Portugal model for fighting drug deaths appeals to B.C.
B.C.’s first minister of mental health and addictions says she will take an “all-ministry” approach to the overdose crisis, influenced in part by Portugal’s renowned policy for drug use and addiction.
Minister Judy Darcy met with Dr. João Goulão, Portugal’s national drug coordinator, at this week’s Recovery Capital Conference of Canada in New Westminster.
In 1998, Goulão was part of a committee that developed policy to deal with a deadly drug crisis in his country, during which one per cent of the population was addicted.
Through measures such as decriminalization, treatment on demand and the expansion of treatment facilities, Portugal’s overdose-death rate plummeted while public perception of addiction shifted from viewing it as a criminal issue to one of health.
By 2015, Portugal had an average of three overdose deaths per one million people, according to the European Monitoring Centre for Drugs and Drug Addiction.
In B.C. this year, amid a fentanyl-related public health emergency, there have been 313 deaths per one million people, up from 206 last year.
After her meeting with Goulão, Darcy said she saw “a pathway to hope” through Portugal’s subsidized employment and housing programs for people in recovery, and its focus on counselling, treatment and education.
“I think we have so much to learn from them,” Darcy said.
In Portugal, addiction is treated as a medical issue and a chronic disease. It offers drug users an appointment with a doctor as soon as they seek help and then creates a “tailor-made” treatment and recovery plan. Failure to comply can lead to penalties such as fines or community service.
B.C.’s new government is promising to implement its own “askonce, get-help-fast” approach to treatment and recovery.
“There are people out there doing amazing work, but it isn’t a system,” Darcy said. “It’s not co-ordinated, it’s not seamless and we have all of these silos.”
Following a tour Wednesday of Vancouver’s Downtown Eastside, Goulão said he was shocked by what he saw.
“It reminds me of the worst times in Portugal during the heroin epidemic in the ’90s,” he said.
Goulão was surprised by the neighbourhood’s uncoordinated harm reduction, treatment and recovery systems.
While he doesn’t know whether Portugal’s system is directly adaptable to B.C., he believes political will could bring agencies together for a system that functions better.
“I saw so many responses — every corner,” he said. “What I kept from the visit that I made is that there (is) probably a lack of communication and articulation of the work of those different institutions.”
Darcy said she would build a coordinated, easy-to-navigate system that provides affordable programs as well as follow-ups after treatment.
She said her short-term goal is to bring all agencies and ministries responsible together to address the overdose crisis.
“Our approach is really an all-government approach. We have to be bold. We have no choice.”
Goulão said his impression of Darcy was she had a good plan in place.
“Clearly, I was very impressed with her speech (at the conference),” he said. “I could subscribe (to) it entirely, and I hope that she has the political and social conditions to go on with what she proposed.” Conference spokesman Marshall Smith said it was important to invite Goulão so the recovery community could better understand the Portuguese model, including misconceptions about decriminalization.
Smith said after listening to a broad array of delegates from all areas of B.C.’s additions-treatment community, he believed B.C. may be ready to “take a page out of” Portugal’s policy.
“I think we’re starting to see the type of will that is needed to explore this, at least on some smaller, pilot basis,” Smith said.
“That could be a very exciting breakthrough.”