July 12th 2023- Thank you to Miguel Vasconcelos, the coordinator of the Addictive Behaviours and Dependencies Intervention Division of the Regional Health Administration of Lisbon for taking time with my colleague MP Brenda Hanley to discuss the Portugal's success in addressing problematic substance use over the last twenty-five years.
The Portuguese model is based on the fundamental principle that substance use disorders are health conditions not criminal behaviours. When HIV infections began to spread in the 1980s, overdose deaths related to heroin use also had begun to rise. Criminality related to substance use resulted in a high rate of petty crimes, which entered political and economic spheres. Portuguese recognized this as a Health Issue not a criminal issue. People needed help and Portuguese knew that people wouldn't benefit from jail time, so it became a public health social issue, rather than a justice issue.
Treatment is medical not judicial. Ninety-five percent of treatment placements are self-referred and services are free. The so-called mandatory or forced treatment is not a practice in Canada. Dr.Vasconcelos recommended that Canada considers a centralized system of services delivered through a national plan that includes investments in education, harm reduction and, when necessary, treatment for between thirty days and twelve months. It was most enlightening to connect with front line staff and patients.