heavy regulations) + harm reduction would be better than the current highly flawed system. There are just some drugs that are so destructive to their users that I don't see how they can be sufficiently fought without some force at some step.
Basically I think this is the right approach. Drug use at low levels in endemic. I don't think it makes sense for huge swathes of otherwise law abiding citizens to be technically criminals. It ends up with grossly distorted demographic distributions of those that suffer legal consequences in deeply unfair ways. Criminalisation on use also aligns the interests of users with those of dealers, where differences in criminal liability help drive a wedge between them.
The 3 year old policy in Oregon looks like it was fumbled. They didn’t put in place essential social and health care support services that a policy like this relies on for 2 years. Portugal has a national health care service, so a co-ordinated approach seems like it was far easier to implement and co-ordinate. Still, Oregon seems to have made much needed improvements in this area.
Policies like this are not silver bullets. Drug abuse is a severe issue with deep roots in individual lives and society, and manifests differently in different societies. I hope Oregon sticks with it and works on trying to get this policy to work, and tailor their response to their needs. 50 years of the war on drugs has failed utterly, let’s give an alternative a chance.