“The Great Portuguese Experiment”: Evaluating the Effects of Drug Decriminalization on Crime and Public Health Outcomes

Abstract

In 2000, Portugal became the first European country to switch from a prohibitionist drug control framework to the decriminalization of all illicit drugs by removing criminal sanctions for drug possession and use and replacing them with administrative sanctions. This rapid reversal in drug policy provides a unique opportunity to evaluate the effects of decriminalization and contribute to the dearth of empirical and theoretical literature regarding decriminalization. With a number of states, inspired by the “great Portuguese experiment”, considering switching to a decriminalized drug policy framework, it is of utmost importance that the effects of decriminalization in Portugal be objectively and thoroughly evaluated. The aim of this paper, therefore, is to evaluate not only the effects of decriminalization on the illicit drug market, drug-related crime, and health outcomes of drug users but also the true role of decriminalization in producing observed results. This paper appraises datasets on drug usage rates in Portugal and other European countries, drug seizure data, and drug price data to establish that demand for drugs had ultimately remained about constant (or increased only mildly) while supply of drugs had increased. This overall expansion of the illicit drug market in Portugal has implied effects on drug-related crime and health outcomes for drug users. Using robbery and homicide rates as proxies for demand- and supply-side drug-related crime, this paper uses difference-indifferences model with Newey-West standard errors to determine that only homicide rates had significantly increased since decriminalization relative to other European countries. Although an increase in drug supply from decriminalization may be responsible for observed increases in homicides in Portugal, previous empirical literature suggests that improved and augmented supply reduction efforts by Portuguese authorities since decriminalization may be more responsible for exacerbations in violence related to the drug trade. Finally, this paper analyzes effects of decriminalization on both drug-related blood borne disease incidence rates and drug mortality rates. Evidence provided from previous studies is critically evaluated to establish that HIV/AIDS and hepatitis incidence rates among drug users have decreased dramatically since decriminalization. Further, this paper uses a difference-in-differences model with Newey-West standard errors to establish that drug mortality rates had significantly increased since decriminalization. However, given that drug usage rates had not dramatically increased since decriminalization and other studies have demonstrated improvements in drug mortality rates, it is more likely that increased drug mortality rates are more attributable to increased and improved use of toxicological reports in Portugal. Ultimately, decriminalization in Portugal has been associated with improvements in health outcomes for drug users and exacerbations in drug-related crime. This paper’s findings regarding drug-related crime hopes to give pause to policymakers and help them consider the role of decriminalization in improving health outcomes as opposed to improvements in harm reduction and treatment programs. Portugal’s experience with decriminalization did not occur in a vacuum, and policymakers should not expect to see similar results to Portugal’s without proper reform in tangential areas.