27 May 2014

Portugal’s capital city, Lisbon, has announced that it is exploring opening the country’s first ever drug consumption room (DCR), a positive, though somewhat belated development in the country’s pioneering drug law reforms.

The Portugal News reported on May 22, that Lisbon city council had selected a site for the first DCR in the Mouraria neighborhood of Lisbon. While this is the only facility currently in development, the director of Portugal’s Intervention Services for Addictive Behaviors and Dependencies, João Goulão, pointed to the potential for more in the future, stating: “This could be an experimental project that could be extended to other areas.”

Consumption rooms, as defined by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), are “professionally supervised healthcare facilities where drug users can use drugs in safer and more hygienic conditions.” Their primary goal is to mitigate the risks that stem from intravenous drug use, particularly among marginalized communities. By providing a safe, secure environment, DCRs can help combat injection-related complications, blood-borne infections such as HIV and Hepatitis C, and overdoses.

The legal framework for introducing DCRs in Portugal has been in place since 2001, when legislation was passed allowing for councils to explore setting up consumption rooms in their districts. This move formed part of a broader paradigm shift whereby Portugal decriminalized the personal possession and use of all drugs that same year in an effort to tackle the country’s high rate of heroin abuse and HIV cases among drug users. In 2000, for example, there were 1,400 newly reported cases of HIV among drug users.

The number of new HIV cases among drug users has fallen drastically since the the laws changed over a decade ago. As the EMCDDA’s 2012 report on Portugal shows, in 2005 the number had dropped to 636 cases, falling even further to 95 new cases in 2011. If DCRs begin to be rolled out nationwide, this number could be cut even further and would mark a dramatic turnaround for a country that once had one of the highest rates of HIV among drug users in Europe.

Though the establishment of DCRs would be a groundbreaking achievement for Portugal, they are by no means the first country in Europe to explore their implementation. Switzerland opened the world’s first DCR in 1986, and since then countries like the Netherlands, Spain and Denmark have followed suit. An NPR report from last December noted the success seen in Denmark in particular, where no people had died in one DCR despite 135 overdoses in the 12-month period, highlighting the effectiveness of having trained health professionals on hand.

Of course, though the benefits offered by consumption rooms are manifold, authorities still face a high potential for backlash from a public which may not want a DCR in their community, something which could damage the efficacy of future harm reduction programs. In Lisbon, this has apparently been taken into careful consideration, with the site currently being explored located near a health center and future police station, without being in a highly populated area. If the proposed DCR is successful once it is operational, the decision to locate it here could go a long way toward generating public acceptance of the initiative, and thus lead to the further installation of DCRs in the country.

All eyes will likely be on the site once it is opened, and the future of DCRs in Portugal could very well hinge on its success. However, in light of Portugal’s victories in combating drug use through treating it as a health rather than a criminal issue, there is hope that this could lead to further positive developments in the country’s harm reduction and drug programs

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