A New Dawn for the Failed War on Drugs

On a recent afternoon in Lisbon, Portugal, more than a dozen people are hanging out in an unassuming building facing a busy street. They’re listening to music, eating snacks and teasing each other while people come and go through a door that opens to the modest, crowded lounge. On the street, tourists walk by, construction workers heave materials and a tram speeds past on a track next to the pavement. Through another door, in a back room hidden from view, five others are injecting drugs under the watchful eye of a nurse.

This is IN Mouraria, one of Lisbon’s three “salas de consumo,” or drug consumption rooms, where the safe use of heroin, cocaine and other “hard” drugs is permitted as part of a program to help prevent fatal overdoses. Here, what started as a revolutionary experiment in decriminalization in Portugal is now firmly in motion, and, although it has taken some time, the rest of the world is beginning to follow.

“We are here to improve safety, enhance people’s lives and work with harm reduction at the highest level,” says João Caldas, a peer support worker at the facility, which is operated by Activists Group on Treatments (GAT). “The numbers are there. It’s for the good of people.”

In 2001, Portugal became the first nation to decriminalize the use of illegal drugs. Since then, rather than jail, the country has offered support to people caught with narcotics. Psychologists, social workers and other trained health professionals engage directly with people who use drugs to understand their challenges and aspirations. They ask questions like, “What do you need to improve your life?” and “What do you want to achieve?” Then they help to secure housing, job training, mental health care or medical treatment. Some of those who receive help end up detoxing in state-funded therapeutic communities where they participate in all sorts of activities, including water gymnastics classes. 

In Lisbon, which was once the heroin capital of Europe, safe-use spaces such as IN Mouraria are a relatively new innovation. Over the country’s 20-year experiment with decriminalization, public health leaders here have learned that providing spaces for people to take drugs with access to health and social care services helps them to get a grip on their dependencies. “People are desperate to find a community to get sober,” Caldas says. Some “visit us after a few years without taking drugs, and you see the difference in them. It’s absolutely incredible.”

In 1999, Portugal saw a record high 369 deaths from drug overdoses. Most were related to heroin. The crisis spurred decriminalization and ramped-up funding for rehabilitation programs that have since helped reduce the annual number of deaths from overdose to about 80. Meanwhile, the rate of HIV infection in Portugal, which once accounted for more than half of cases across the entire European Union, has also plummeted. 

Statistics like these and the existence of facilities such as IN Mouraria are signs that a new dawn is appearing above the wreckage left in the wake of a futile half-century war on drugs. In Portugal and elsewhere around the world, policymakers are reckoning with the reality that no matter how many millions of people are imprisoned, and no matter how much money is spent on anti-drug policies, people are going to continue to do drugs. Despite the U.N.’s 1998 declaration that a drug-free world was possible and the U.S. spending more than a trillion dollars over the past 50 years to stymie drug use, rates of use have risen hand-in-hand with significant upticks in addiction and death, even while most people take and enjoy drugs without any serious harm.

“Initiatives such as the establishment of drug consumption rooms in Scotland, Ireland and the USA, the growing embrace of drug checking in Australia, and the call from over 60 countries for a review of the international drug control system all reflect a shift in how societies are rethinking their response to substance use — a challenge with which humanity has grappled with for centuries,” says Helen Clark, chair of the Global Commission on Drug Policy, and former prime minister of New Zealand.

There have been setbacks and policy reversals in some places, notably in Oregon and British Columbia, where leaders scaled back decriminalization initiatives in response to public frustrations and accusations that the government had become too lenient. But global drug policy is broadly becoming more evidence-driven, with public health prioritized over punishment, Clark says. In the U.S., one of former president Joe Biden’s final acts in office was commuting the sentences of almost 2,500 prisoners sentenced under harsher penalties than would apply now. However, there is still a very long way to go, Clark adds, and “the need for reform is urgent.”

Globally, at least 467 people were executed for drug offenses in 2023, according to Harm Reduction International, an advocacy organization promoting drug policy reform. That is the highest number of reported executions since it began monitoring in 2007, but the true figure is probably much higher, because the number of drug-related executions in China, Vietnam and North Korea is unknown. 

U.S. law does not permit capital punishment solely for drug offenses. However, President Donald Trump, who signed an executive order resuming executions after the Biden administration had scaled them back, has expressed support for executing drug dealers. At the very least, it seems clear that the U.S. under Trump’s purview will not be lobbying for reform in places such as the Philippines or Saudi Arabia, where people are routinely executed for using and selling drugs.

Although regressive drug policies in such countries are unlikely to change anytime soon, little by little, governments of all persuasions are becoming aware of the threat drug-related organized crime poses to society. 

It makes little sense to leave what is estimated to be the world’s fourth-largest business in the hands of criminals who launder the profits through the high streets of the legitimate economy, argues Neil Woods, a former undercover police officer and board member at Law Enforcement Action Partnership (LEAP). “We are almost at the tipping point,” he says. “We have no choice but to collectively face facts: Prohibition is a catastrophe.”

LEAP will hold an event at the U.N. later this year highlighting the extent of the corruption caused by prohibition, and Woods says his organization is in conversations with high level officials over the issue. “The war on drugs has always been an oil tanker steering ceaselessly into a cliff, but it’s turning,” he said. Cannabis, for instance, has been legalized across most of the U.S. and elsewhere in the world. Now billions are being collected in taxes without any major rises in use, contrary to the warnings of critics. Meanwhile, psychedelic drugs such as LSD and psilocybin mushrooms are emerging squarely in the cultural mainstream despite their illegality.

At the center of the gradual shift toward wholesale policy change at the global level is United Nations human rights chief Volker Türk. In December, he condemned how the drug war has destroyed lives and damaged communities. “Criminalization and prohibition have failed to reduce drug use and deter drug-related crimes,” he said in remarks that were striking for an official in his position. Current drug policies “are simply not working” and fail some of the most vulnerable people across the world, he added. “We need new approaches prioritizing health, dignity and inclusion, guided by the international guidelines on human rights and drug policy.”

Still, there remain staunch opponents to drug legalization. “We should be discouraging recreational drug use, not enabling it,” says Kevin Sabet, president and CEO for the Foundation for Drug Policy Solutions. “A better approach to reduce harm is to invest in prevention, treatment and recovery services, which would discourage drug use among non-users and help current users to quit. There is certainly a place for harm reduction and outreach in the context of getting them help. We need to meet people where they are at — but not leave them there.”

For legalization supporters, however, the current regime’s failures are on display in both the Mexican-American border city Ciudad de Juarez, which has been ripped apart by fighting among cartels over lucrative drug routes, and Antwerp, where criminals are fighting over $63 billion worth of illegal drugs that pores through the port each year. Among the increasing number of high-profile world leaders of past and present who have indicated they are keen for change is Colombian President Gustavo Petro, who declared to the U.N. in 2022 that “the war on drugs has failed.”

“There has been an increase in deadly consumption, from soft drugs to harder ones, genocide has taken place in my continent and in my country, millions of people have been condemned to prison,” he said. “I demand from here, from my wounded Latin America, to put an end to the irrational war on drugs.” 

Upon Colombia and Bolivia’s direction, the U.N.’s health agency is reviewing the evidence underpinning the prohibition of the coca leaf, the source of cocaine that Indigenous people have consumed for some 8,000 years. The review is due in July and could lead to a change in coca’s legal status globally.

At the U.N. level, the drug control system is facing its most significant challenges in history, says Jamie Bridge, deputy director of the International Drug Policy Consortium, a pro-reform global network. “The ‘consensus’ that was held on drugs has completely fallen apart, and there is clearly no agreement on what the future holds.” Bridge envisages that change will continue to happen at a local and national level. “The U.N. will then have to try and keep up if it wants to remain relevant,” he says.

Since decriminalization went into effect, Portuguese health officials have seen drug-related death rates rise and fall. The use and availability of treatment has also wavered. From a peak of 1,150 in 2015, the number of people in treatment fell to just 352 in 2021, after Portugal’s economic crisis slashed more than 75% from funding to treatment programs. Now officials are seeking to reinvigorate the country’s innovative drugs project.

Lisbon’s IN Mouraria has helped prevent more than a dozen potentially fatal overdoses since it opened three years ago. And, after a visit there, one could be mistaken for thinking the drug war is over. But unlike in countries such as Switzerland, which provides people addicted to heroin with the drug for free, service users at this sala de consumo must procure their heroin from outside dealers who might cut it with contaminants. That’s why, for drug policy reformers like Caldas, getting a grip on rates of addiction and taking power away from criminal gangs will require yet another bold leap. 

“We want to actually know what they’re taking,” he says of those who use his service. Providing tested heroin and cocaine free to people with addictions “is the next step.”