Are Portugals Policis Towards Drugs More Preventative

Introduction

According Anderson (2010), Portugal’s drug decriminalisation policy was a radically different approach in a region where governments enforce zero tolerance on drug possession and abuse. Dickie (2014) reports that the general drug use in Portugal in the 1990s was comparable to other European countries but there were higher incidences of problematic drug use. In 1998, a special commission comprising of lawyers, doctors, psychologists and activists appraised the drug situation in the country and suggested decriminalisation of all drugs and establishment of measures geared towards education, prevention and harm reduction (European Monitoring Centre for Drugs and Drug Addiction, 2016). As such, the main objective of the policy was to reintegrate drug abusers and peddlers into the society instead of isolating them.

According to the UK Home Office report of 2015, the UK policy on drugs is founded on continued focus on three major aspects namely reducing demand for drugs, restricting supply and building recovery. The European Monitoring Centre for Drugs and Drug Addiction (2010) reports that devolved administrations in the UK produce their drug

strategies which are a reflection of their ideologies and the devolution of duties from the central government. Currently, the government is building up on the Drug Strategy 2010, Reducing demand, restricting supply, building recovery: supporting people to live a drug-free life. Similar to the Portuguese approach, the strategy emphasises support to drug addicts to achieve recovery and provision of integrated support that is necessary to reduce rates of recidivism (UK Focal Point on Drugs, 2015). Domoslawski (2011) cites another similarity where in both UK and Portugal, there has been a characteristic shift in responsibility from the central government to locally-administered treatment options which highlights the creation of Public Health England (PHE). The strategies for devolved units will be discussed in the next section. .

The aim of this report is to provide an in-depth and evidence-based analysis of drug policies in Portugal and the UK through a comparative research approach. As such, it compares the similarities and differences in the policies and discusses evidence supporting their success and/or failures. Through comparative analysis, the report determines whether Portugal’s drug policies are more effective than UK’s or not.

An overview of Literature

This chapter reviews the relevant literature concerning the impact of Portugal's and UK's drug policies from a variety of sources to establish a tentative proposition based on the research topic. The section draws from government statistical reports, European Union country findings and international bodies’ research findings.

Literature search strategy

This section builds an argument based on recent findings regarding the influence of prevailing drug policies in Portugal and the UK on preventing drug abuse. The presentation is by theme since there are several aspects of prevention that must be considered separately before being brought together.

According to the European Monitoring Centre for Drugs and Addiction (2016), UK’s drug policy was designed to align planning and policy development across government agencies and departments to support an interrelated and cohesive approach to delivery at the local level. As mentioned earlier, the government continually updates the policy which is a prerequisite given that there is the risk of obsolescence if the policy is not restructured with time. The drug strategy in the UK is a cross-government plan although the management and the secretariat are functions of the central government.

In Portugal, the General-Directorate for Intervention on Addictive Behaviours and Dependencies (SICAD) is the government agency whose mandate is to promote a decline in the use of psychoactive substances, decrease drug dependencies and prevention of addictive behaviours. Surveys are carried out among school-going children every 2 – 4 years while health behaviour surveys are carried out every four years (European Monitoring Centre for Drugs and Drug Addiction, 2011). Such elaborate schemes are intended to prevent or reduce the prevalence of drug abuse, especially in the formative years.

According to Burton et al. (2014), the Portuguese National Plan for the Reduction of Addictive Behaviours and Dependencies 2013 – 2020 strategy recognises the need for age-specific prevention of drug abuse and addiction in the contexts of school, family, sports settings, workplaces, prisons and other social contexts. Further, the national plan contains the Operational Plan of Integrated Responses (PORI) which is a health promotion intervention framework that targets reduction in demand for drugs at the domestic and the regional levels (Drug Policy Alliance, 2015). In comparison to the UK policies, it is evident that Portugal’s drug policies are structured to address different contexts. On the other hand, UK’s central government policies towards drugs and drug abuse are wholly applicable to the citizenry.

In early 2014, a UK government-funded study found that there is no relationship between the strictness of a country’s enforcement of drug laws and levels of drug abuse. The eight-month study compared drug laws and the rates of drug use in 11 countries including Portugal. It was also found that Portugal’s drug prevalence had significantly declined despite lax laws in the country (Drug Policy Alliance, 2015). In fact, the government recognised that the Misuse of Drugs Act of 1971 had been a complete failure. This report expects to find signs of perspective change especially in the UK's approach to the treatment of drug users.

According to Stover et al. (2008), the decriminalisation of drugs in Portugal was a shift in paradigm since possession of small quantities of drugs which were a crime previously was treated as a public health issue. According to the Drug Policy Alliance report of 2016, currently, there are only 3 drug overdose fatalities per 1,000,000 citizens which are lower as compared to other European countries such as Netherlands – 10.2 for every one million and the UK – 44.6 per million to highs of 126.8 in Estonia. Additionally, the average number of deaths per one million people in the European Union is 17.3. This shows that the tough UK penalties for drug dealership have not had any significant benefits for the country. On the other hand, Portugal’s treatment of drug abuse as a health issue has had significant benefits for the country. According to the World Health Organisation report of 2012, health promotion entails enabling individuals to take complete control over their health and wellbeing to enhance improvement in their qualities of lives. Dickie (2014) observes that Portugal’s approach to drug abuse is founded on the tenets public health and health promotion. Therefore, Portugal does not punish offenders but enables them to take more control over their health outcomes by reducing dependencies on drugs (Hollersen, 2013). In contrast, UK policies are founded on the penal code and offenders are punished irrespective of their status as peddlers or abusers.

From the narrations above, a tentative proposition can be drawn. As such, it is evident that Portugal’s approach is holistic and caters for all age groups. Additionally, the country recognises the need to approach the drug issue through social contexts. Besides, Portugal’s policies are comparable to health promotion practices since offenders are facilitated in adopting healthier lifestyles by reducing dependencies on drugs. On the other hand, UK's policies are largely founded on the criminal code and drug users and offenders are severely punished. As the UK government established, a country's toughness in the enforcement of drug laws does not in any way impact on the rates of drug abuse. This statement invokes the need to study the Philippines’ barbaric approach. Given the toughness of the new regime on drug users, it remains to be seen whether drug abuse in the country will reduce. This report anticipates a reinforcement of the proposition in the Analysis chapter since Portugal’s age-specific prevention is unlike any methodological approach in the UK. In summary, this chapter has established a transient supposition that Portugal’s policies towards drugs are more preventative than the UK’s. The next section discusses the methodology employed during the investigation.

Methodology

This chapter narrates and justifies the procedure employed during the research survey.

Literature Search Strategies

Timothy and Levy (2008) report that secondary research is an established form of inquiry particularly where authoritative information is required. This report is a secondary analysis of large international data sets obtained from the European Monitoring Centre for Drug and Drug Abuse and Drug Policy Alliance. The smaller sets are longitudinal studies undertaken by the UK Drug Policy Commission and the UK Focal Point on Drugs.

Search strategies

The search and article identification was accomplished in three stages as follows: first, a multistage systematic approach was used to filter through the ESPON database portal, the Wiley Online Library and European Commission for Public Health databases. Articles published from January 2001 to January 2017 were reviewed. Next, a refined search was used using key terms as shown in the inclusion criteria subsection. Third, full articles were identified and read with those that focus on the type of drug policies being included in the elective.

Inclusion criteria

In identifying relevant articles, four groups of keywords were used in the databases. They include “UK and Portugal drug policies”, “preventative drug policies in Europe”, “comparison and contrast of UK’s and Portugal’s drug policies” and “how preventative are UK’s and Portugal’s drug policies. Articles were admissible if they were published in the aforementioned timeframe, if the content was relevant to the research topic and if they were written in the English Language. Published and unpublished research articles were also admissible. Out of 74 citations, only four were selected.

Exclusion criteria

Articles published before January 2001 were excluded from creating room for appraisal of new evidence. Next, articles were excluded if their content deviated from the research topic. Additionally, articles focusing on Portugal’s and UK’s territories were excluded since they represent an insignificant minority. Therefore, the geographical location was the mainland.

Challenges and difficulties

The lack of standardisation of instruments and categories for use in diverse settings is a major challenge in comparative research, especially between countries. Next, the language of policy discourse is often imprecise and this makes it open to multiple interpretations. The major difficulty faced during the research is the denial of access to Wiley Online Library due to non-subscription. Additionally, it was difficult to find comparable databases.

Analysis

According to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) (2016), the Operational Plan of Integrated Responses (PORI) contained in the National Drugs Policy is flexible and adaptable. As such, in each specific territory in the country, an intervention may address problems specific to local needs through bringing together local partners and working in different contexts. This approach facilitates mapping of territories that need to be prioritised. In mainland Portugal, about 170 territories have been identified for establishment of integrated intervention responses at several phases namely prevention, treatment, harm and risk reduction and reintegration.

According to Drug Policy Alliance (2015), a reassessment of territories in 2014 led to the identification of new gap areas for activities where 16 integrated response prevention projects were undertaken covering over 21,000 people. The projects were implemented through the Operational Plan’s scope by educational interventions, creating and raising awareness and educational interventions. Further, the universal drug prevention is incorporated in Portuguese schools’ curriculums and is mainly implemented in civic educational studies and the sciences. Prevention programmes are delivered to students and pupils through awareness raising activities, training sessions and dissemination of printed information regarding drug abuse. According to Hollersen (2013), the Safe School programme policy has an established an enforcement agency that patrols areas surrounding schools to protect and prevent criminal activities such as drug trafficking in areas neighbouring the schools. The enforcement officers are also involved in teaching establishments that target teachers, students and school staff on the importance of prevention of drug abuse, especially in the formative years. There are numerous standardised school-based prevention and intervention programmes at domestic and regional levels in the country. There are elaborate prevention programmes for students in higher learning institutions. Portugal’s National Policy on drugs also recognises the importance of community-level support in the success of its decriminalisation policy. As such, there are numerous integrated support centres in the country that focus on individual psychosocial and psychological support particularly for young people that have experimented with hard drugs.

In the recent past, the government has expanded its counselling programmes through the establishment of a free-toll helpline and via the internet (Drug Policy Alliance, 2015). Lastly, the government is strongly involved in the development of new guidelines to support planning and implementation of prevention programmes in the country. The outcomes of these policies will be discussed in the next chapter.

According to the UK Drug Policy Commission (2007), the UK drug policy aims to establish a whole-life approach to drug prevention that covers formative years, drug education, family support and targeted specialist support. Beaumont (2010) found that the focus on prevention has recently shifted from drug use programmes towards strengthening resilience factors related to the reduction of the desire to explore dangerous behaviours. Drug abuse is prioritised. Similar to Portugal's approach, the universal drug prevention is incorporated into the national curriculum and mainly focuses on building resilience among young people to eradicate their desires to try drugs. Most UK schools have elaborate guidelines on dealing with incidents of drug usage. Further, England has made universal drug prevention a statutory part of the science curriculum for schools. The non-statutory personal, social, and health education (PSHE) programme was established to facilitate the expansion of the universal drug prevention. It is important to note that Ofsted has often found that the PSHE programme requires being updated in more than 40 percent of the schools in England.

According to the UK Focal Point on Drugs (2013), prevention is part of the wider life learning for young people in Scotland, Wales and Northern Ireland. Scotland's Curriculum for Excellence has been integrated with the traditional education for children and adolescents. Choices for Life is a prevention programme initiated and run by Police Scotland. It gives young people lifelong education on the perils of using drugs and facilitates the exchange of prevention practices with teachers. In Wales, the All Wales School Liaison Core Programme targets children aged 5 – 16 years while in Northern Ireland, school curriculums emphasise the development of relevant life skills to keep children healthy and safe.

Discussion and Conclusion

From the above chapter, it is evident that the UK government prioritises early identification of at-risk families and children and provides appropriate interventions, especially through the Tailored Family Programme. Some of the interventions in this programme include intensive interventions where necessary, parenting skills, drugs education, family support and support for kinship carers (European Monitoring Centre for Drugs and Drug Addiction, 2016). This approach is similar to Portugal’s policies where the Portuguese National Plan for the Reduction of Addictive Behaviours and Dependencies 2013 – 2020 emphasises age-specific interventions especially in the basic social unit which is the family. As such, both countries recognise the importance of societal units in addressing the drug menace. Similarly, UK’s drug policies reach out to the wider community through the Integrated Family Support Services (IFSS). The vulnerable in the community including young offenders, the underprivileged, youths whose parents have substance abuse problems are catered for through the IFSS. In Portugal, the government recognises the importance of the community in promoting prevention programmes. For this reason, it has established social amenities for drug users especially targeting those in early stages of drug abuse. Therefore, there is a variety of friendly solutions for young people in Portugal.

In Portugal, age-specific prevention interventions recognise the importance of social settings in invoking behavioural changes among individuals. As such, the programme targets drug users in social settings such as where they work, live, learn and meet among other social contexts. By mapping drug hotspots, PORI prioritises effective prevention programmes to minimise drug abuse especially for those yet to explore drugs. Similarly, UK’s policy is age-specific. In fact, it is a lifetime approach to prevention that offers life skills to young people according to their age. The universal drug prevention is incorporated into the curriculum of both countries where young people are taught more about drugs as they advance in their education.

As mentioned earlier, UK’s drug policies are strict and require punishment of offenders. However, its prevention programmes employ a health promotion perspective. As such, non-offenders and offenders are empowered to take more control over their health and wellbeing. Similarly, the UK’s Troubled Families Programme has an increased focus on the health outcomes of victims. However, Portugal’s policies are fully geared towards health promotion through prevention as opposed to the UK.

Portugal has numerous programmes that encourage resilience among young people against abusing drugs. Similarly, UK’s Rise Above programme launched in 2014 is assisting in building resilience among young people by empowering them to make positive choices for their health.

It can be inferred that to a small extent, Portugal's drug prevention policies are more preventative than the UK's.

Conclusion

Drawing from the Analysis and Discussion chapters, it is evident that UK's and Portugal's drug policies are at par concerning prevention. However, Portugal's devolution of the policies to regional and local levels and structural adjustments of the policies to accommodate all drug abusers irrespective of their age and gender have yielded much better results in comparison to the UK. For instance, reported deaths due to drugs overdose in Portugal are way lower than both Europe's average and the UK's deaths.

Additionally, it has been found that Portugal’s and UK’s policies are largely similar concerning the approach, key policymakers and dissemination. Although there is no evidence on the degree of policy transfer between the two countries, there is marked semblance between the approaches. Besides, it would have been appropriate to conclude that both countries’ policies are at par but Portugal’s strikingly low death rate per a million people is indicative of the effectiveness of the country’s drug policies.

References

• Anderson, S. (2010). European Drug Policy: the cases of Portugal, Germany, and the Netherlands. EIU Political Science Review, 1(1), 1-13.
• Beaumont, P. (2010). What Britain could learn from Portugal's drugs policy . Retrieved January 29, 2017, from The Guardian:
• https://www.theguardian.com/world/2010/sep/05/portugal-drugs-debate
• Bulsara, C. (2014). Using mixed methods approach to enhance and validate your research. Notre Dame: Brightwater Group Research Centre.
• Burton, R., Thomson, F., Visintin, C., & Wright, C. (2014). United Kingdom drug situation: Annual report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) 2014. London: United Kingdom Focal Point at Public Health England.
• Chatwin, C. (2007). Multi-level governance: The way forward for European illicit drug policy? International Journal of Drug Policy, 18, 494-502
• Dickie, E. (2014). Outcomes framework for problem drug use. Edinburgh: NHS Health Scotland.
• Domosławski, A. (2011). Drug policy in Portugal: The benefits of decriminalizing drug use. Open Society Foundations.
• Drug Policy Alliance. (2015). Drug decriminalisation in Portugal: A health-centred approach. New York: Drug Policy Alliance.
• European Monitoring Centre for Drugs and Drug Addiction. (2011). Drug policy profiles. Brussels: European Monitoring Centre for Drugs and Drug Addiction.
• European Monitoring Centre for Drugs and Drug Addiction. (2016). Portugal country overview. Retrieved March 16, 2017, from European Monitoring Centre for Drugs and Drug Addiction: https://www.emcdda.europa.eu/countries/portugal
• European Monitoring Centre for Drugs and Drug Addiction. (2016). United Kingdom country overview. Retrieved March 15, 2017, from European Monitoring Centre
• https://www.emcdda.europa.eu/countries/united-kingdom
• Greenwald, G. (2009). Drug decriminalization in Portugal: Lessons for creating fair and successful drug policies. Washington D.C: Cato Institute.
• Hollersen, W. (2013). Portugal, 12 Years after decriminalizing drugs. Retrieved March 15, 2017, from Spiegel Online:
• https://www.spiegel.de/international/europe/evaluating-drug-decriminalization-in-portugal-12-years-later-a-891060.html
• Jeong-Yeon, L., Podsakoff, M., & McKenzie, B. (2007). Common method biases in research: A critical review of the literature and recommended remedies. Journal of Applied Psychology, 88(5), 879-903. Retrieved January 10, 2015
• Luse, A., Mennecke, B., & Townsend, A. (2012). Selecting a research topic: A framework for doctoral students. International Journal of Doctoral Studies, 7, 1-10.
• Stover, H., Weilandt, C., Zurhold, H., & Thane, K. (2008). Final report on prevention, treatment, and harm reduction services in prison, on reintegration services on release from prison and methods to monitor/analyse drug use among prisoners. Berlin: Bremen Institute for Drug Research (BISDRO).
• The UK Drug Policy Commission. (2007). Bringing evidence and analysis together to inform UK drug policy. London: UKDPC.
• Timothy, J., & Levy, Y. (2008). Framework of problem-based research: A guide for novice researchers on the development of a research-worthy problem. The International Journal of an Emerging Transdiscipline, 11, 1-17. Retrieved February 9, 2015
• UK Focal Point on Drugs. (2015). United Kingdom drug situation. London: United Kingdom Focal Point at Public Health England.
• Werb, D., Rowell, G., Guyatt, G., Kerr, T., Montaner, J., & Wood, E. (2011). Effect of drug law enforcement on drug market violence: A systematic review. International Journal of Drug Policy, 30, 411-415.

Continue your journey with our comprehensive guide to Anaemia Management in Chronic Kidney Disease.