Dr. Joao Goulao, who helped transform Portugal’s drug policy to a decriminalized model in the 1990s, speaks with Sarah Blyth, who operates a safe injection site in Vancouver’s Downtown Eastside, on Sept. 6, 2017. Goulao was in Vancouver to speak at an addictions recovery conference. The head of Portugal’s addictions directorate is urging Canada to declare the opioid overdose crisis a national health emergency.
On a tour of Vancouver’s Downtown Eastside, the inner-city neighbourhood that is home to many people who struggle with addictions and mental health, Dr. Joao Goulao said the sheer number of deaths caused by the tainted supply of illicit drugs warrants the declaration.
Portugal is often held up as a model of progressive drug reform. Policy changes started in the late 1990s in that country included decriminalizing drugs, something many public health advocates are now advocating for Canada as the only truly effective way to remove the risk of ingesting illicit drugs tainted with fentanyl, a powerful synthetic opioid.
Goulao recently met with Canada’s federal health and justice ministers, Jane Philpott and Judy Wilson-Raybould, who travelled to Portugal in July to see how the country’s addictions health system works. While the federal government has embarked on the process to legalize marijuana, there are no plans yet to decriminalize other drugs.
So far Canada’s federal government has refused to declare the opioid crisis a national health emergency.
Goulao emphasized that Portugal’s policies are about much more than decriminalization.
“Decriminalization is important,” he told reporters outside Vancouver’s Crosstown Clinic, the only clinic in Canada to offer prescription heroin to patients. “We are dealing with a disease, so it makes no sense to criminalize people. And it’s important to reduce stigma.
“But otherwise what is really important is the co-ordinated response. Some people need to be in a facility like this one for a while…they (may) want to stop using and then you need to have detoxification clinics. Then…you need to think about housing, you need to think about employment.”
Goulao said he was impressed by the number of harm reduction facilities in the Downtown Eastside — from Insite, Canada’s first supervised injection site, to new overdose prevention sites opened since the overdose crisis hit, to Crosstown Clinic — but said he would suggest better communication and co-ordination between the services.
Goulao, who served on the initial policy panel that recommended decriminalization in 1999, reflected on how international attitudes towards his country’s drug policies have changed over the years.
“We had a lot of problems with the United Nations when we decided to decriminalize,” he said. “Nowadays, 15 years later, Portugal is an example of best practices.”
Goulao will speak at the Recovery Capital Conference of Canada, which takes place this week in New Westminster.
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