No Money in Sobriety – 

Nov. 9, 2019 – Some U.S. states have taken tentative steps down the path of legalization. Cannabis, for example, is now legal for recreational use in 11 states and the District of Columbia. And Nadelmann says he sees growing support among people and some policymakers for an approach that views drugs as a medical problem. But the U.S. is different from Europe, he says, in ways that make bigger changes feel unlikely anytime soon. Society is different. “The [U.S. social] support system is not as robust,” says Nadelmann. 

Plus there is less tolerance for addiction. “There is a much stronger tradition of sobriety being a moral issue,” says Nadelmann. In the U.S., generally speaking, when you’re caught with drugs the lucky ones may get a chance to go into treatment. But if the treatment proves ineffective, you may go to prison. “We have less patience,” he says. What may prove a catalyst to change is the breadth of the current opioid crisis. “Just as in Portugal, the fact that the [drug] problem happened across all social classes gave us a window of opportunity to implement these progressive policies,” says Goulão. “The moment of the opioid crisis in the U.S. can be used by activists, consumer associations, other progressive people, to switch the focus from the war on drugs to a more realistic policy.” 

In Portugal, the essence of the system is recognizing that treatment tends to fail the first time, and often many times after that, and the door should be kept open. The person should be kept inside the health system, not outside it. Before Portugal changed its approach, says Félix da Costa, there were huge numbers of long-term drug users who had never had any treatment. “I’ve had cases of people who had been doing drugs for 30 years and coming [to my practice] was the first time they actually went into treatment,” he says. An emphasis on a humane approach over punishment and a government willing to put money and resources behind it, mean fewer people fall between the cracks. Those whose lives have been ravaged by drug addiction, he says, like the men outside his office, are much rarer these days.  

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