In 2001, after two decades of increasing rates of drug use and addiction, the European nation of Portugal took a radical step: it decriminalized drug use. 

By many measures, the gambit has worked exceptionally well. Portugal’s prison population dropped significantly in the years following decriminalization, as did its HIV transmission rates via syringes. Despite warnings to the contrary, the country did not experience any sort of dramatic rise in drug consumption.

In the decades since, a smattering of other European nations have followed Portugal’s example and moved to treat drug consumption as a public health issue, rather than a criminal one. But it wasn’t until 2020 that an American state took a similar step, when Oregonians voted overwhelmingly for a ballot measure to decriminalize small amounts of illegal drugs. 

The measure took effect in early 2021 as Oregon was dealing with the COVID-19 crisis, the arrival of fentanyl, and an uptick in crime. This fall, a coalition of wealthy business leaders and politicians announced a plan to “fix” the ballot measure by re-criminalizing small amounts of methamphetamine, fentanyl and heroin and prohibiting the use of hard drugs in public. The group is calling its effort the Coalition to Fix and Improve Measure 110.

It was in that atmosphere that a group of 24 Oregon lawmakers, healthcare providers, community leaders, and law enforcement officers traveled to Portugal on a trip sponsored by the non-profit Health Justice Recovery Alliance to learn more about the Portuguese system. 

The trip, which was funded by nonprofit dollars, included stops in both of Portugal’s two biggest cities and meetings with a range of public health officials, providers, and drug users. For a number of the participants on the trip, the overarching takeaway was clear: people in Portugal, by and large, are happy with the framework of their current system. 

“We couldn’t find anybody who said that they wanted to see mere possession of substances re-criminalized,” Joe Bazeghi, director of engagement with Recovery Works NW, said. “Everybody was basically very, very together on the belief that it’s a public health issue and that criminal system intervention does not lead to better outcomes.”

Portland Police Association president Aaron Schmautz, one of two police officers on the trip, heard a similar level of agreement about the role the government should play when it comes to drug use. 

“From a societal standpoint, there seems to be very clear accord about what they think the government should interdict or navigate and what they should not,” Schmautz said.  

But for all the encouragement the Oregon delegation got from their Portuguese counterparts for the decriminalization approach, the trip also helped illustrate the ways in which the situation in Oregon is not perfectly analogous to the Portuguese case.

For one, Portugal instituted the decriminalization policy as an entire country with a socialized healthcare system and effectively nationalized education and policing systems—administrative advantages that Oregon, as a single state with significantly more local governance, doesn’t have.   

A number of participants on the trip were also quick to point out that Oregon and Portugal differ in at least one other significant way: Portugal does not have the same level of fentanyl use Oregon has. 

Fentanyl, a synthetic opioid 50 times stronger than heroin, arrived in Oregon in significant quantities in 2019 and has since passed methamphetamine as the drug most commonly involved in overdose deaths in the state. 

Portugal does not currently have the same levels of fentanyl use, especially in its cities. But Bazeghi said the Portuguese are preparing for an influx of the drug, and doing so in a manner indicative of how the country approaches drug use more broadly as a public health issue.

“They’re already taking proactive measures,” Bazeghi said. “For instance, they are truly stockpiling narcan. They are making sure that all these harm reduction sites have access to it, training in it, and that it’s going to be and already is available in large quantities to push out into the drug user community and supply these sites. So they are lightyears ahead of Oregon.”

As a whole, the story of Portugal’s public policy approach is not just about decriminalization, but also about investment in treatment resources. More than half of the country’s public expenditure on illegal drugs is on treatment and prevention, sustaining a system in which people who want help are much more easily able to access it. 

In fact, State Rep. Rob Nosse of Portland said one of the biggest challenges the Portuguese have faced in their decriminalization effort was in the aftermath of the recession of 2008 when the country, struggling financially, cut back on social services. That had a major, years-long effect. 

“They’re just now sort of rebuilding back up to what they believe they had when they first started,” Nosse said. 

The issues in healthcare investment in Oregon extend far beyond drug use. The state consistently ranks as one of the worst in the country for addressing mental health issues, including in the kinds of areas that could make a sizable difference in the success of a drug decriminalization program.  

“We should probably double what we’re spending on ballot Measure 110 kinds of services and make those kinds of things way more available—the detox part, the peer mentoring part, and housing supports,” Nosse said.


The Measure 110 coalition’s plan to alter the law would not just re-criminalize fentanyl, methamphetamine, and heroin, but it would also compel addiction treatment instead of leaving it as a voluntary choice. That would be a departure from the Portuguese system, which is not designed to eliminate drug use or addiction but rather to build trust in the public health system and save lives. 

“They’re not trying to get to 0 percent addiction,” Bazeghi said. “They recognize the addiction is a human phenomenon and that it will be present, and so they provide treatment resources. They have people accessing doctors when they need them, and they have people willing to engage with police when there is harm.”

While the lack of criminal penalties has frustrated a segment of Portuguese law enforcement officials, Schmautz said he appreciated the extent to which the country has embraced “community policing” and the role of law enforcement officers in its public safety architecture. 

“I think the things that we know now are that, certainly… we’ve got to have more treatment and people need more help,” he said. “We’ve got to have pathways to treatment that exist with and without our justice system. We’ve got to equip law enforcement to be a good vector towards service provision, but not being the actual service provision.” 

Even with its relative advantages, Portugal’s decriminalization approach has its detractors—especially currently, with public usage rates increasing. But even the policy’s detractors largely aren’t advocating for its repeal, but rather targeted changes. 

Some of the Portuguese officials who spoke to the Oregon delegation were also conscious to point out that the country’s success with its decriminalization program didn’t happen overnight, but instead after a number of years. 

“It took five years before really things started to stabilize in the system,” Bazeghi said. “And that was one piece of advice they gave us. They were like, ‘Hey, your system can’t be our system.’ But what we know for sure is that there was learning in the beginning, and that it required recommitting.”

Nosse said that Oregon, like Portugal, shouldn’t tolerate drug use in public spaces like parks and buses. But for him and a number of the other participants on the trip, a return to the kinds of War on Drugs policies that failed to improve public health and disproportionately targeted non-white people over the last half-century is a non-starter.  

“The start is hard,” Bazeghi said. “You have to be committed. Be committed—don’t go backwards.”