You are on page 1of 13

VAN01268877_1_1

MAKING CHEMISTRY
TRACKS LESSON
Council candidates Young Swedes

YOU share positions on


public transit A10
connecting on
a higher level D1

FOOD
Vancouver
Island emerges
as culinary
powerhouse C1
THE TOUGHEST JOB IN HOCKEY
Rebuilding the Humboldt Broncos NP1-3
DINING
Readers tell us
S A T U R D AY, S E P T E M B E R 8 , 2 0 1 8 S E R I O U S LY W E S T C O A S T S I N C E 1 9 1 2
where you can
get great tacos C4

LESSONS FROM How a radical approach to an


addiction crisis, from free

PORTUGAL
treatment to decriminalization
NEWS of drugs for personal use, led
CRIME to a dramatic drop in overdose
Province suing deaths and drug use. A12-13
gangsters for
cars, cash  A4

ECONOMY
Budget update
paints a rosy
picture A11, A17

WEEKEND
REVIEW

In a weeklong series from Lisbon, Vancouver Sun columnist Daphne Bramham looks at how Portugal has achieved one of Europe’s lowest rates of drug,
alcohol and tobacco use and reduced overdose deaths from an average of 360 a year in the 1990s to just 26 in 2016. GET T Y IMAGES

TODD
Criticism of
speculation tax S E A H AW K S
irks Eby G3 Inspirational rookie continues to defy odds D4

M A S S AC R E

NP
Texas town
will never be
the same G1 SPORTS
U SA H O C K EY
Trump’s America Grizzlies star
0 57040 10075 7
$3.33 plus GST ‘is not normal,’ is BCHL’s top
$3.81 m
 inimum in Obama says NP1 prospect D5
outlying areas

VAN01268500_1_1
A12 S A T U R D A Y, S E P T E M B E R 8 , 2 0 1 8 VA N C O U V E R S U N CITY

A patient is handed his daily dose of 85 milligrams of methadone by nurse João Matos from a van parked near Praca Espanha in 2017 in Lisbon, Portugal.
The daily methadone program is run by the Ares do Pinhal Association for Social Inclusion.  H ORACI O VI L LALOBOS / CORBI S VI A GE T T Y IMAGES

WHY DECRIMINALIZATION ADDICTION:


WINNING
T H E WA R

ISN’T A SILVER BULLET TODAY


World comes to study Portu-
gal’s grand experiment.

Day 2
In the 1990s, Portugal was in the throes of a national crisis, averaging 360 drug overdose Dissuasion commission aims
to set users straight.
deaths a year in a country of 10 million. Today, it has one of Europe’s lowest rates of
Day 3
drug, alcohol and tobacco use and the number of overdose deaths in 2016 was 26. In Life today for drug addicts in
Portugal.
a weeklong series from Portugal, Vancouver Sun columnist Daphne Bramham looks at
Day 4
the lessons to be learned from the country’s radical approach to addiction treatment. Outreach workers have a
long-term goal.

The only thing that most outsid- can be asked to do community ser- will. I have to help him with his Day 5
ers know about Portugal’s laws is vice or even, eventually, facing a limited capacity to make his own Harm reduction just a piece
that all drugs for personal use are fine, perhaps even having posses- choices. And, step-by-step, the of the puzzle.
decriminalized. But what most sions confiscated and sold to pay ability of the citizen increases.”
fail to understand is that all drugs, the fine. Portugal created pathways to Day 6
other than alcohol and tobacco, re- It’s why Goulão is so quick to health that aren’t punitive. This re- Treatment centres abound;
main illegal. point out that Portugal’s success quired investing in treatment and so do waiting lists.
DA PH N E B R A M H A M If police find you with illicit isn’t because of decriminalization. recovery services and establishing
Lisbon, Por tugal drugs, you’ll be arrested and taken It’s because, in 2001, his country a network that connects citizens Day 7
to a police station where the drugs made a commitment to providing to whatever they need in a timely Applying the Portuguese
Almost every day, foreigners knock will be weighed. If the amount is whatever its citizens need to be manner, whether that’s outpatient model to B.C.
on João Goulão’s door seeking a above the strictly enforced thresh- as healthy and as fully engaged in counselling, time in a detox centre,
solution to their countries’ drug old limits — designed to be a 10- society as possible. even up to three years in a thera- cut spending by 30 per cent in most
addiction problems. day supply for personal use, or 25 “Decriminalization is not a silver peutic recovery community. areas this year. Again, the excep-
Goulão is Portugal’s director- grams of cannabis, five grams of bullet,” he said. “If you decriminal- And it meant that the govern- tion was addictions treatment and
general of drug policy and the cannabis resin, two grams of co- ize and do nothing else, things will ment made a long-term commit- recovery.
architect of its radical approach, caine, or one gram each of ecstasy get worse. ment to ensuring that those ser- “We had cuts of 10 per cent be-
which included decriminalizing all or heroin — you can be charged as “The most important part was vices wouldn’t disappear when the cause we could explain to politi-
drugs for personal use. Among the a trafficker. If convicted, jail terms making treatment available to economy crashed in 2008. cians that to disinvest would cost
pilgrims who have come here are range from one year to 14 years. everybody who needed it for free. One of Europe’s poorest coun- more later on,” said Goulão. “We
philanthropist Richard Branson, If the amount is below the limit, This was our first goal.” tries before 2008, Portugal was es- had to sacrifice some things —
Canadian Justice Minister Jody you’ll be sent the following day to Underlying the policies is a na- sentially insolvent after the global studies, research and surveys. But
Wilson-Raybould and, recently, the Commission for the Dissua- tional conviction that addiction is meltdown. The US$115-billion the health responses and treat-
an army of politicians and policy- sion of Drug Addiction — even if a chronic, recurring disease best bailout from the International ment facilities, we kept them.”
makers from Norway. you’re a tourist. There, you will dealt with through treatment not Monetary Fund and the European It shows how far Portuguese pol-
Fortunately, the former family be interviewed by a psychologist jail. Union came with strings. The gov- iticians, citizens and even bankers
doctor is infinitely patient, as he’s or social worker before appearing “Our approach is based on re- ernment had to increase taxes and have come in understanding what
been answering the same ques- before a three-person panel that spect,” said Goulão. “It’s incremen- cut spending. Yet, the addictions has been accomplished here.
tions for almost 20 years. will offer suggestions aimed at tal. Our system works by asking treatment and recovery services The country’s drug policy has
In the late 1990s, Goulão and 10 stopping your drug use. citizens what he can give at that survived almost unscathed. not only saved lives, it’s saving
others were charged with advising From there, you’re fast-tracked given moment. Helped by a boom in tourism, Portugal money. In the first five
the government how to deal with to whatever services you’re willing “If he is completely dependent, Portugal’s economy is recovering. years, the social costs related to
the 100,000 people — one in every to accept. If you refuse help, you I cannot appeal through force of Even so, its coalition government drug abuse dropped 12 per cent,
100 citizens — using heroin. Over- according to a peer-reviewed study
dose deaths were averaging 360 a in the International Journal of
year in the country of 10 million Drug Policy in 2014.
and Lisbon was called the junkie Within the first decade, the cost
capital of Europe. We had to saving had jumped to 18 per cent.
Goulão was an unusual choice. Those reductions are in the health
He had no training in addictions sacrifice some costs of drug use and overdose
and, rare among Portuguese, no deaths, but also savings to the le-
direct connection with addictions. things — gal system associated with drug-
The closest family connection he related criminal prosecutions and
has to drugs is a niece, who is in studies, reductions in lost income and lost
her 40s and living in a therapeu- production of individuals serving
tic community with schizophrenia research and time in jail for drug offences.
caused by drug use. Of course, that wasn’t initially
As for his four children, “Hope-
surveys. But obvious to many. In 2001, the
fully, none of them will have prob- the health United Nations threatened sanc-
lems.” tions to punish Portugal for de-
Because of its interventions, responses criminalization and some in the
Portugal now has one of Europe’s European Union threatened to
lowest rates of drug, alcohol and and treatment close the borders.
tobacco use across all ages, and The first indication of change
the lowest infection rates for facilities, came in 2002. The left-wing party
HIV/AIDS and hepatitis that are that brought in the changes was
associated with injection drug use. we kept them. defeated, but the right-wing gov-
In 2016, the number of overdose ernment stuck with it because the
deaths dropped to 26 from 40 the João Goulão is the architect of Portugal’s 2001 overhaul of drug policy that first indication of the improve-
previous year. included decriminalizing drugs for personal use.  DAPH N E BRAM H AM ments were becoming obvious.
CITY S A T U R D A Y, S E P T E M B E R 8 , 2 0 1 8 VA N C O U V E R S U N A13

Today, António Guterres, the rates” — people quitting metha-


prime minister who enacted the done and buprenorphine — and an
policies, is the UN secretary-gen- under-utilization of opioid replace-
eral and Norway is about to follow ment therapy as a treatment op-
the Portuguese model. tion, particularly in northern B.C.
“Our first goal is to help people to In 2016, there were only 27 over-
resume their dignity,” Goulão said. dose deaths in Portugal, down
“An addict has to do whatever to get from 40 the previous year.
his fix each day, I cannot ask him In B.C., 993 people died of illicit
or her to behave as a free citizen.” overdoses in 2016. The total rose
Often the first task is getting what to 1,422 last year.
Goulão described as “the citizen- Nuno Capaz During two weeks here, I saw
ship tools that they need — an iden- no more than half a dozen people
tification card and a health card.” a regular schedule for those whose who were clearly high. The most
If they are acutely addicted to doctors don’t allow them multiple obvious were two in Lisbon’s un-
heroin, they’ll be offered enrol- doses to take home. derground Metro. Another was
ment in an opioid substitution Despite the easy access to opioid screaming and dancing in the
program so they can get metha- substitution therapy, use is stable middle of a street in the upscale,
done or buprenorphine to curb with a slight drop in 2016 (the Chiado shopping district, while a
their cravings as they move to the last available statistics) to 16,368 couple of others were curled up in
next step. people. It mirrors the generally de- parks or on church steps sleeping
Once users are stabilized, Goulão creasing trend in opioid addictions. off the effects of drugs or alcohol.
said, “I can ask for more from Abstinence — defined as free- Even the small shantytown that
them, but always with them being I went to with outreach workers
assisted with those new focuses.” didn’t come close to what’s become
normal in Vancouver’s Downtown
Eastside or in the tent cities that
These days, Lisbon is no Vancou-
Our first goal is have sprung up in this province.
ver. There are no cannabis shops, to help people
let alone one on almost every cor-
ner. The smell of marijuana doesn’t to resume their Goulão still can’t get over what
permeate downtown streets, or he saw when he visited Vancou-
any streets for that matter. dignity. An ver’s Downtown Eastside last fall.
Medical marijuana was only le- “I was shocked. What I saw took
galized in June. The notion of le- addict has to do me back to the end of the 1980s
galizing recreational marijuana is and 1990s in Lisbon with the pub-
anathema here. whatever to get lic visibility of drug use and nui- Lisbon is colourful and graffiti-rich, especially in the neighbourhood where
No addicts openly inject heroin, sance,” he said. “What shocked me IN-Mouraria, a harm-reduction centre, is located. DAP HNE BR AMHAM
smoke or inhale illicit substances, his fix each day, was that there are lots of responses
and there is no drug market where but they do not seem to communi- is washing over North America. companies and we were convincing
dealers openly sell.
I cannot ask him cate. They’re not centred on what Goulão noted that heroin — opi- them to employ these guys.”
No fentanyl has yet been detect- or her to behave citizens need. … Citizens should be oids in general — have little ap- The companies would be given
ed in the illicit drugs. So there’s no able to move through the system peal, especially among Portugal’s tax deductions and government
need for take-home naloxone kits, as a free citizen. and get what they need.” youth who have been regaled with help with the wages. The recover-
pop-up treatment tents or special- It’s got worse since his visit, with tales of the bad days in the 1990s ing users would have access to a
ized training and trauma counsel- the overdose deaths only moder- and learned the lessons from their therapist who was available to as-
ling for first-responders. dom from any form of illicit drug ating slightly in the spring as B.C. parents and grandparents about sist and motivate.
Until July, there were no super- use — is the long-term goal for all entered its third year of a public its serious consequences. But since 2008, those compa-
vised injection sites. Three opened addicts, according to Goulão, and health emergency. Also, European doctors have not nies have been closing. The gov-
in July — two in Lisbon and one in Nuno Capaz, vice-president of Lis- He was asked about what would prescribed painkilling opioids in ernment subsidies disappeared in
Porto, the country’s second largest bon’s commission for the dissua- happen in Lisbon if an opioid user anywhere near the quantities that the mandated cost cutting because
city. When you ask citizens what sion of drug use. Both do, however, had to be revived with naloxone have been handed out in North they weren’t directly linked to ad-
they’d do if they saw someone sell- acknowledge that it may be impos- multiple times in a week. America. “Portugal’s system is dictions treatment and recovery.
ing or using drugs in public, most sible for all addicts. “It wouldn’t happen,” Goulão not perfect,” said Goulão. “But I “That’s a problem — the sustain-
say they’d either tell them to do it In B.C. with a population of 4.7 said. “If it did, he’d probably be believe we have the tools to meet ability of these kinds of programs.
somewhere else or they’d call the million, there were 27,553 people in a hospital under intensive psy- the challenges.” These people lost their new lives.
police in hopes the user could be with methadone or buprenorphine chiatric treatment. Four times in Among its challenges is how to They collapsed like a house of
coaxed into treatment and recov- prescriptions in 2016, twice as a week is not an accident. It has to deal with thousands of former cards and they relapsed. So now,
ery. many as a decade earlier, with the be intentional. So he would need heroin addicts who are returning they’re not as confident in our sys-
There is a national opioid re- number forecast to rise to 58,000 intensive therapy. … But I don’t to drug use in their older age. tem of care,” said Goulão.
placement program that provides by 2020. know of somebody who would “Twenty years ago, it was pos- “Now, we are opening injecting
free methadone to addicts as a Despite that, provincial guide- have overdosed so many times.” sible to find jobs for thousands of rooms because they will not accept
means to stabilize them and get lines for opioid substitution pro- He acknowledges that Portugal people at the final part of their (ad- our invitation to treatment.”
them into treatment. A dispensing grams approved last year raised and Europe are lucky to have been dictions) treatment,” Goulão said. dbramham@postmedia.com
van circulates through the city on concerns about “low retention spared the wave of fentanyl that “There were a lot of small and micro Twitter: @daphnebramham

BACK BY POPULAR DEMAND!

33 % OFF
BASE FARES
ON ALL FLIGHTS FROM NOW TO OCTOBER 3, 2018
Promo Code: 333

Sale ends Monday, September 10, at midnight. Limited time with limited
seats available. Subject to Government approval.

Visit flairair.ca

VAN01285170_1_1
4 DAYS LEFT FOR THE $33,000
FALL BONUS
DETAILS ON
PAGE A6
VAN01269707_1_1

INDIGENOUS JUSTICE
Gladue reports patchwork at best A8-9

CINDERELLA
SURGERY
Keeping feet
in shape B8

M O N D AY, S E P T E M B E R 1 0 , 2 0 1 8 S E R I O U S LY W E S T C O A S T S I N C E 1 9 1 2

NEWS
CA N NA B I S
Post-secondary
policies gear up
as legalization
draws near A3

L E BA N O N
Mom has few
options after
father abducts
their kids  A4

NP Nuno Capaz, vice-president of Lisbon’s Commission for the Dissuasion of Drug Addiction, says Portugal was able to radically reduce drug addiction
by using homegrown solutions that took into account the country’s health care and policing systems.  R ICHAR D LAM

Portugal’s ultimate goal is setting


WO R L D
Far right party
makes gains
in Swedish
vote NP1 drug users on the path to recovery
CA NA DA
In the 1990s, Portugal that people who show up at the “People are normally not happy
Rural ski averaged 360 drug overdose nondescript office of Lisbon’s when they come here,” he said.
deaths a year in a country of Commission for the Dissuasion “They’ve been caught by police
slopes face 10 million. Today, it has one of Drug Addiction might be a bit and are not fully aware of the
uphill battle of Europe’s lowest rates of intimidated. process. But if they show up
drug and alcohol use and Capaz, 41, is the commission’s unhappy, in the end they will be
to survive NP2 there were just 26 overdose vice-president. happier.”
deaths in 2016. In a week- DA PH N E B R A M H A M He has a doctorate in sociol- Capaz is bemused by the sheer
long series from Portugal, Lisbon, Por tugal ogy and it’s his job to try to put number of foreigners and media
Daphne Bramham looks at the Portuguese drug users on a path who show up at his door.
lessons to be learned from the Nuno Capaz is a tough-looking to recovery and ensure that they On my way out, I passed a
country’s radical approach to guy, tall, unshaven and slow are contributing members of Belgian TV crew in the lobby.
addiction treatment. to smile. So, it’s not surprising society. S E E P O R T U G A L   O N A7

SPORTS Indo-Canadians in uproar over student surge


region, are being victimized
by the system or exploiting it.
Canada’s South Asian popu-
CA N U C K S lation numbers more than
mistreatment of young women, sent their children to Canada 500,000, mostly in Metro Van-
Coach Green employer abuse, drug deal- to study. But now tens of thou- couver and Greater Toronto.
ing and the “stealing” of South sands of low-income Indians, Indian education officials,
likes blue-liner Asians’ jobs. including farming families, are especially in the Punjab, are
Juolevi’s play at The number of international stretching their meagre finances complaining about losing stu-
students from India in Canada to get their children into the dents to Canada.
Young Stars B1 has jumped by roughly five times Canadian education system, job They’re also alleging many
DOUGLAS TODD in the past few years, after the market and family immigration of the foreign students are
federal government in 2012 stream. being exploited by unscrupulous
The Indo-Canadian community bucked the trend of other West- South Asian media outlets in immigration agents and English-
is in turmoil over a recent surge ern nations and made it easier Canada and India are buzzing language trainers in India, as
in foreign students from India, for international students to with articles and commentary well as by money-hungry col-
0 57040 10035 1
whose presence is feeding com- work and to go to the front of on the changes, often revolving leges and universities, landlords
$1.90 plus GST munity tensions amid allegations the immigration queue. around debate on whether the and South Asian business
$2.62 minimum in of financial exploitation, an In- In the past it was mostly 130,000 foreign students from owners in Canada.
outlying areas dian brain drain, exam cheating, well-off Indian families who India, mostly from the Punjab S E E T O D D   O N A6

W
NE
Retirement Health Plans with the
most coverage for British Columbians.
PERSONAL
HEALTH
INSURANCE Call 1 800 USE-BLUE
Most available coverage options from leading BC providers based on survey of conversion from group employee benefits to a retirement plan 3/28/17.

VANSAH70449_1_1
CITY M O N D A Y, S E P T E M B E R 1 0 , 2 0 1 8 VA N C O U V E R S U N A7

While possession of drugs for personal use is illegal in Portugal, it is no longer a crime. Portuguese police concentrate much more on tracking down traffickers.  AFP/GET T Y IMAGES/FILES

DRUG STRATEGY MULTI-FACETED


P O R T U G A L   F R O M A1 ADDICTION:
WINNING
An Irish crew was there the day T H E WA R
before. The steady stream of
visitors to the commission is tes- Day 1: World comes to study
tament to the global problem of Portugal’s grand experiment.
drug addiction that Portugal may TODAY: Dissuasion
have among the few solutions on commission aims to set
offer. users straight.
“What makes me mad is that Day 3: Life today for drug
normally people hear decrimi- addicts in Portugal.
nalization and they mix it up Day 4: Outreach workers
with legalization or they are have a long-term goal.
thinking that it is a free-for-all,” Day 5: Harm reduction just
Capaz said. a piece of the puzzle.
“It’s not like that at all.” Day 6: Treatment centres
He also bristles at the sugges- abound; so do waiting lists.
tion that there even is a Portu- Day 7: Applying the
guese model, despite the fact that Portuguese model to B.C.
what this country of 10.5 million
has done is unique. where the services are available.
“It works for us because it If a person doesn’t appear as
was devised for us because we ordered before the commission,
knew our health care system and it asks police to serve another
our policing system. We knew warrant. If the person doesn’t
what our options were.” appear the second time, the com-
If other countries should take mission will make recommenda-
anything from Portugal’s experi- tions and orders in absentia.
ence, he said, it’s the process that If people don’t pay their fines,
was used to devise the policy. the commission has the power to
Portugal put together a com- order police to seize and sell us-
mittee of experts, users and ers’ assets with the proceeds go-
former users in 1998. People ing to help pay for treatment and
with personal experience added recovery services. Seizures can
a human element to the facts and Nuno Capaz, a top official in Portugal’s strategy to reduce drug use, says sanctions can be applied if drug users be appealed through the courts.
figures, which made it more dif- will not voluntarily enter treatment.  DAPH N E BRAM H AM Of those who appear before
ficult for politicians to ignore. the commission, 90 per cent are
The recommendations were ed through education and subtle, drugs, alcohol, tobacco, gambling Gonsalves was also defiant, recreational cannabis users and
widely debated by politicians early intervention before drug or even the internet (all of which insisting on his right to cannabis most are young men. A third of
and by the public. It took several use becomes abuse. fall under the dissuasion commis- for personal possession. those who appear here are in
years before some changes, As with other illnesses, ad- sion) — is considered a chronic His story is a familiar one here. need of some sort of referral
including decriminalization, diction treatment and services disease that affects individuals Gonsalves said police came because they have some prob-
were implemented. Others, are covered by Portugal’s public differently and therefore requires to his village after a complaint lems that they’re attempting to
including supervised injection health care system. The Commis- tailor-made recovery plans. about some youths who were mask with substance use.
sites and medical marijuana use, sion of Dissuasion was set up as a “If people are willing to comply partying. Since decriminaliza- Fewer than 10 per cent are
have only been approved within fast track to those early interven- with what we recommend, good,” tion, police don’t go looking for addicts, which helps explain why
the past few months. tions and a link to services for Capaz said. “If not, that’s their people with small quantities of it’s called the dissuasion commis-
“Drug addiction is a complex the most acutely addicted. problem.” drugs, although they put consid- sion. Its primary role is to deter-
problem that we’re likely not Capaz said that while possess- That’s not entirely true. erable resources into tracking mine the root causes of people’s
going to solve,” he said. ing and using illicit drugs in Por- Drug users don’t have to take down traffickers. drug use and remedy that before
“The best we are likely to do is tugal is not a criminal offence, the commission’s advice. But police do check for them use escalates to addiction.
manage it and we need to devise it remains illegal. And the sale But if they don’t, the commis- if they’re called to complaints Yet for all of the focus on illicit
ways to better manage the situa- and purchasing of those drugs sion has a variety of punitive about public disorder — noise, drugs, Capaz said the most prob-
tions that we’re faced with.” remains a criminal offence. As measures that it can take. It can shooting heroin in public, smok- lematic cases are alcohol-related.
Capaz suggested that the per- a result, there is no tolerance levy fines and confiscate prop- ing dope near children, break and Asked what advice he had for
sonalizing of the issue by grieving here for drugs in public places. erty if those fines aren’t paid. enter, theft and so on. Canada, Capaz replied: “If you
parents and others has skewed Police still arrest people found If addicts and people with HIV Gonsalves said he was going go back to Canada and copy what
some of the decisions being made in possession of drugs. They con- don’t comply with the commis- to the café for an espresso when we did, it probably will not work.
in Canada and the U.S. fiscate the drugs and weigh them, sion’s orders to seek treatment the police stopped and searched You shouldn’t do what we did.
“It’s differences of opinion that comparing the weight against the him. That was the day before. But you should do like we did to
result in the best ideas,” he said. limits set by law for what’s accept- And now, here he is. come up with your own system.”
“But you need to maintain the able for personal use. For can- By the end of his meeting with Portugal put together a group
logic part because in the end it’s nabis, the threshold is 25 grams. If people are Lopes, Gonsalves was more re- to study everything about drug
decided at the political level … by For hashish, it’s five grams, for laxed. He’d been assured that he use and addictions services.
guys in grey suits and ties.” cocaine two grams, and for heroin willing to would not have a criminal record It made recommendations
When Portugal decriminal- or ecstasy it’s one gram. comply with what and that whatever recommen- and then several years went by
ized possession of illicit drugs João Goulão, the national drug dations the commission made as people discussed it and politi-
for personal use in 2001, it was a policy co-ordinator, has said we recommend, — it might be family counsel- cians argued over it.
radical idea born in crisis. By the those thresholds are outdated good. If not, that’s ling, referrals to social workers In the end, the group’s propos-
late 1990s, an estimated 100,000 and need to be reviewed because for help in finding housing or als were only partially imple-
people — almost one per cent when the cannabis limit was set,
their problem. employment tor even long-term, mented. Dropped were the rec-
of the population — were using its potency was more or less the government-funded treatment ommendations for legalization
heroin and there was an epidem- same as five grams of hashish. and meet regularly with their in therapeutic communities — he of cannabis, legalized medical
ic of heroin overdose deaths. Today, marijuana is much more family doctors, the commission would not be forced to follow any marijuana and the establishment
Decriminalization was only a potent. Goulão said Portugal can ensure that their govern- of them. of supervised injection sites.
small part of that basket of mea- has no intention of following ment benefits such as social But part of the commission’s It wasn’t until this June that
sures aimed at curbing Portu- Canada’s lead and legalizing assistance are “interrupted.” role is to motivate people to medical marijuana was ap-
gal’s crisis but that one measure marijuana, let alone all drugs Vitor Gonsalves was both ap- make the necessary changes. proved. In July, three supervised
initially put the country at risk of as some Canadian activists are prehensive and defiant when he “Treatment has to be volun- injection sites opened as pilot
being ejected from the Union Na- demanding. showed up for his assessment tary,” said Capaz. “But if there projects. Before there was the
tions. Its European neighbours Anyone found with more than meeting with a clinical psycholo- is not voluntary compliance, we so-called Portuguese model,
threatened to tighten border the personal use limit in Portugal gist, Raquel Lopes. can apply sanctions. For addicts, Capaz said it was the Portuguese
controls. faces criminal charges. People Like most Portuguese, he that wouldn’t be a fine. It would experiment.
The underlying philosophy was with drugs for personal use are didn’t have a clear understanding likely be community service.” What was that like?
and is that addiction is a chronic, written a summons to appear about what the Commission for But for addicts agreeing to “The experiment part felt like
recurring disease from which before the dissuasion commis- the Dissuasion of Drug Addic- treatment, commission staff ar- we were mice in a lab looking for
people can recover with treat- sion the following day. tion does, even though it handles range it and, if needed, will even a way out.”
ment, and that it can be prevent- Addiction — whether to illegal about 11,000 cases a year. But drive them from the office to dbramham@postmedia.com
A8 M O N D A Y, S E P T E M B E R 1 0 , 2 0 1 8 VA N C O U V E R S U N CITY

Martha May Kahnapace believes a Gladue report, which provided the judge with background on her upbringing, made a difference in her sentence and in her life.   GER RY KAHR MANN

GLADUE REPORTS, RESOURCES


HAVE HAD LIMITED REACH
Background, other factors are considered following conviction of Indigenous offenders
KEITH FRASER in Canada. In 1996, Parliament consultation with Aboriginal due reports, but exactly how the considered by a judge in deciding
recognized there was a crisis and communities who felt the most money will be allocated has not on a sentence.
Martha May Kahnapace believes amended the Criminal Code to di- important thing to improve their been determined. As much as possible, the reports
in Gladue reports, the court- rect judges to look at all available experience in the criminal jus- “That money isn’t earmarked are written by people familiar
ordered documents that provide sanctions, other than just prison, tice system was to provide the for the reports necessarily be- with an offender’s Aboriginal
judges with background informa- that are reasonable in the circum- reports. cause we’re going to work with the community and involve inter-
tion on Aboriginal offenders. stances, with particular attention The Legal Services Society of Aboriginal Justice Council on what views with the offender, family
The B.C. woman has nothing to Aboriginal offenders. B.C., which provides legal aid in the the Gladue process looks like,” said and other community members.
but praise for the writer who pre- In 1999, the Supreme Court of province, until recently has been Kurt Sandstrom, a B.C. assistant The Gladue Writers Society has
sented a report to the judge at her Canada released its Gladue deci- getting about $100,000 in non- deputy Attorney-General. a roster of about 15 writers who
sentencing after she was convict- sion, which also dealt with a B.C. governmental funding for Gladue “Maybe it’s an Indigenous or- have been producing many of the
ed of killing her partner during a Aboriginal woman who was con- reports from the Law Foundation ganization that takes over some reports in B.C.
drunken, drug-induced fight. victed of manslaughter. of B.C. of it, a hybrid between the Legal Pamela Shields, a lawyer who
“If they’re done properly, they’re The ruling set out factors that Services Society and other orga- trains Gladue writers across Can-
very, very helpful,” said Kahna- should be considered in the sen- nizations.” ada and is the former manager of
pace, who is a member of the We tencing of Indigenous offenders, Mark Benton, chief executive Aboriginal services at the Legal
Wai Kai (Cape Mudge) First Na- urging judges to use a restorative There’s a lot of officer of the Legal Services Soci- Services Society of B.C., says that
tion, which is based on Quadra justice approach to sentencing. barriers because ety, said that after a “generation” of it’s been an “uphill battle” from
Island and in Campbell River. Restorative justice involves waiting for some progress on Gla- the beginning to get the reports
“Judges need to be more open to bringing together the victim, of- it’s preferable due, he’s optimistic that changes written.
accepting them.” fender and some members of the that the writers will happen. She organized the program that
Kahnapace received a sentence community to discuss the effects Benton, who said he’s not di- resulted in the first Gladue report
of time served after an 8½-year of crime and includes such things are Indigenous rectly involved in the discussions being written.
court battle during which two as Aboriginal healing circles. themselves but surrounding how the $750,000 will “I realized that the bench and
murder convictions were over- In 2012, a second ruling from be spent, said that despite the long- the bar knew very little about
turned and eventually substitut- Canada’s highest court basically that’s difficult. term involvement of his society, Gladue. Rather than doing full
ed with a conviction for the lesser repeated the message of Gladue, they’d be happy if somebody else reports, which were done in
offence of manslaughter. finding that the situation had got About 75 reports a year were was to take it over. Ontario, the courts were relying on
She didn’t know until a year after worse. being written, at a cost of about “Some of the stuff that’s happen- pre-sentence reports from proba-
he died that her father, whom she “There’s a complete lack of any $1,500 a report. ing right now suggests it may go tion officers. It wouldn’t delve into
described as being “angry, bitter kind of national strategy in rela- Last year, for the first time, the in that direction, but nothing has Gladue factors.”
and an alcoholic,” had been in a tion to it,” said Doug White, co- provincial government kicked been decided yet.” Shields said they developed poli-
residential school. chair of the B.C. Aboriginal Justice in money, providing another White said he appreciates the cies and because there was very
“I didn’t understand the way Council and the secretary of the $100,000 to the society for the work that has been done by the little funding, she had to routinely
things were at the time because Gladue Writers Society of B.C. reports. society over the years, but imag- decline requests for reports.
I didn’t know a lot about it. I didn’t “You see across the country, Increases to legal aid will re- ines that ultimately it will be in the “We set priorities that were
know about residential schools. To there’s a very ad hoc approach to sult in an anticipated $500,000 in hands of some kind of Aboriginal women with children.”
me our way of life was normal. If the implementation of Gladue. funding next year for the reports, justice entity in B.C. Female Aboriginal offenders
it was someone else looking in, it “Some provinces do nothing, which are contracted out to writ- often lose their children to govern-
would be totally dysfunctional and some provinces take a very im- ers around the province. R E P O RT S ment care if the moms are incar-
not just the normal way of living.” poverished approach. The only That’ll allow several hundred Gladue factors that judges must cerated, she said.
She spent much of her childhood two provinces that have anything more reports to be written, but consider when sentencing an As a result, she said, children
in foster homes. She become an that is remotely like a significant it’s still scratching the surface as offender include the effects of “grow up in care, they often be-
alcoholic and an intravenous drug approach are Ontario and British thousands more Aboriginals in the colonialism, residential schools, come parents themselves and it’s
user at a young age. Columbia.” system will not get reports. dislocation, isolation and racism. just a continuous cycle. Gladue
Those details and others were In the spring budget this year, The reports, which take several reports are one way to break that
outlined in her Gladue report and S L OW PR O G R E S S I N B.C. the B.C. government set aside months to write and run to about cycle and provide a remedy and
were considered by the judge in In B.C., the first Gladue reports $750,000 in funding, some of 15 pages, focus on each individual support and acknowledgment and
crafting the sentence. were written in 2009 following which will likely go to more Gla- offender and are just one element try to stop the kids from going into
care and the kids becoming part of
PAT C H W O R K SY S T E M the justice system.”
Gladue reports are routinely Another challenge was finding
ordered for the most serious of- the people to write the reports,
fences, but critics say the systems which need to be neutral, accurate
for delivering them in B.C. and and corroborated, said Shields.
elsewhere in Canada are a patch- “And there’s a lot of barriers
work at best. because it’s preferable that the
The reports are aimed at trying writers are Indigenous themselves
to deal with the grossly dispro- but that’s difficult. There’s a cer-
portionate number of Aboriginal tain level of writing skills that’s
offenders incarcerated in Canada, required for the court.”
a problem that has plagued the In 2013, an evaluation of the Gla-
country for more than two decades due pilot project in B.C. found that
and is on the rise. Aboriginal offenders who received
Figures on the Statistics Cana- a Gladue report prepared by a
da website note that, in 2015-16, Legal Services Society-trained
Aboriginal adults accounted for writer had fewer jail sentences
27 per cent of provincial and terri- than comparable offenders with-
torial jail admissions, while repre- out a report.
senting only about three per cent The study found that when jail
of Canada’s population. was imposed, those with Gladue
The incarceration rates for reports were incarcerated an aver-
Aboriginal women — they make age of 18 days compared to 44 days
up 38 per cent of committals — are for those who did not benefit from
even more worrying. such a report.
A recent study by an Ottawa And offenders being sentenced
think-tank found that B.C. has one for a repeat offence received a
of the most disproportionally high An increase in funding means more Gladue reports will be created for Indigenous offenders but one of the big shorter sentence with a Gladue
levels of Indigenous incarceration challenges that remains is finding Indigenous people to write them.   NATH AN D E N E T T E / THE CANADIAN P R ES S report in 76 per cent of the cases.
CITY M O N D A Y, S E P T E M B E R 1 0 , 2 0 1 8 VA N C O U V E R S U N A9

T R O U B L E D SY S T E M
But there were problems with
the system, with some defence
lawyers raising objections in court.
Terry La Liberté, an experienced
Vancouver criminal lawyer, had
one Aboriginal client who didn’t
qualify for legal aid and was there-
fore facing a hefty bill to pay for
a Gladue report of his own.
His client had been sexually
assaulted by residential school em-
ployee Arthur Plint.
“This man was actually raped.
A lot of people say, well, yeah, he’s
blaming residential school his-
tory. This guy was a victim right
out front and he would have to pay
for a Gladue report. That is of itself
offensive in the extreme.”
Victoria lawyer Kevin Mc-
Cullough and his colleague, Tim
Russell, have applied for a stay of
proceedings for a client arising
from delays in getting the court-
ordered report.
“The government in this case,
the defence says, farted around
for six months after the court had
ordered a Gladue report. They kept
saying, well, go to Legal Services
and there’s a program to fund it,
they’ll pay for the Gladue report.
And our position has been, no, no, Almost a decade ago the Supreme Court of Canada dealt with a B.C. Aboriginal woman convicted of manslaughter, resulting in a ruling setting out
these are court-ordered reports.” factors that should be considered in sentencing Indigenous offenders.  S E AN KI LPATR I CK / THE CANADIAN P R ES S
There have also been some con-
cerns raised by judges about the Gord McVicor, the college’s dean Some travelled from as far away
quality of the reports. of continuing studies. as Thunder Bay, Ont.
Currently there is no accredita- “People couldn’t afford to travel. Jonathan Rudin, director of
tion or certificate required for the Other opportunities came up for the Aboriginal Legal Services in
Gladue writers, which means that people, but all in all seven people Ontario, says his program makes
theoretically anyone can write one. did complete that course.” use of a full-time staff including
A pilot program to train Gladue McVicor said that since the pro- 14 writers whose sole job is to write
writers through Vancouver Com- gram finished, there have been a Gladue reports.
munity College was launched ear- number of inquiries from institu- “Our reports don’t say what the
lier this year, in part to provide tions across Canada that are inter- sentence should be, because that’s
a more systematic approach to the ested in the course. part of our realm. We will do a
writing of the reports. “So we do get these inquiries, but Gladue report for any Indigenous
“We’d like to see the Gladue we’re not really advertising that person facing a sentence of 90 days
writing be an accredited compo- we’ve got this program because or more if it’s requested, ” said Ru-
nent to ensure the quality and we recognize that we’re still de- din, who added the reports were
educational background of those veloping it.” first written in Ontario in 2001.
individuals who are writing those The requirements for the course “If what’s being requested is a
reports,” said David Wells, dean of include Grade 12 English, some sentence of less than 90 days, then
the school of arts and sciences at knowledge of Indigenous cul- our Gladue case workers write Gla-
the college. “We know that there ture and history, knowledge of due letters, which are less lengthy
is a huge shortfall of people able to the Canadian judicial system and and take less time to prepare.” Increases to legal aid will result in an anticipated $500,000 in funding for
write those reports.” awareness of community support Between 400 and 500 reports Gladue reports for Indigenous offenders in B.C.  AR LEN R EDEKOP
A total of 15 people started the services. are being written every year by
college’s pilot program, which was The first students in the program the Ontario program. ing a book on Aboriginal justice ly no reports in Manitoba and
free, but only seven completed it included people with various back- “Every year the numbers keep issues, said that Gladue reports are Saskatchewan.
in March. grounds such as Aboriginal justice going up. The demand goes up and being produced in Nova Scotia and “Alberta has a fairly robust pro-
“There were a couple of reasons workers, justice and public safety we have more staff, so we’re able to Prince Edward Island and some in gram but is very different from
why people never finished, like the students, native court workers and serve that demand.” Quebec. ours.”
travel was a bit of a problem,” said social service workers. Rudin, who just finished writ- But he said there are effective- kfraser@postmedia.com

WOMEN’S VOICE
®

presents

WOMEN’S Health & Wellness Lectures


Put Calcium in

HEALTH Its Place for Strong


Bones and a
Healthy Heart
LECTURE Kate Rhéaume, ND
Why do so many of us have a lack of calcium in our bones

SERIES
(osteoporosis), while calcium builds up in our arteries?
This is the Calcium Paradox. Join Dr. Kate Rhéaume
to learn about the surprising, overlooked keys to strong
bones and healthy arteries. How much calcium do you
really need? Not as much as you think!

Hormones, Digestion, Hormone Health


and Nutrition Throughout the Ages
Karen Jensen, ND
GUEST SPEAKERS: Kate Rhéaume, ND,
Hormone health is the foundation of vitality.
Karen Jensen, ND, Karlene Karst, RD Whether you need to balance weight,
sleep, moods, and libido, prevent skin aging, or your ability
TUESDAY, September 11 to deal with stress, hormones are at the core. Learn how
organs like the gut, liver, thyroid, and adrenal glands all affect
7:00 pm – 9:00 pm hormone health throughout the generations from puberty
to postmenopause.
Italian Cultural Centre
3075 Slocan Street, Vancouver Fuel Your Body
with Energy from
REGISTER TODAY: the Ground Up
WomensHealthShow.ca/tour Karlene Karst, RD
The overabundance of processed and high-sugar foods
Admission combined with an imbalance of fats in the diet are some

is FREE. of the main contributors of fatigue, inflammation, dysbiosis,


and mitochondrial dysfunction. Learn how fermented,
sour, and probiotic-rich foods help rebalance your gut.
Limited seating! Also how to choose the right types of healthy fats
and proteins for a healthier, more energized, you!
Ask for a FREE Women’s Voice
magazine in natural health
food stores or read online:
WomensVoiceMagazine.com

9220606
9220781
VANSAI15416_1_1
CITY T U E S D A Y, S E P T E M B E R 1 1 , 2 0 1 8 VA N C O U V E R S U N A5

ADDICTION CRISIS
FORCED COUNTRY
TO TAKE ACTION
Portugal did much more than decriminalize
drugs; it improved treatment and recovery

In the 1990s, Portugal was in the


throes of a national crisis, averag-
ing 360 drug overdose deaths a
year in a country of 10 million.
Today, it has one of Europe’s
lowest rates of drug, alcohol and
tobacco use and the number of
overdose deaths in 2016 was 26.
ADDICTION:
In a weeklong series from Por- WINNING
tugal, Vancouver Sun columnist T H E WA R
Daphne Bramham looks at the
lessons to be learned from the
country’s radical approach to Day 1: World comes to study
addiction treatment.  Portugal’s grand experiment
Day 2: Dissuasion com-
mission aims to set users
straight
TODAY: Life today for drug
addicts in Portugal
Day 4: Outreach workers
have a long-term goal
Day 5: Harm reduction just
DA PH N E B R A M H A M a piece of the puzzle
Day 6: Treatment centres
LISBON, PORTUGAL  Adelaide An- abound; so do waiting lists
tunes has a strong, but careworn Day 7: Applying the Portu-
face that hints at tragedies that guese model to B.C.
have affected her family, her
friends and her country deeply. Like most kids, he started with
There’s scarcely a Portuguese alcohol, but made the switch to
family that survived the 1990s injecting heroin when he was 16 Joao Crespo, 20, is a dual citizen of Portugal and Hong Kong who moved to Portugal because of easier and cheap-
without losing at least one or 17. er access to drugs. Even though drugs are decriminalized for personal possession, Crespo was arrested for having
member to a heroin overdose. The drug suddenly began flood- more than the legal limit of hash, and expects to be sentenced to community service. DAP HNE BR AMHAM
Antunes was lucky. She lost only ing into the country as Portugal
friends. Her husband survived emerged from 40 years of dic- freely and widely consumed on
and recovered. And because of tatorship and soldiers returned the streets.
Portugal’s massive overhaul of its from the colonial wars in Angola, But others, like João Crespo,
drug laws in 2001, she was able to Mozambique, Guinea and Cape come for the drugs.
rescue her younger brother. Verde. A dual citizen of Hong Kong
“The whole country decided to “I don’t know if it was a form and Portugal, the 20-year-old
change because we didn’t want to of rebellion,” Jorge said. “But arrived a year ago.
see young people taking drugs,” there was no information about He’d been told drugs were
Antunes, 50, explained when we heroin and it was a new thing. I more readily available and of a
met to talk about Portugal then was already working. I’d started higher quality. And Crespo also
and now. working early and I never left my knew that if he were caught with
Initially, her 20-year-old work. It’s where I got the money Jorge Antunes Adelaide Antunes them, the penalty would be much
brother was on methadone, an for the heroin. lower than in Hong Kong, where
opioid-replacement drug used “I was very innocent, naive. That moment coincided health matter, not a criminal one. buying, selling or smoking mari-
to curb cravings, and living with Because all my friends jumped with the government’s policy They’re surprised to learn that juana carries a maximum penalty
her. She was responsible for for that, I did as well to be ‘social,’ changes in 2001 that included a most outsiders believe the only of seven years in jail and a fine of
giving him his daily dose. But to belong.” guaranteed minimum wage, an thing Portugal did was decrimi- up to $1 million.
methadone wasn’t enough of a In those days, there were whole educational campaign, decrimi- nalize drugs for personal use. Since coming to Lisbon, he has
high. He stole from her as he’d neighbourhoods where people nalization of drugs for personal “It’s not OK to do drugs here,” overdosed once on a combina-
stolen from others to get enough lined up to buy heroin and then use, and free enhanced treat- said Jorge, noting their 30-year- tion of Xanax, Adderall, alcohol
money to buy heroin. shoot up in parks, regardless of ment and recovery options, old son has never done drugs.  and ecstasy.
Antunes went to the police whether there were children or including outpatient community “The problem is that drugs He’s been arrested and charged
for advice. “If you love your others present. services and long-term residen- are toxic things. They have a after police found him with 5.7
brother, it is better to take him Two of his close friends over- tial recovery communities. destructive effect. If I had been grams of hash — 0.7 grams over
to jail. That’s what they told me,” dosed. But they didn’t stop using Jorge, now a massage therapist, informed, I’m sure I wouldn’t the quantity legally allowed for
she said. “I remember that day. and neither did he. All drugs — said those changes “gave me the have done drugs.” personal use.
I cried and cried. I remember other than alcohol and tobacco tools to recover.” Had Portugal only decriminal- He’s awaiting his sentencing.
them saying, ‘If you want to see — were illegal. It took a rising overdose death ized drugs and not improved Having chosen not to get any
your brother tomorrow, you have But Jorge said he and his toll and nearly a decade of often- access to treatment and recovery, treatment or pay a fine, Crespo
to send him to jail.’” friends never worried about the heated public debates before Jorge said, “then, it would just expects to be sentenced to some
But when he appeared in court, law. consensus was reached on most have been a party and people form of community service.
he was given a choice between He got arrested a couple of of the recommendations made would have been lost … It would Exactly what, he doesn’t know
jail or going to a therapeutic times. Once, he told the officer by the 11-member panel charged have been a mess.” yet.
community for two years for he was an addict and needed the with finding a solution to the Of course, there are those who The skateboarding musician is
treatment and recovery. He drug. The officer left him alone crisis. do come for the drugs and to certain that he doesn’t have an
emerged clean, sober. He’s never with his heroin. Like most Portuguese citi- party. Lisbon, in particular, is addiction problem. He’s con-
relapsed, has a family of his own “I stopped using at some zens, the Antuneses are proud an increasingly popular tourist vinced he’ll know when it’s time
and now works quietly within his moment of consciousness. I that even in the face of severe destination, especially for the to stop.
community telling young people, said, ‘Enough is enough. I want economic constraints over young. Although he said he prefers
including Antunes’ son, what to live and I know this is not liv- the past two decades, Portugal On hot summer nights, large Hong Kong to his adopted home
heroin addiction was like. ing.’ I wanted to taste things … has continued its support of groups of young men and women in Lisbon, Crespo said he won’t
Her husband was also an addict to embrace things around me. It enhanced education, prevention, move up and down the wide be moving back any time soon.
in the 1990s. Now 48, Jorge was because of the simple things. treatment and recovery services streets of Chiado, Baixa and the “The drugs here are too good.”
Antunes tries to explain what it I hadn’t tasted those — not the and that it has never wavered in Alfama. Their drug of choice dbramham@postmedia.com
was like then. cinema, not dating.” its recognition that addiction is a seems to be alcohol, which is Twitter: @daphnebramham

VAN01285182_1_1
CITY W E D N E S D A Y, S E P T E M B E R 1 2 , 2 0 1 8 VA N C O U V E R S U N A7

HARM REDUCTION JUST ONE PART


OF PORTUGAL’S WAR ON DRUGS
DA PH N E B R A M H A M
ADDICTION:
WINNING
In the 1990s, Portugal was in T H E WA R
the throes of a national crisis,
averaging 360 drug overdose
deaths a year in a country of Day 1: World comes to study
10 million. Today, it has one of Portugal’s grand experiment
Europe’s lowest rates of drug, Day 2: Dissuasion com-
alcohol and tobacco use and the mission aims to set users
number of overdose deaths in straight
2016 was 26. In a weeklong series Day 3: Life today for drug
from Portugal, Vancouver Sun addicts in Portugal
columnist Daphne Bramham TODAY: Outreach workers
looks at the lessons to be learned have a long-term goal
from the country’s radical ap- Day 5: Harm reduction just
proach to addiction treatment.  a piece of the puzzle
Day 6: Treatment centres
LISBON, PORTUGAL  It’s only after abound; so do waiting lists
being assured that there are Day 7: Applying the Portu-
no police around that a wan, guese model to B.C.
skinny heroin addict emerges
from a shack that’s been cobbled don’t use drugs or sell drugs,”
together from spare boards and Alves said.
cardboard. Although the focus of Portu-
The shack is surrounded by gal’s national drug strategy is
discarded drug paraphernalia, treatment and recovery, it does
but no needles. It’s on a dry hill- fund harm-reduction programs
side, below a government hous- including outreach teams like
ing project and not too far from this one.
the national cemetery where for Like everything else in the
centuries Lisbon’s most powerful strategy, the results have been
citizens have been laid to rest. impressive. Through education
The addict’s name is Jose. and prevention, there has been
He doesn’t give a last name. He a sharp drop in injection-drug
brightens at the sight of social use. Now, there are an estimated
worker Andreia Alves and nurse 33,290, high-risk, opioid users,
Rita Abrantes. The outreach down from an estimated 100,000
team is here to check on Jose and in the late 1990s.
about a dozen other addicts who Infection rates for HIV/AIDS
hunker here and they bring sup- and hepatitis have also fallen.
plies aimed at reducing the harms The most recent data indicate
associated with his drug use. that HIV diagnoses related to Social worker Andreia Alves and nurse Rita Abrantes are part of an outreach team that visits shantytowns to pro-
That includes syringes of dif- injection drug use dropped from vide basic harm-reduction supplies to addicts and help motivate them to seek treatment. DAP HNE BR AMHAM
ferent gauges — smaller ones nearly 500 in 2006 to 30 in 2016.
for users who inject in their legs Despite that decline, 1.35 million scrounged couches and orna- them during the heroin overdose heroin to addicts out her window
and groin, bigger ones for use on syringes were distributed in 2016 ments including a toy — one of epidemic in the 1990s. It scared along with bowls of chicken soup.
arms, legs and neck — and pack- through programs like this one. Disney’s 101 Dalmatians — that him clean. One in every 10,000 Portuguese
ages of distilled water and citric As we carried on down the worn stands guard at the entrance. “I hate heroin. Even the smell used heroin and overdose deaths
acid. The water and citric acid path, Alves and Abrantes pointed Until this past summer, Por- of it makes me puke,” he said. were deemed to be of epidemic
are used to dissolve heroin. out horses grazing in the distance. tugal had no official supervised For Antonio, clean means get- proportion, with 360 dying from
Abrantes rips a length of alumi- But then they quickly reminded injection sites. In July, three ting a daily dose of methadone. overdoses annually.
num foil off a roll and hands it us to keep our heads down and pilot projects were launched: two He can’t get it from a clinic and The drug crisis had its roots
to him. Later, Jose will use it to watch for used needles. At a bend, in Lisbon and one in Porto, the bring it home because doctors in war. Just as American sol-
cook and then smoke his heroin. two junkies appeared startled at second-largest city. fear that he’ll sell it in this shan- diers came home from Vietnam
The outreach workers ask him the sound of our approach. Antonio regards himself as a tytown. Instead, Antonio goes addicted, so did Portuguese
how he’s doing. Can they help in Police come here often looking bit of a hero. every day to the mobile dispens- soldiers who had been fighting
any way? Does he know about for drugs, drug users and deal- ing van that cruises the neigh- colonial wars in Angola, Guinea-
the methadone van that makes ers. Depending on the officer, bourhood on a regular schedule. Bissau and Mozambique.
the rounds? Does he need to see some make arrests and confis- “One more year, I’m going to Goulao, a family physician,
a doctor? During their conver- cate drugs. At the police station, stay on it,” he said. led an 11-person committee that
sation, Jose tells them it’s his if they’re found to have only Although Alves and Abrantes convinced the government that
birthday. enough for personal use, police offer to get people into detox, radical change was needed.
As evening sets in, we sing will write them a summons to treatment and recovery, they “There were many differences
Happy Birthday in English. appear the following day at the admit that long waiting times of opinion,” Goulao said. “But
While we sing, his roommate Commission for Dissuasion often keep users from getting our main guidance was humanis-
huddles behind the shack beside of Drug Use, where they’ll be into residential care. In 2016, tic and respect for the dignity of
a pile of used wrappers. He offered a fast track to help. there were 27,834 people in people using drugs.”
couldn’t wait to use one of the But sometimes, they say, offi- treatment with 2,090 of them Since almost every family
clean syringes to inject his drugs. cers threaten them, demanding Antonio first-time entrants. had personal experience with
It is the saddest birthday I’ve information about their dealers in “If you want to pay, you could addiction, citizens needed little
ever witnessed. exchange for not arresting them. “I’m not afraid of the police. I go tomorrow,” said Alves. “Every- convincing that addiction was an
Earlier, the outreach team was Assured by the outreach work- have nothing to fear because I’m body who doesn’t pay waits two illness and that addicts needed
barely out of the van when an ers that none of us was with the doing things that nobody else or more months. But you can go help, not jail.
older man with deep wrinkles police, one man dug two handfuls does. I explain to the police that to the central treatment centre Casal Ventoso was bulldozed.
and no teeth approached, asking of used syringes out of a bag and it’s better to inject here than near in the meantime. There is also a Nearby, the government built
for aluminum foil. dropped them into the bright a school or at a public park. And, shelter where they have activities social housing units in apartment
He told the strangers with yellow bucket that Alves carries. I’ve already sent five people to and you can stay there and have towers for the shantytown’s resi-
them that these workers were A neatly dressed man came up institutions to get better.” professional help. And, you can dents who weren’t addicts.
“very good.” the path as they talked. He was He picks up used needles and go to the methadone program.” Cres Car, the non-profit orga-
“They come here every day returning from another, larger when he finds toys, he sells them If users ask for help and pro- nization that Alves and Abrantes
to help raise people up and give shack down in the valley. There to local kids for the equivalent vide their names and ages, the work for, is on the ground floor
them what they need,” he said, Antonio, a 20-year methadone of a Canadian quarter. It helps team makes the connections to of one of them, providing a wide
tapping his heart before mean- user and former heroin user, supplement the $640 he receives the services the next day and will range of services that include
dering away. has fashioned what he calls a each month in social assistance. even drive the users to where counselling for addictions and
“Sometimes we are the only supervised injection site. It’s At 64, Antonio said he’s lost they need to be. family problems, help with find-
people who they talk to who surprisingly tidy inside, despite too many friends — most of “In the past, there were a lot ing employment and housing,
of tents here. But that’s changed and specialty services to those
since they (the government) sleeping rough.
started to provide methadone Cres Car used to have a needle-
and to create shelters where exchange program, but residents
people can go inside even if they complained when addicts were
use drugs outside,” Alves said. shooting up in the underground
Before 2001, when drug use parking lot half a block away. So
was decriminalized, the shelters it no longer hands out needles
were only for people who weren’t and syringes from its office.
users. As a steady stream of people
At the outreach workers’ first came and went, a little girl rode
stop of the night, we met only six by on a pink bike. A couple of
men. Women — other than the little boys ran shouting along the
outreach workers — don’t come concrete that separates one high-
here. rise from another, delighting in
Less than 20 years ago, Lisbon the sound of their voice echoing
was known as the junkie capital in the concrete cavern.
of the world because it was home A few doors down from Cres
to the largest illicit drug market Car, mothers with babies in arms
in Europe. drank espresso and exchanged
In the city’s Casal Ventoso, a gossip at the two cafes.
shantytown that attracted up to And above it all? Grandmoth-
5,000 people a day, even grand- ers looked down from their win-
mothers sold heroin. Portugal’s dows — the informal enforcers of
national drug policy co-ordina- public order.
A homeless addict shoots up at the Casal Ventoso slum in Lisbon in 2000. The shantytown has since been razed, tor, Joao Goulao, recalls seeing dbramham@postmedia.com
with new social housing units built for its residents who weren’t addicts. G AE L CORN I E R/ TH E AS S OCI ATE D PRE S S one elderly woman handing twitter.com/daphnebramham
A8 T H U R S D A Y, S E P T E M B E R 1 3 , 2 0 1 8 VA N C O U V E R S U N CITY

HARM-REDUCTION PROGRAM
PROMOTES PATH TO RECOVERY
DA PH N E B R A M H A M
ADDICTION:
WINNING
In the 1990s, Portugal was in the T H E WA R
throes of a national crisis, averag-
ing 360 drug overdose deaths a year Day 1: World comes to study
in a country of 10 million. Today, Portugal’s grand experiment
it has one of Europe’s lowest rates Day 2: Dissuasion com-
of drug, alcohol and tobacco use, mission aims to set users
and the number of overdose deaths straight
in 2016 was 26. In a weeklong Day 3: Life today for drug
series from Portugal, Vancouver addicts in Portugal
Sun columnist Daphne Bramham Day 4: Outreach workers
looks at the lessons to be learned have a long-term goal
from the country’s radical ap- TODAY: Harm reduction just
proach to addiction treatment.  a piece of the puzzle
Day 6: Treatment centres
LISBON, PORTUGAL  Fado is this abound; so do waiting lists
country’s two-centuries-old mu- Day 7: Applying the Portu-
sical genre that’s characterized guese model to B.C.
by a deep melancholy, longing
and resignation to one’s fate. residential recovery program,
Getting it right requires and to help with other needs as
plumbing the depths of one’s soul well.
to produce the right sounds, the Francisco came here looking
right passion. For guitar player for legal help, which the staff
Francisco, heroin and other helped him get.
drugs helped him get there. His father had died, throwing
“It’s a dangerous life because him into depression that deep-
all of the music is an expression ened as his estranged siblings
of the feelings and sensitivities, tried to claim the house that
so there is a propensity to use Francisco had lived in all his
drugs,” he said. “The drugs made life. His drug use escalated in
me have more sensitivity. They an attempt to salve his pain and
help me with my music. In so grief.
much feeling, it helps me to play As he talked about his father’s
and expand what I play … like death, Francisco wept.
Jim Morrison and others. “Heroin is a drug that is so
“I experimented because I nice that it’s dangerous,” he said.
wanted to see with my eyes or to “One day you wake up and the
get into a mental situation that drug controls you. The first thing
would give me some news about you want to do is go and inject.
feelings that I don’t know. Most … Every day, when I wake up, I
musicians die with drugs, not like think I have come to the jungle
marginalized people, but because (with the danger always lurking) Francisco is a former heroin user who accessed legal services at a harm-reduction and treatment centre, which
they are trying to conciliate these even when I go to the cafe I have led to him accessing more of the centre’s services to stop using heroin.  P HOT OS: DAP HNE BR AMHAM
feelings into their work.” a little fear (of relapsing).”
Now 55, Francisco said that With legal help, Francisco But he got much more than Despite those successes,
GAT’s In-Mouraria office saved eventually got sole title to the legal help from GAT. His hepati- Curado is critical of Portugal’s
his life. GAT is a non-profit orga- house. It means that he has some tis C has been cured. By coming drug policies.
nization set up to provide harm- stability in his life though he here, Francisco said his drug use “Portugal is still under a
reduction programs to users like still uses drugs, is unemployed has been reduced to smoking prohibitionist paradigm. Drugs
him. Its graffiti-decorated office and lives on €180 a month from hash occasionally and having the aren’t legal and people are still
is near the heart of Mouraria, social assistance bolstered by odd drink. penalized,” she said, noting that
Lisbon’s medieval quarter of nar- what he makes busking and play- “Coming here creates a kind the police still collect people off
row, cobbled streets lined with ing the odd gig. of competition to get better,” he the streets and give tickets that
houses that were once home to said. require them to go to the Com-
sailors and miscreants, the place Adriana Curado is GAT’s proj- mission for the Dissuasion of
where Fado is believed to have ect co-ordinator, with a doctor- Adriana Curado Drug Addiction.
been born. Heroin is ate in clinical psychology. Although the commission is
GAT does the usual harm- “Harm reduction is about tak- not be available when needed.” supposed to be a fast track to
reduction stuff — providing a drug that is ing care of people regardless of Naloxone is an antidote to an services for those who are willing
needle exchange, free hash pipes, so nice that whether they are using drugs or opioid overdose and has proven to accept help, Curado said, “The
distilled water and citric acid not,” she said. important during Canada’s commission penalizes people
for dissolving heroin, condoms it’s dangerous. The cramped office is filled epidemic of deaths from illicit and I don’t agree with that. …
and testing for HIV/AIDS and One day you with comfortable sofas. There fentanyl. Increased availability It’s not my role or our role to tell
hepatitis. are books that can be borrowed is something that Portugal’s drug people to stop using drugs.”
But, unlike in Canada, harm wake up and and half a dozen loaves of bread policy director Joao Goulao said What she and her organization
reduction here includes much the drug on a shelf. The needles, condoms is under consideration. But both want is full legalization of all
more. It provides a pathway and hash pipes are kept in a he and Curado noted that Portu- drugs, a regulated and legal drug
to substance abuse treatment, controls you. locked, glass counter. gal’s overdose death rate is low market.
either as an outpatient or in a Eighty per cent of those who — 40 in 2016 — and that fentanyl Of course, she added, “One
come here are men over 40 “with has yet to hit this country. country can’t go it alone.”
long careers in drugs” and little Unlike Canada, where harm At GAT, the word addict isn’t
education, Curado said. Most are reduction has been front and used. “It stigmatizes people,”
unemployed or have no formal centre of its drug policies, Portu- Curado said.
job history. gal has put few resources in harm Francisco disagrees.
“We’re working in a context of reduction, instead choosing to He has no problem describing
poverty,” she said, which is why focus on prevention, education, himself as a former addict. It’s a
GAT is lobbying hard for super- treatment and recovery. It has strong word, he said. And strong
vised injection sites for those resulted in a steep reduction words are the only ones that
who have nowhere else to use in injection drug use with the provoke action.
drugs and more availability of number of high-risk opioid users He also doesn’t think super-
naloxone to reverse the effects of now estimated at 33,290, down vised injection sites are a good
opioid overdoses. from an estimated 100,000 in the idea.
Curado admitted there is a late 1990s. “I can understand drugs, but
naloxone kit on site even though An estimated 1.35 million I can’t accept them,” he said.
GAT isn’t supposed to allow syringes a year are distributed “Doing drugs is an illusion
drugs to be injected here. by outreach teams and organiza- because it is a weight on your
“We have it because we are tion’s like Curado’s, and the most soul.
doing civil disobedience,” she recent data indicate that HIV “Don’t use drugs. Don’t drink
said. “We need to have it because diagnoses attributed to injection and you’ll sleep very nice.”
At the In-Mouraria harm-reduction centre, needles, hash pipes, condoms it is a life-saving medication and drug use has dropped to 30 in dbramham@postmedia.com
and other supplies are handed out to reduce risks of drug use.  there is no reason why it should 2016 from nearly 500 in 2006. Twitter: @daphnebramham

Personal loans for life’s


twists and turns.
Borrow up to $35,0001 with MogoMoney.

C H E C K YO U R R AT E : mogo.ca/money

(1) See website for details.


VANSAI12608_1_1
A8 F R I D A Y, S E P T E M B E R 1 4 , 2 0 1 8 VA N C O U V E R S U N CITY

Quinta das Lapas is the former manor home of a marquis. Today, it houses one of 63 therapeutic communities dedicated to the treatment of substance abuse.  P HOT OS: DAP HNE BR AMHAM

PORTUGAL’S ADDICTION TREATMENTS


RANGE FROM SPA-LIKE TO SPARTAN
DA PH N E B R A M H A M
ADDICTION:
WINNING
In the 1990s, Portugal was in T H E WA R
the throes of a national crisis,
averaging 360 drug overdose Day 1: World comes to study
deaths a year in a country of Portugal’s grand experiment
10 million. Today, it has one of Day 2: Dissuasion com-
Europe’s lowest rates of drug, mission aims to set users
alcohol and tobacco use and the straight
number of overdose deaths in 2016 Day 3: Life today for drug
was 26. In a weeklong series from addicts in Portugal
Portugal, Vancouver Sun col- Day 4: Outreach workers
umnist Daphne Bramham looks have a long-term goal
at the lessons to be learned from TODAY: Harm reduction just
the country’s radical approach to a piece of the puzzle
addiction treatment. Day 6: Treatment centres
abound; so do waiting lists
MONTE REDONDO, PORTUGAL  The Day 7: Applying the Portu-
moat is long gone and so is the guese model to B.C.
family of the 1st Marquis of Ale-
grete, who built Quinta das Lapas non-profit organizations and three
more than two centuries ago. by government. The goal of the
Today, the manor’s residents are communities is to treat residents’
recovering substance users. They addictions and provide them with
live in dorm-style rooms built the tools they need to avoid re-
behind the main house. But they lapsing into drug or alcohol use.
have full access to the expansive This includes building a network
gardens, carpentry shop, art room of social supports, employment
and, of course, counselling rooms. training and skills development.
Less than an hour outside of For some, the stay can be as little
Lisbon, it’s in a picturesque vil- as a few months. Others may re-
lage with both old-fashioned and main in the community for up to
modern windmills towering over three years
the winding streets. The privately paying patients
“I felt loved here,” said 63-year- here, including foreigners like a
old Jorge Faustino. He’d only young Portuguese-American who
recently completed six months we met during our visit, pay 3,000
here at the Quinta das Lapas com- euros or about $4,600 a month.
munity when we spoke, and was Those referred here by the Com-
in the third and final stage of his mission for the Dissuasion of Drug
treatment: re-integration into the Addiction or by their family doc-
community by working at a restau- tors pay less. The government
rant job that the staff had helped picks up 80 per cent of the tab —
him find. 720 euros or about $1,100 — and
Faustino had been a heroin ad- the residents or their families
dict in the 1990s, recovered, and provide the remaining 20 per cent.
then relapsed after 20 years of ab- But if the families can’t pay or if Pavilion 21B at a former psychiatric hospital is now the Taipas Centre, one of Lisbon’s two out-patient drug treat-
stinence. He’d been walking by the the clients are on social assistance, ment and recovery centres.
place where he used to use drugs their costs are fully covered by the
and thought he’d try it just one government. had access then because the treat- the waiting time has increased to lapse, she said, they no longer have
more time. When we visited, eight of the ment wasn’t government funded. up to four months, and during that to worry they might end up in jail.
“It was a bad idea. It was very 40 beds were empty even though Now more people have access to time a lot of people lose their mo- About 45 minutes west of Lisbon,
hard on me. I had a very violent there are 15 people waiting to have therapeutic communities, but they tivation.” another therapeutic community
reaction,” he said. their applications processed. It have to go through the process of But the legal changes had posi- called Farol (meaning Lighthouse)
Faustino left Quinta das Lapas didn’t used to be like this, said Rui either having the treatment rec- tive effects as well, according to is tucked into the mountainside in
after two months in treatment. But Martins, the centre’s communica- ommended by addictions special- Dr. Rosalie Francisco, the com- a tony neighbourhood of Sintra, a
almost immediately, he regretted tions director. Before the govern- ists at regional treatment centres munity’s technical director. popular tourist destination be-
it and was allowed to return. ment passed laws in 2001 aimed at or by the commission. Those rec- With decriminalization of drugs cause of its beaches, two castles
Quinta das Lapas is one of Por- making it easier to get treatment, ommendations take time. for personal use, people are more and a Moorish fortress that tow-
tugal’s 63 therapeutic communi- there were fewer steps and less pa- “Before, people might be waiting likely to admit their substance ers over the valley.
ties — 60 of which are operated by perwork. Of course, not everyone three weeks,” Martins said. “Now abuse and seek help. If they re- C O N T I N U E S O N N E X T PAG E
CITY F R I D A Y, S E P T E M B E R 1 4 , 2 0 1 8 VA N C O U V E R S U N A9

The long walkway from the the plan set out for them, prefer-
parking lot to the former college ring to continue using methadone
is shaded with mature trees. Farol or illicit drugs, said Vasconcelos.
is a collection of classrooms con- “I don’t believe in forced treat-
verted into dorms and therapy ment,” he said. “It’s unthinkable
rooms. As we walk to the office, to tell a patient what to do. Noth-
we can hear the shouts of resi- ing is mandatory unless the pa-
dents playing volleyball. Like tient puts himself at risk or puts
most people in recovery, 70 per someone else at risk.”
cent of the residents here are men Those who refuse treatment are
ages 28 to 35. told how to get free methadone
The government handed the from a mobile clinic, and that free
buildings over to the Associacao needles, hash pipes and condoms
para o Tratamento das Toxicode- are available from local organiza-
pendencias in 1995, and since The problem is Recovery for us It was a bad tions whose mandate is harm re-
then close to 2,000 people have duction, not treatment.
been treated here. that for a 12- is abstinence idea. It was “Harm reduction is an attitude
Despite the promise of fast step treatment, and giving the very hard on me. based on the idea that I should
pathways to treatment, everyone accept whatever someone else
who winds up here has had to wait. the program is client a differ- I had a very does,” Vasconcelos said.
The waiting list for the 27 beds is very condensed. ent kind of life ... violent reaction. That’s something the psychia-
at least a month. trist firmly rejects.
“It’s not quick to get in,” Farol’s People only get to give them the J O RG E FAU S T I A N
Even before the new law de-
(ON DECIDING TO
director, Assuncao Cruz, said. supported for self-esteem that T RY H E RO I N O NC E
criminalizing drugs for personal
“It’s never less than a month or a use, he said that medical profes-
month and a half on the waiting three months ... they’ve lost. MORE AFTER 20
sionals here agreed that drug us-
Y E A R S O F S O B R I E T Y. )
list. They can go to a treatment ZE DIAS DE CUNHA AS SUNCAO CRUZ ers weren’t criminals. Now, with
centre for support once a week the national guidelines, that’s en-
while they wait. But we do lose shrined in law.
many patients during those wait- beautiful therapeutic commu- by the Commission for the Dis- brightens the walls. But there Still, despite all the laws, rules
ing times. nities like Farol and Quinta das suasion of Drug Addiction. are still many reminders that and regulations and even though
“Recovery for us is abstinence Lapas, it is a bit like winning the There is no waiting list. During this is an institution, not least of this is a small country, Vasconce-
and giving the client a different lottery, which is fitting since they their first appointment, patients which the windows in bathroom los said there are regional differ-
kind of life with the internal and are the most acutely addicted, in are asked to talk about their situ- doors that allow staff to check to ences in the types of treatment
external reserves to have a family need of the most intensive and ation, then informed about the see if patients are taking drugs or, and the ways it’s delivered.
and a job. That’s the most impor- tender care. services the centre has to offer worse, have overdosed. “Every region thinks it’s best. So
tant thing: To give them the self- The reality is that most sub- and the rules of treatment. “Treatment is a tailored pro- we have the risk of disaggregating
esteem that they’ve lost.” stance users — whether in Portu- Some require immediate treat- gram,” he said. “Sometimes part the national plan.”
Ze Dias da Cunha, a 62-year-old gal, Canada or any other country ment and there are six detox beds. of the healing is to reintegrate to If regional differences and dis-
former heroin addict, has been — end up being treated as out- There used to be 15, but when the jobs and to school, so it can’t be agreements threaten a national
on the association’s board since patients, with some studies sug- financial crisis hit in 2008, nurses done as an in-patient. … But I am addictions treatment system in
it began more than a decade ago. gesting that the results are at least and other staff were transferred not God. I don’t foresee what will Portugal — a country with a tenth
He had to go to London for treat- as good as those for in-patients. to other institutions because of happen to my patients. I can only of the land mass of British Colum-
ment 33 years ago, and when he In Lisbon, being an outpatient budget cuts. give them my best advice.” bia, albeit double the population
returned in 1985 Dias started Por- means going to the rather grim The same thing happened at And his best advice is always — it’s certainly worth considering
tugal’s first Narcotics Anonymous Pavilion 21B at the city’s former Lisbon’s other institution that aimed at motivating patients to the challenges if Canada were to
chapter. psychiatric hospital. Built during deals with alcoholics. Its detox eventually get entirely off drugs. embark on a national plan.
“There are two issues with the Second World War, the pink- beds were cut to 16 from 30. “The treatment program here But it doesn’t mean that Canada
treatment in Portugal that I stuccoed building has peeling, It means that 90 per cent of peo- is directed toward abstinence shouldn’t have a national addic-
would change,” he said. “The state white-painted trim. Inside what’s ple who are voluntarily going into and maintaining the rules in the tions strategy.
has beds and pays a certain fee per now called the Taipas Centre, withdrawal will do so at home. process of healing,” he said. “But We’re used to different inter-
month for treatment. The prob- people wait for appointments in Within a week of the first visit, I will try to ensure prevention of pretations of the Canada Health
lem is that for 12-step treatment, a dimly lit rotunda with too few Vasconcelos and his team of psy- HIV.” Act across 10 provinces and three
the program is very condensed. chairs. chiatrists, psychologists, social Among the rules to which pa- territories that stretch over a land
People only get supported for They brighten with the arrival workers, nurses and physiother- tients must agree when they com- mass that is 100 times larger than
three months, while some other of the irrepressible Miguel Vas- apists come up with a treatment mit to the plan is that they cannot Portugal with more than triple the
therapeutic communities that concelos, a psychiatrist and the plan. be on drugs when they come to ap- population.
don’t use 12-step are funded for centre’s director. It’s presented to the patient at pointments. Far from viewing regional dif-
a year.” Ninety five per cent of the pa- a team meeting, and it might in- The only exception is metha- ferences as an assault on a na-
The second issue is that Dias tients are here because they clude methadone therapy, inten- done, an opioid replacement. But tional plan, it could mean that
believes the government ought called the well-publicized phone sive counselling, even laughing it’s considered a short-term ther- Canadians’ needs are better met
to be spending money research- number for addictions help, and yoga, dancing or art classes. apy needed to get the patient to by programs and services tailored
ing what kinds of treatment are some may well be referred for in- Those classes are given on the the next stage of recovery, which to their diverse needs.
the most effective. patient treatment. somewhat cheerier second floor is abstinence. dbramham@postmedia.com
For those who end up at Only five per cent are sent here of the building, where artwork Of course, some don’t agree to Twitter: @daphnebramham

BIGGEST CLEARANCE SALE


on selected Stressless chairs See in store for details

ADMIRAL
STARTING AT

CONSUL
REG $3248
NOW $1998
STARTING AT SAVE $1250
REG $2338
NOW $1598
SAVE $740

SAVE UP TO
50%
ON SELECTED
PIECES
BUCKINGHAM
STARTING AT
REG $7668
NOW $4698
SAVE $2970

MAGIC
STARTING AT
REG $4808
NOW 8
$3298
SAVE $1510

INVENTORY WILL VARY BY LOCATION Don’t sit this one out...


COQUITLAM LANGLEY NANAIMO
1400 United Blvd 20429 Langley By-Pass 1711 Bowen Rd
604.524.3444 604.530.8248 250.753.6361
VICTORIA
RICHMOND KELOWNA
SCANDESIGNSFURNITURE 12551 Bridgeport Rd 1912 Spall Rd
661 McCallum Rd
SCANDESIGNS.COM | Millstream Village
SCANDESIGNS_FURNITURE 604.273.2971 250.860.7603
250.475.2233
VAN01285484_1_1
A12 S A T U R D A Y, S E P T E M B E R 1 5 , 2 0 1 8 VA N C O U V E R S U N CITY

CANADA SHOULD LEARN FROM, BUT


NOT COPY, PORTUGAL’S DRUG POLICY
DA PH N E B R A M H A M

In the 1990s Portugal was in the


throes of a national crisis, averag-
ing 360 drug overdose deaths a
year in a country of 10 million.
Today, it has one of Europe’s
lowest rates of drug, alcohol and
tobacco use and the number of
overdose deaths in 2016 was 26.
In a weeklong series from Por-
tugal, Vancouver Sun columnist
Daphne Bramham looks at the
lessons to be learned from the
country’s radical approach to
addiction treatment.

LISBON, PORTUGAL  It’s irrefutable


that Portugal’s radical departure
from conventional wisdom on
how to deal with drug addictions
and an overdose crisis has been
an overwhelming success.
Among the telling statistics is
that Portugal has an overdose
death rate barely a quarter of the
European average. HIV/AIDS
and hepatitis infection rates are
among the lowest in Europe. So
is drug use in every demographic
group.
The other statistics are eco-
nomic. Indirect health costs
related to addictions and over-
dose deaths dropped 12 per cent
in only five years. Over a decade,
the reduction in social costs —
direct and indirect spending on
health care, legal costs including
prosecuting and incarcerating
drug users plus the costs of lost
production and lost income
because of incarceration — have
been estimated at 18 per cent.
A recent report by the B.C. Cen-
tre on Substance Use urged Brit-
ish Columbia to consider Portu-
gal’s robust recovery-oriented
model, which offers universally
accessible, comprehensive and
co-ordinated treatment for drug
users. Four working groups are
developing recommendations for
the B.C. government.
A year ago, Canada’s justice Lisbon is a colourful and graffiti-rich city. But what’s not tolerated on the streets is open drug use, even though
minister, Jody Wilson-Raybould, in 2001, the Portuguese government overhauled drug laws, decriminalizing personal possession. It also increased
was in Lisbon to take a look, spending on education, prevention and treatment. DAP HNE BR AMHAM
along with Jane Philpott, who
was then federal health minister. policy. Those beliefs include There are no city-licensed pot migrant, is in need of help, he has
Since 2001, the Portuguese the concepts that addiction is shops in Lisbon as there are in exactly the same access to the
government has been taking an illness and that addicts are Vancouver. There is nothing like responses as nationals,” Goulão
measures to treat illicit drug use
ADDICTION: citizens with a chronic, relaps- Vancouver’s Downtown Eastside said, adding with a rueful laugh,
as a health problem, not a crimi- WINNING ing disease who need help to with its open shooting galleries, “That’s why we are poor.”
nal one. T H E WA R make the best decisions about pop-up consumption sites, sanc- Universal access to treatment
A first step was to make all their own health. They are not tioned street market for mostly is what Goulão said Portuguese
addiction treatments free, while regarded as lost causes who are stolen goods and a lowered citizens are most proud of.
ramping up spending on treat- Day 1: World comes to study going to keep using and need speed limit to protect users who But what works in Portugal
ment and recovery facilities and Portugal’s grand experiment. to be kept as safe as possible in stumble into driving lanes. is not a template for Canada.
networking those services to Day 2: Dissuasion com- their addiction. There are too many differences
make it as easy as possible for mission aims to set users It would be impossible in Por- between our countries, their cul-
people to tap into those services. straight. tugal for someone to overdose tures and political systems.
Part of designing a treatment- Day 3: Life today for drug several times in the same week That doesn’t mean that there
oriented system was decriminal- addicts in Portugal. or even the same day, as happens aren’t things Canada can learn
izing possession of illicit drugs Day 4: Outreach workers in Vancouver at the epicentre of from Portugal.
for personal use. Anyone found have a long-term goal. Canada’s opioid overdose crisis.  Let’s start with universal access
with quantities of drugs that fall Day 5: Harm reduction just a In Portugal, such a person to treatment for our citizens,
under the limits set for personal piece of the puzzle. would be taken to hospital and especially since we are in the
possession is required to attend Day 6: Treatment centres put under psychiatric care. third year of a public health
counselling aimed at educating abound; so do waiting lists. Children under 18 who refuse emergency.
and discouraging use. Anyone TODAY: Applying the Portu- treatment also can be taken into Let’s use the enabling powers
repeatedly found with drugs guese model to B.C. care in Portugal, either with under the Public Health Act to
who refuses treatment faces an their parents’ consent or under collect data from private treat-
escalating series of sanctions, where. In B.C., it’s balkanized by child protection legislation. Care ment and recovery facilities to
including confiscation of prop- health region. People are limited might include a stay in a psychi- augment information gathered
erty, to pay fines. to the services available in their atric hospital for assessment,
If someone, through publicly funded services
But it bears emphasizing that region and some regions have followed by long-term care in a a tourist or so that we have a complete pic-
possessing drugs other than more services than others. therapeutic community. a migrant, is in ture of what treatment is avail-
alcohol and tobacco is illegal. It’s further complicated by the “Our first goal is to help people able and what works best.
Anyone caught with more than multitude of non-governmental to resume their dignity,” said need of help, he The emergency powers pro-
the limit for personal possession service providers who are under João Goulão, the architect of has exactly the vided by the act could also be
goes through the criminal justice contract to heath regions. Portugal’s drug policy. used by medical health officers to
system. While some can be Among the other unique “An addict has to do whatever same access to order the most acutely addict-
diverted from jail to treatment, challenges Canada faces are: to get his fix each day, I cannot the responses ed, who are repeatedly being
others are prosecuted as dealers the widespread availability of ask him or her to behave as a free resuscitated, into secured care
and traffickers and are subject to fentanyl, a deadly scourge that citizen.” as nationals. for their own safety. Naloxone is
penalties ranging from one year has yet to strike Portugal; the But given help, he said, they JOÃO GOULÃO never going to be enough until
to 14 years in jail. over-representation of First can regain that freedom and also someone deals with the root of
One tangible benefit of these Nations people with addictions, resume their lives as full citizens. their problems.
combined policies is that it has a legacy of the residential school Having survived their own What may be the most impor-
cleaned up the streets. There system, and; the potential reper- overdose crisis in the 1990s, When ordinary people in Lis- tant lesson, however, is also the
are no longer open drug markets cussions of this fall’s legalization tight-knit communities in Portu- bon were asked what they would most basic.
and, no longer, open drug use. of cannabis, which is the No. 3 gal no longer tolerate the kind of do if they saw someone injecting Portugal’s system works
Portugal has plenty of lessons drug of choice listed by recover- open drug use and sales that have heroin — a routine occurrence in because it has widespread sup-
for Canada. To start, Canada ing addicts in Canada. been normalized in Vancouver. parts of Vancouver — there were port across political and eco-
doesn’t have free, universal Cannabis use is 90 per cent of Maybe it’s because virtually two responses. Some said they’d nomic lines. Through years of
access to addiction treatment. the reason that people are sent to every family was touched by that approach the user and suggest discussions and conversations at
While there may be lots of ser- Portugal’s Commission for Dis- crisis two decades ago. Maybe it’s they seek treatment. Others said every level, Portuguese citizens
vices in Canada, users and their suasion of Drug Addiction and because their much older cities they’d call police, who they trust forged both a comprehensive
families often can’t afford them from there into treatment. and villages have such narrow to be a conduit to getting a user national drug plan and a univer-
or they can’t find them. Using a long lens, what’s most streets that people’s laundry — help. sal addictions treatment sys-
Not only is there no linked striking about the Portuguese both clean and dirty — is in full This is the case whether the tem that is tailor-made to their
network of services available in model is the cohesiveness of the view of their neighbours. user is a citizen or a foreigner. unique needs.
B.C., there isn’t even a central society’s beliefs about addiction But the result is zero tolerance “We are quite a poor country. dbramham@postmedia.com
list of what services are available and how that translates into for drugs. But if someone, a tourist or a Twitter: @daphnebramham