Gord Johns Visit to Portual- Meeting with Dr. João Augusto Castel-Branco Goulão

One of the most important experts I connected with during my visit to Portugal to study its policies and practices that addresses substance use was meeting with Dr. João Augusto Castel-Branco Goulão. Dr. Castel-Branco Goulão was an architect of Portugal's drug policy in 2000 and is the current national drug coordinator for Portugal. A lot has been written about the "Portugal Model" as legislators, public health, justice and social services experts along with those with lived and living experiences have watched with interest. Unfortunately, considerable misinformation is disseminated about the model- too often, deliberately by those with political or other vested interests. 

Dr. Castel-Branco Goulão explained the evolution of Portugal’s approach which has its genesis. In the 1980’s when HIV infection was spreading along with increased overdose deaths related to heroin use and criminality including a high rate of petty crimes. The government of the day held the view that it was a health issue not a criminal issue and that people needed help. They believed that users of illicit substances would not benefit from being criminalized or from going to jail. It was not a justice issue, it was a public health social issue. In 1998, the Prime Minister identified a group of eight leading professionals including law enforcement leaders, medical practitioners and other experts to develop a national strategy to respond to what had become a “drug crisis”. The strategy became the framework for the current “Portugal Model”. It included provisions for individuals who were unable or unwilling to seek recovery and recognized the fundamental human right that they are entitled to the same benefits as those who do, through harm reduction. The object was to support a better quality of life and longer life expectancy for all. 

Additionally, during my meeting with Dr. João Augusto Castel-Branco Goulão, we discussed Portugal’s work on recruitment which is important to support its healthcare system by diverting problematic substance users to the appropriate areas that can meet their needs. A timely response is essential as their “dissuasion commission” finds that 85% of those who are referred show up after first meeting with a social worker or a psychologist to review where they are in their life. Starting where people are at is a critically important feature of the model. Contrary to disinformation that is currently being pushed out as part of our political discourse, there is no mandatory treatment in Portugal.

Dr. Castel-Branco Goulão emphasized that one should not be stigmatized for the rest of ones life which is what happens with criminal charges. He also emphasized the importance of recognizing that the system must understand and accommodate relapse. It is a “chronic relapsing disease,” he told me, “so when you build up the systems, you need to maintain and keep them in place because people do relapses.” He said, “you should learn from us, but don’t copy us, this is your opportunity to take action.” 

Pictured above is Liberal MP Brendan Hanley (left), Courtenay-Alberni NDP MP Gord Johns (right) and Dr. João Augusto Castel-Branco Goulão the General Director of the Intervention on Addictive Behaviours and Dependencies and the architect of Portugal Intervention Program in 2000 (middle)

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