5. A strategy for all drug uses

Our purpose was to reflect upon changes in addictive behaviours in Portugal, roughly over the last two decades, and to produce recommendations that allow improvements to Portuguese Drug Policy (PDP).

We parted from our personal, academic and professional experience with the intention to question PDP’s strategy ability to accommodate recent changes in addictive behaviours. It is our understanding that, although innovative and widely successful, there is the need for adjustments that will ensure PDP to remain adapted to today’s challenges, which are inevitably distinct than what they were 20 years ago.

Despite Portugal’s early understanding of the need for social innovation in DP, internationally, other countries came later but have now achieved considerable progress we should keep up with. Twenty years ago Portugal dealt with challenges almost exclusively related with opiate IV use. The system was challenged to handle the extremely fragile health and mental health status of intravenous drug users, and it didn’t establish any distinction between addiction and crime. Currently, however, it is no longer possible to ignore the diversity and visibility of profiles and groups of citizens that present any sort of use of psychoactive substances. We call for attention to these groups of people of all ages, socially normalized, often highly educated, that are almost invisible to our current strategy. We also call for attention to the specific challenges that come from the lack of attention to women’s vulnerability associated with alcohol and other drugs; from the lack of attention to the use of psychedelics for therapeutic, self-enhancement or recreational purposes; and to the need to advance in adult cannabis regulation.

We recommend the concept of ‘addictive behaviour’ is questioned as the label adopted to guide PDP. This is a consequence of the fact that many of the decisions we face in what concerns DP today have little or nothing to do with addiction. We also recommend that focus is turned into increasing and professionalizing the technical interventions offered to the variety of people that cross paths with mind altering substances.