A lot of anglo speaking countries like to quote Portugal as an example, I would just like to add some reality to the picture perfect descriptions I read:
- The main public opinion driver for both the needle exchange programs and the decriminalization was a _massive_ Heroin epidemic which lead to an HIV, Hepatitis B/C, AND Tubercolosis epidemic, the last one of those is particularly airborne contagious. I often see the lumping of 'heavy' drugs but (although decriminalized) Cocaine consumption in Portugal was marginal at the time (mostly because the majority of the population couldn't afford it). The main precipitator was Heroin consumption.
- These programs served as a 'trojan horse' anchor point to bring these, often homeless/missing, people back into the healthcare system. For added controversy for the americans out there, healthcare is universally free in Portugal.
- There was a clear rupture point both in crime rates and the prison system capacity due to the heroin epidemic. Police forces could no longer be bothered with the 'noise' of the numerous small possessions of 'non-heavy' drugs like haxixe or marijuana. Offloading that to mental health practioners was also logistically useful for law enforcement.
- It took a considerable amount of additional healthcare funding for these programs to be implemented. This would _not_ have been possible for an economy like Portugal without supplementary funds from the European Union economic development programs.
- I am very suspicious of the counter-argument insinuation that the program initially _caused_ an increase in crime rates and consumption, because the start of the program also matched the start of a fairly large economic downturn. The main idea of the program was that people could go and ask for help, without the fear of being put in jail. If you have a desperate person, willing to do desperate things, not pushing them against a corner is usually a good policy for crime rates.