Documente Academic
Documente Profesional
Documente Cultură
Decriminalisation of drugs in Portugal - the real facts! was written by Manuel Pinto
Coelho (Chairman of APLD - Association for a Drug Free Portugal and member of
International Task Force on Strategic Drug Policy) on February 2nd, 2010.
It sounds like an interesting title. But, published on the World Forum Against Drugs it is
immediately disqualified from seriously being considered accurate. The WFAD is a bastion
of opinionated, pseudoscientific, deceptive, ideological, inhumane and intellectually
insulting pieces. Whilst such rambling today needs a response, I await the day of Illicit
Drug Policyʼs own version of Scopieʼs Law. We shall revisit Scopie in a moment.
The article was brought to my attention by Jo Baxter, E.O. of Drug Free Australia. Jo had
taken issue with Director of Alcohol and Drug Service St. Vincentʼs Hospital, Sydney, Alex
Wodak's insightful piece "Agony over Ecstasy is helping no-one". It examined the arrest of
Matthew Chesher, a suddenly erstwhile official in the NSW government and hubby to state
level minister Verity Firth, for purchasing an Ecstasy tablet. Recently returned from Lisbon,
Wodak chose to reflect on Portugalʼs vastly different policy and how this would have tallied
with one decent manʼs desire for a recreational drug.
Examination of Coelhoʼs piece reveals his wide sweeping claims do not begin to deserve
the confidence in which they are presented. Some can be shown as simply false. Otherʼs
are a clever misrepresentation, whilst at best he can rely upon some few negatives which
in no way support his accusations of manipulated numbers, “opposite” realities or a
damning proof of Portugalʼs changed illicit drug legislation. Without defending
decriminalisation itself, an examination of evidence shows Coelho to be in towering error.
Scopie's Law originated on the Bad Science forum thanks to Rich Scopie and states;
As usual without a cursory bibliography it is difficult to confirm or deny the context of such
sweeping statements, particularly as they are presented without trend or
comparison. Citing the European Observatory for Drugs and Drug Addiction 2007, a
number of claims are made. A quick search for the "Observatory" yields only the same
articles by Coelho, and indeed The European Monitoring Centre for Drugs and Drug
Addiction. The Observatory is mentioned in the Nov. 2003 Congressional Record USA, Vol
149, under "Intervention of the delegation of The Holy See", and a nice little reference to
Pope John Paul II. Perhaps he meant the EMCDDA. Either way, it does him no good.
In 2006, the total number of deaths as a consequence of overdose did not diminish
radically compared to 2000, nor did the percentage of drug addicts with AIDS decrease
significantly (from 57% to 43%). The opposite occurred.
"The opposite occurred"? Page 48 of EMCDDA 2006 data, gives us some clarity on
changing drug related death trends over time;
Data from the GMR (Selection B of the DRD Protocol) continue to indicate a
decrease which started to take place from 1996 (114 cases) until 2005 (9
cases). The number of cases implies that breakdown data on them ceased to
be available for statistics privacy reasons.
Although acute drug-related deaths are not yet possible to identify amongst
the cases reported by the SMR, it has been possible to identify the
percentage of suspected acute drug-related deaths. In 2006, 216 cases with
positive post mortem toxicological tests were reported by the Special
Register.
This percentage, which decreased between 2000 and 2003, increased in 2004
to 51% and again in 2005 to 58%, in comparison to previous years (44% in
2003, 58% in 2002, 73% in 2001 and 72% in 2000) and decrease again in 2006.
Taking only 2006 notified cases, 37% of the AIDS cases, 28% of the AIDS
related complex cases and 19% of the asymptomatic carriers cases were
drug use associated.
This agains reinforces the decreasing trend, verified since 1998, in the
absolute numbers and percentage of drug users in the overall number of
diagnosed AIDS cases, as seen in the graph below, despite the fact that, in
Response to “Decriminalisation of Drugs in Portugal - the real facts!” by Manuel Pinto Coelho
2005, the infection by HIV was included in the national list of diseases which
implies mandatory notification.
Further reading of that page offers more clarity. The 2007 data report reads very closely.
Coelho continues;
Portugal faces a worrying deterioration of the drug situation. The facts prove "With 219
deaths from 'overdose' per year, Portugal has one of the worst results, with one death
every two days. Along with Greece, Austria and Finland, Portugal registered an increase of
deaths by more than 30% in 2005 " and " Portugal remains the country with the highest
increase of AIDS as a result of injecting drugs (85 new cases per million residents in 2005,
when the majority of countries do not surpass 5 cases per million). Portugal is the only
country that recorded a recent increase, with 36 new cases estimated per million in 2005
when in 2004 only 30 were registered" (European Observatory for Drugs and Drug
Addiction 2007). The European report also confirmed that in 2006, Portugal had registered
703 new cases of SIDA, which corresponds to a rate eight times higher than the European
average!
It's a bit like screaming at surgeons in Causality as they begin to operate on a loved one
bleeding to death from multiple injuries. "His B.P. is lower than when he arrived, he lost
consciousness not long after you touched him! Of the 27 people in here he's the worst!
This is a hospital and he's not getting better - why isn't he better? There's blood
everywhere and I now have proof of bone fractures and swelling on the brain - which I
didn't have before I came here!"
What's truly devious about the tactics used by anti-drug campaigners is the cherry picking
of data. Despite having read, and quoted from, the World Drug Report 2009 our friend
Response to “Decriminalisation of Drugs in Portugal - the real facts!” by Manuel Pinto Coelho
Manuel will ignore it when it suits him. Extraordinary claims require the evidence to back
them and that means a link, or a citation backed by a bibliography.
Another trick used to pass Portugal off as a nation of drug induced tragedy and woe, is
Coelho's use of "Western European" figures or "France, Ireland, Spain, The United
Kingdom, Italy, Denmark and Portugal". He omits to share with us, for example in the case
of opiates, that of nine indices Portugal has lower usage per capita than Switzerland and
on UK population figures, Portuguese addicts would equal approximately 260,000 - not the
UK's own 440,000. Statistically, opiate use is still lower than Italy, whilst higher than
Germany, France, Spain and The Netherlands.
Whilst writing hat 219 deaths from overdoses and a 2005 increase of 30%, "along with
Greece, Austria and Finland" is eye catching, Coelho's "real facts" are quite welcome if we
note annual OD's were ~ 400 before decriminalisation and "HIV cases caused by using
Response to “Decriminalisation of Drugs in Portugal - the real facts!” by Manuel Pinto Coelho
dirty needles to inject heroin, cocaine and other illegal substances plummeted from nearly
1,400 in 2000 to about 400 in 2006, according to a report released recently by the Cato
Institute, a Washington, D.C, libertarian think tank."
http://www.scientificamerican.com/article.cfm?id=portugal-drug-decriminalization
Coelho is having none of this academia that doth offend him and dispatches Cato and
others smartly in his opening. He writes;
Recent articles in the weekly British magazine, The Economist and The Cato Institute of
Washington promote government options as a legitimate right. The problem is the rest; the
manipulation of the facts and numbers is unacceptable!
Remember that - "...manipulation of the facts and numbers...". More so, the very recent
slight increase in negative outcomes is not contested by policy analysts nor a viable proof
of legalisation's social malignancy, as seemingly claimed. The Boston Globe reported last
month, citing research by Caitlin Elizabeth Hughes and Alex Stevens;
"In fact, drug-related deaths in Portugal — after falling between 1999 and 2002 —
jumped considerably between 2005 and 2008. But the drug-related death data is
misleading, most likely due to a “shift in measurement practices,” and an increase
in the number of toxicological autopsies performed, according to Hughesʼs and
Stevensʼs research. And Hughes also takes issue with [Keith Humphreys, a
professor of psychiatry at Stanford University who focuses on negative
developments] argument that drug use, in general, is increasing at a dramatic clip.
Whatʼs most relevant, she [Hughes] said, is not the percentage of people reporting
using drugs at some point over some course of their lifetime, but the percentage of
people reporting using drugs in the past year. “Thatʼs going to be affecting the
government and communities now,” she said. And here, the increase of Portuguese
reporting illicit drug use is much smaller — up from 3.4 percent in 2001 to 3.7 in
2007."
"The percentage of people reporting drug use in the past year... going to be affecting
government and communities". Wise words from Hughes. When we look at “ever used”,
“lifetime use” and recent use, vastly different conclusions can be drawn. If drug use is
falling over a short time frame or in response to new initiatives, the drop can be lost if “ever
used” figures are quoted. This includes, say, one time experimenters and new/long term
sober ex-users responding to treatment, giving a skewed view of ever increasing drug use.
Audaciously, Coelho scurrilously quotes the same IDC 2008 data as that used by Hughes
and Stevens who arrive at almost polar conclusions, to state the mundane. "On the
contrary, the consumption of drugs in Portugal increased by 4.2% - the percentage of
people who have experimented with drugs at least once in their lifetime increased from
7.8% in 2001 to 12% in 2007". Which, in the context of pre-legalisation uptake and the
now much reduced harm, increased treatment, reduced crime and deaths is nothing short
of petulant and laughable.
More so, if one searches for these key words hoping to find the IDT making much of the
equation, 12% - 7.8% = 4.2% one finds Coelho lurking in almost every corner of the
internet that Portugal's success is reported. As noted he repeated his claim in Rapid
Responses to Drug Decriminalisation in Portugal, BMJ - Oct. 2010. It's repeated in a
Response to “Decriminalisation of Drugs in Portugal - the real facts!” by Manuel Pinto Coelho
comment to a BBC article September 2010. The same day as he published it at WFAD it
appears on Brazilian Humanitarians in Action. Comments at Wired In To Recovery January
12th, 2011 see "PeaPod" copy/paste the same text. In fact, everywhere one sees that
4.2% pop up, it is attributed to Manic Manuel. Golf clap, dear reader, golf clap.
In The British Journal of Criminology, [Vol 50 Issue 6, pp. 999-1022] What Can We Learn
From The Portuguese Decriminalisation Of Illicit Drugs?, Caitlin Hughes and Alex Stevens
consult the IDT data extensively. Strangely, Manuelʼs meaningful 4.2% is entirely absent in
this voluminous text. It is here we can see why Coelho makes liberal use of combining
Portugal with Spain and other nations. Consider Fig's 2 & 3 - Number of offender arrests.
In the Portuguese case, the statistical indicators and key informant interviews that
we have reviewed suggest that since decriminalization in July 2001, the following
changes have occurred:
• reduced illicit drug use among problematic drug users and adolescents, at
least since 2003;
Perhaps the most damning abuse of evidence at Coelho's hands is that of the World Drug
Report 2009. He quotes it in his article and thus, has clearly read it. From
misrepresentation to fabrication, "references" made can be qualified differently. For a chap
popping lofty titles after his name and leading the charge for a "Drug Free" Portugal it's
incomprehensible that he's unaware of the INCB's 2004 mission to Portugal, and their
conclusion that possession remained prohibited.
a small amount of drugs for personal use are issued with a summons rather
than arrested. The drugs are confiscated and the suspect must appear before
a commission. The suspectʼs drug consumption patterns are reviewed, and
users may be fined, diverted to treatment, or subjected to probation. Cases of
drug trafficking continue to be prosecuted, and the number of drug trafficking
offences detected in Portugal is close to the European average."
On Page 183;
The intentional deception goes on. Coelho writes in a masterpiece of Special Pleading;
"With regard to hashish, it is difficult to assess the trends and intensive use of hashish in
Europe, but among the countries that participated in field trials, between 2004 and 2007
(France, Spain, Ireland, Greece, Italy, Greece, Italy (sic), The Netherlands and Portugal)
there was an average increase of approximately 20% " (EMCDDA, 2008)."
20%! Remember, his article is called "Decriminalisation of drugs in Portugal - the real
facts". What if we isolate Portugal from page 111 of the 2009 WDR. In 2001 Portugal's
annual prevalence of cannabis use was 3.3%. Five years later in 2006 it was 3.6%. Italy
had more than doubled from 6.2 to 14.6% up to 2007. But the juiciest bit on page 110 is
that DRUG FREE Sweden increased cannabis use by almost 300% rising from 0.7% in
2000, to 2.2% in 2004 to 2.0% in 2006. So, by 2006, Sweden's Drug Free Zero Tolerance
led to a three fold increase vs Portugal's 9.0% increase.
And how convenient to include Spain in misrepresenting illicit drug trends in Portugal.
Spain tops the world for cannabis resin seizures grinning away at 50% or 653,631 kg for
2007. Portugal manages 3% - or 42,772 kg. So, Manuel almost certainly knows it's not
"difficult to assess" at all. Coelho is cherry picking his data to convey his outmoded
ideology as statistically valid.
However, Manuel has referenced the European Monitoring Centre for Drugs and Drug
Addiction - EMCDDA 2008. It would indeed be most remiss of me to not fan the smoke
and remove the mirrors here also. The site itself is a triumph of illicit drug research
collation for Europe. A search for "Portugal, 2008" pulls up 300 items. This is where
Coelho's lack of citation gives him the inside lane again. The EMCDDA publishes 2007
Portugal data in 2008. 2008 Portugal data in 2009. Hence "EMCDDA, 2008" is a nonsense
reference not worthy of a high school essay. Referring to psychoactive
substance EMCDDA 2007 data states (page 17);
and ecstasy are the substances preferely used by Portuguese, with lifetime
prevalences respectively of 11,7%, 1,9% and 1,3%. Between 2001 and 2007,
despite the increase of lifetime prevalence in several illicit substances, a
generalised decrease was verified in the continuation rates use.
You can read the breakdown of populations into sex, age, military, etc for yourself. Lifetime
prevalence for cannabis for 3rd cycle students in 2001 was 10%, in 2007 6.3%. High
school students showed 26% in 2001 and 19% in 2007. For total population use over the
last 12 months is the same in 2001 and 2007 - 2.4%. 15 - 34 years indicate 4.4% in 2001
and 4.7% in 2007. These figures really aren't cause for carry on in either direction. They
certainly don't support Coelho's claim of a 20% increase as part of policy failure.
But what perhaps exposes our Chairman of the Association for a Drug Free Portugal for
the reckless chap he is, must be his obsession with prohibition. Right up to the point of
ignoring the growth in Drug Free communities and referrals laid out on page 46 of the
same document he uses in his failure to statistically condemn Portugal. As in Australia the
Drug Free mob seem to be lonely fringe dwelling outcasts, unable to reciprocate outside
their peculiar conservative beliefs.
As the Chairman of a national organisation Coelho has had ample time to retract and/or
correct his piece/s. He hasn't and ignores further data to the contrary. The 2009 National
Report on Portugal (2008 data) to the EMCDDA gives a swift rebuttal to Coelho's trick of
submerging Portugal in a string of nations. It is heavy on IDT data - the source of Coelho's
primary claim of increasing drug use - which we shall consult and clarify. However the IDT
website offers the following measured view;
In the context of Drugs and Drug Addiction, the year 2006 was distinguished by the effort
developed by all Bodies and Entities with intervention in this area, in order to find effective
coordination forms, with a clear definition of the priorities and responsibilities of each
intervenient.
Following the assessment of the Portuguese Drug Strategy 1999, the year in which the
strategic goals were redefined and included in the National Action Plan Horizon 2012 and
was outlined the Action Plan mid-term (Horizon 2008), with the actionsʼ schedule, clear
assumption of the responsibilities in the carrying out and definition of measurable
indicators in order to be monitored
Drug use
Cannabis continues to be the most used drug and its visibility in several indicators
continues to increase, alone or in combination with other substances.
Response to “Decriminalisation of Drugs in Portugal - the real facts!” by Manuel Pinto Coelho
Nevertheless, heroin remains as the main drug involved in health drug use related
consequences and in some of the legal drug use related consequences.
The presence of cocaine is increasingly being mentioned in several indicators, namely
concerning the recreational, treatment and market settings.
2006 school survey data seems to indicate a decrease in drug use prevalence amongst
the pupils of the 6th, 8th and 10th grades (aged 12 to 19). However this is based on
preliminary data only and more in-depth analyses will be needed to confirm this apparent
decrease.
Responses to drug use were re-organised at national level, following the 2004 evaluation
and the 2005 drafting of new National Plan.
Emphasis will be placed in local needs assessment and the provision of integrated
responses, in accordance with the identified needs. Integrated responses will have the
possibility of including the areas of prevention, harm reduction, treatment and
rehabilitation.
The news ticker on the site happens to only offer The Success of Drug Decriminalisation in
Portugal.
Page 6 does indeed show a negative trend in General Mortality in 2008 - up 6 from 14 to
20 which Coelho misses. However, Coelho's claims of increasing use and HIV are seen to
be false along with a welcome drop in HCV rates.
Response to “Decriminalisation of Drugs in Portugal - the real facts!” by Manuel Pinto Coelho
The decreasing trend in the percentage of drug users in the total number of
notifications of HIV/AIDS cases continues to be registered. Concerning HIV infection
in the treatment setting, the percentages of HIV positive cases (prelavences) varied
between 9% and 25%, showing a tendency for decrease in last years.
Hepatitis B positive cases (prevalences) remained stable in comparison to previous
years and Hepatitis C registered the smaller values of the last four years.
This decrease may be related, amongst other factors, to the implementation of harm
reduction measures, which may be leading to a decrease in intravenous drug use
(also visible in data concerning administration route in first treatment demands), or
to intravenous drug use in better sanitary conditions, as indicated by the number of
exchanged syringes in the National Programme “Say no to a second hand syringe”.
...In Portugal, treatment for HIV, AIDS and Hepatitis B and C is included in the
National Health Service and therefore available and free for those who need it.
In 2008, it is worth noting the enlargement of the socio sanitary structures and
responses to drug users, the definition and implementation of technical guidelines
in order to improve the quality of intervention and procedures that are more
efficient, as well as the participation in working groups to define responses to
populations with specific needs.
In the prison setting, inmates and staff are routinely vaccinated against Hepatitis B.
"The decriminalization of drugs in Portugal did not in any way decrease levels of
consumption. On the contrary, "the consumption of drugs in Portugal increased by 4.2%
- the percentage of people who have experimented with drugs at least once in their lifetime
increased from 7.8% in 2001 to 12% in 2007 (IDT-Institute for Drugs and Drug Addiction
Portuguese, 2008)."
On the contrary? On the contrary, Manuel, that's remarkably ignorant. Did you correct for
that ubiquitous inflator of "drug use" figures - the one off or infrequent cannabis user?
Perhaps not. What does the IDT data show within EMCDDA 2008, seeing as you're
booming about it?
There are no significant differences between 2001 and 2007 results; there was a
slight increase of cocaine and heroin use at least once in lifetime by females and a
decrease in all the other substances.
Response to “Decriminalisation of Drugs in Portugal - the real facts!” by Manuel Pinto Coelho
Clearly, cannabis is the dominating drug. And we can see the relevance of Caitlin Hughes
stating that, "... percentage of people reporting drug use in the past year", is of
significance. With no change over the past 30 days in six years and an insignificant
change over 12 months, this reflects more experimentation and infrequent use - not
lumbering stoners.
Some of Manuel's best distortions however, are in carving up his cocaine lines. Pun
intended.
Coelho correctly informs us that drug related murders increased 40%. The report notes
elsewhere Portugal's position as a transit nation. "It was the only European country with a
significant increase in (drug-related) murders between 2001 and 2006", he warns citing the
WDR 2009. So, let's check that very report on page 168 to note;
This rapid increase in trafficking was probably related to the use of Guinea-
Bissau and Cape Verde, former colonies, as transit countries. Most of the
traffickers arrested in Portugal in 2007 were of West African origin. As
international awareness of the problem increased, cocaine seizures fell in a
Response to “Decriminalisation of Drugs in Portugal - the real facts!” by Manuel Pinto Coelho
number of European countries, but France and Portugal, two countries with
former colonies in the region, showed the most pronounced decreases."
But let's examine that sentence referring to Portugal and France - "pronounced
decreases";
Again, I can only think of the moron in the man who thought he could quote this report and
expect to get away with misrepresenting it. Plainly, Coelho must retract his piece in itʼs
entirety and issue an apology to be disseminated widely.
Cocaine use for Portugal was 0.3% in 2001 and 0.6% in 2006 - a doubling in 5 years.
Seizures over a similar time frame are 5,574 kg in 2001, 3,021 kg in 2003, 18,083 kg in
2005, 34,477 kg in 2006 and 7,363 kg in 2007. If seizures reflected usage they would
be around 11,000 kg in 2006 to accommodate the doubling of use. As they reflect
transit we see over 34,000 kg.
Published in February 2010 Coelho's piece purposely shirks more recent data conveying
an entirely different trend. His deception is confirmed by republishing again and again after
the World Drug Report 2009 became available in July 2010, refuting his intellectual
rampage most thoroughly.
Seizing on poor data sets and extreme examples out of context, heʼd do climate change
denialistʼs proud. Cocaine, cannabis, heroin, stimulants, hashish, murder, HIV and even
one of those spooky opinion polls recording “attitudes” of the Portuguese that as we well
know, are not science.
At the last, he tries to pass off an esoteric analysis in which Portugal allows criminal
activity to be conducted by “the sick” such that “Pretend you are sick and the government
pretends to treat you”. Addicts are now seen as patients, not “delinquents” he bemoans
pathetically, who are “assumed” free and responsible. The state is feeding the “disease”.
What is worse however, is that this nonsense is swallowed in it's entirety by Drug Free
Australia who then spread it into the community as, no doubt, "the real facts".
And in doing so, they continue to contribute to ignorance, crime, drug related harm,
reduction in treatment income, incarceration and the building of more prisons, blood borne
viruses - which affect us all - wasted funding dollars and the sequestering of same away
from worthwhile community projects.
Some topics are too serious for stupidity and contrariness. There comes a time when
despite the media's desire for "balance" and the government's view to allow airing of all
views, we must decide if any "debate" still exists. The simple fact is, Jo Baxter and cohorts
within Drug Free Australia - despite analogues around the world - cause far too much
damage to allow them the quaint belief they might be correct.
--------------------
Paul Gallagher
EMCDDA
2006 Data
2007 Data
2008 Data
====================================================================