Ireland's radical new plan to treat drug addicts like addicts instead of criminals

Ireland's top drug official is embracing a public health approach to drugs.

On Monday, the minister in charge of national drug strategy said that Ireland's next government will likely move toward decriminalizing all drugs, the Irish Times reported. Aodhán Ó Ríordáin also said that the country will open up injection rooms for heroin addicts, where users can obtain and use the drug — under strict medical supervision — without resorting to criminal traffickers and dealers.

This does not mean that Ireland stores will begin selling marijuana, heroin, and cocaine anytime soon. But if the next government takes up the plan outlined by Ó Ríordáin, it would remove criminal penalties for the possession of these drugs, eliminating the risk of prison time for drug possession, while criminal penalties remain for manufacturing, trafficking, and selling the substances.

"I am firmly of the view that there needs to be a cultural shift in how we regard substance misuse"

"I am firmly of the view that there needs to be a cultural shift in how we regard substance misuse if we are to break this cycle and make a serious attempt to tackle drug and alcohol addiction," Ó Ríordáin said.

Ireland wouldn't be the first country to do this. In a move that got a lot of media attention, Portugal in 2001 decriminalized all drugs, including heroin and cocaine. Reports from Portugal have found largely promising results, with drug use remaining relatively flat as more people get treatment for their drug problems.

But Portugal didn't just decriminalize; it also paired up decriminalization with a much greater emphasis on public health programs for drug addicts. That seems to be what Ireland is trying to do, as well. And at a time when the US is dealing with a harrowing opioid painkiller and heroin epidemic, Portugal and Ireland's radical approaches could provide a lesson to America.

How decriminalization can help drug addicts

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Very few people actually think drug users and addicts should go to jail and prison for simple possession. Even ardent opponents of ending the war on drugs — such as Kevin Sabet of the anti-legalization Smart Approaches to Marijuana — acknowledge that users should get treatment, not jail or prison time. But some drug warriors support keeping criminalization to maintain a stigma against drug use — and fear that drug decriminalization would signal that illicit drug use is now culturally acceptable.

But eliminating or at least diminishing the stigma surrounding these drugs could also come with a public health benefit: It would make it so that people aren't as scared to get help when they need it. This is what a 2009 report from the libertarian Cato Institute found when it looked at Portugal's decriminalization scheme: "The most substantial barrier to offering treatment to the addict population was the addicts' fear of arrest. One prime rationale for decriminalization was that it would break down that barrier, enabling effective treatment options to be offered to addicts once they no longer feared prosecution. Moreover, decriminalization freed up resources that could be channeled into treatment and other harm reduction programs."

"Decriminalization freed up resources that could be channeled into treatment and other harm reduction programs"

Although studies have found that Portugal's anti-drug laws were largely unenforced even before decriminalization, it's true that decriminalization completely eliminated the fear of arrest. And the country went one step further, using its officially freed-up resources to set up commissions that essentially connect addicts to treatment, as the European Monitoring Centre for Drugs and Drug Addiction explained in its report on Portugal's drug policies. (These commissions are very similar to drug courts in America, which prioritize sending addicts to treatment instead of to jail or prison.)

This is essentially what Ireland's drug minister is advocating, although it's still unclear if the next government — which will be elected next year — will follow along with the full plan.

Ireland wants to combine decriminalization with public health programs

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The details of Ireland's new drug policies are still being worked out. But the country's current government seems interested in adopting an approach that focuses first on treating instead of imprisoning drug users. And Ó Ríordáin seems convinced that the next government will continue along that path with full decriminalization.

For one, Ó Ríordáin said that his government will move to repeal legal barriers and set up regulations for heroin injection sites, where addicts will be able to get a dose of heroin under a supervised environment.

The idea, which has been tried in several European countries, is that these programs allow some addicts to satisfy their drug dependency without a large risk of overdose and without resorting to other crimes to obtain drugs, such as robbery and burglary. Researchers credit the program in Switzerland — the first national scheme of its kind — with reductions in drug-related crimes and improvements in social functioning, such as stabilized housing and employment.

"These are clinically controlled environments which aim to engage hard-to-reach populations" of drug users

But this is typically allowed only as a last resort for heroin addicts after they try more traditional treatments, including opioid alternatives like methadone. It's very likely not going to be possible for just anyone to casually stroll into an Irish injection site and get a shot of heroin. "These are clinically controlled environments which aim to engage hard-to-reach populations" of drug users, Ó Ríordáin said.

Still, the policy proposals and Ó Ríordáin's comments indicate that Ireland is moving in a different direction with its anti-drug efforts, with new regulations expected to be in place next year.

But more broadly, the new Irish approach is increasingly becoming the new norm. As more countries take another look at the war on drugs and its failures to significantly cut down on drug use, they're looking to rely less on law enforcement and more on doctors and hospitals to deal with drug abuse and addiction. Ireland is just the latest high-profile example of this shift. America, as it deals with its opioid epidemic, might not be too far behind.

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