17: Tackling the drug problem in the UK and Portugal – with Dame Carol Black and Dr João Castel-Branco Goulão

The Health Foundation podcast

Like many other countries, the UK has a growing drug problem.

In England around 3 million people take drugs and drug deaths are the highest on record at nearly 3,000 a year. In the last decade, heroin-related deaths have more than doubled and cocaine-related deaths have grown fivefold. The situation in Scotland is even worse – now the drug death capital of Europe.

The UK government tackles drugs as a criminal justice matter focused on punishment, rather than a public health matter focused on support. But many countries are taking a different approach, most famously Portugal which in 2000 decriminalised all drugs and concentrated instead on public health and harm reduction. The result? From one of the highest drug death rates in Europe to one of the lowest.

How did they do it and what can we learn?

Our Chief Executive Dr Jennifer Dixon is joined by:

• Dame Carol Black, who was commissioned by the Home Office and the Department of Health and Social Care to undertake a two part independent review of drugs, to inform the government’s thinking on what more can be done to tackle the harm that drugs cause.
• Dr João Castel-Branco Goulão, a Portuguese physician and the current national drug coordinator for Portugal. He is credited as being the main architect of Portugal’s drugs policy established in 2000 and since then has advised on drug policy for successive governments.

Show notes

• Independent review of drugs by Professor Dame Carol Black
• From harm to hope: A 10-year drugs plan to cut crime and save lives (December 2021)
• Ferreira, S. Portugal’s radical drugs policy is working. Why hasn’t the world copied it? (December 2017)
• National Records of Scotland, Drug-related deaths in Scotland in 2020 (July 2021)
• Nutt, D. UK drugs strategy promises to be tough on criminals, but evidence shows this doesn't work. BMJ 2021; 375 doi: https://doi.org/10.1136/bmj.n3066
• The House of Commons Scottish Affairs Committee report on Problem drug use in Scotland (October 2019) includes an outline of some international case studies.