Two dissimilarities with the Portugal model of drug decriminalization

Portugal's drug policy is often pointed to as a model of how drug decriminalization could work in the US.

In Portugal, all drugs are decriminalized. If a law enforcement officer encounters someone using drugs, the officer sends the user to a "Dissuasion Commission", where the user is assessed as either a "problematic" drug user or a "non-problematic" drug user.

"Non-problematic" users are given advice & educational material about the drugs they are using. "Problematic" users are referred to addiction treatment services. (See p. 239-43 of Chasing the Scream for more on Portugal's system).

It seems useful to study Portugal's system, though we worry that the US drug policy reform community is benchmarking too heavily on Portugal as a model for what reforms the US should target.

Below are two dissimilarities of the situation in Portugal and the situation in the US.

We feel it's important to keep these factors in mind when drawing comparisons between the two policies – due to dissimilarities like this, what worked in Portugal may not work in the US.

1: Transnational cartels supply the bulk of illicit drugs used in the US.

Following a simple economic model, decriminalizing all drugs in the US would increase demand (because it becomes less risky, i.e. less costly, to buy drugs), but wouldn't introduce a legal method of supply.

Currently, transnational cartels supply a large portion of the illicit drugs that are used in the US.

From the 2018 National Drug Threat Assessment (a), on p. 105:

Mexican [transnational crime organizations (TCOs)] will most likely continue to maintain a dominant influence over the wholesale importation and distribution of cocaine, heroin, marijuana, methamphetamine, and fentanyl in U.S. markets in the near term.

No other criminal organization currently possesses a logistical infrastructure that can rival that of Mexican TCOs. Mexican TCOs will continue to grow in the United States through expansion of distribution networks and interaction with local criminal groups and gangs.

Cartels would probably benefit from the increased demand, as they are the default suppliers of illicit drugs to the US market.

If decriminalization doesn't introduce a legal, regulated alternative to cartel-supplied drugs, it seems plausible that decriminalization in the US would increase the income & influence of cartels. This would be undesirable for a variety of reasons.

Portugal is a much smaller market than the US, so effects of Portuguese decriminalization on cartel suppliers have probably been much smaller than the effect of US drug decriminalization would be.

It's possible that decriminalization would not lead to an increase in the overall rates of drug use. But because simple economic reasoning implies that decriminalization would increase use (decreased risk leads to increased demand), we would want to better understand the mechanism(s) by which all-drug decriminalization does not lead to increased use before no longer holding this as a concern.

2: Portugal has better public health infrastructure than the US.

Under the Portugal model, "problematic" drug users are routed into a system of government-sponsored treatment & social services (see p. 241-5 of Chasing the Scream).

Under the present US policy, drug users are routed into the incarceration system. This is clearly suboptimal, but it's unclear where "problematic" drug users would be routed otherwise. US healthcare & social service systems are less well-ordered than their Portuguese counterparts, and routing a large population of drug users into these systems without reforming their structure may lead to unintended & undesired consequences.

It seems very possible to design a drug policy reform that addresses this concern, but a viable design would need to include a plan for changing US healthcare & social service systems such that they become able to robustly handle an influx of "problematic" drug users (who would no longer be routed into the US prison system).