Students visited Lisbon and Porto to observe harm reduction services put in place by doctors, legislators, counselors and police officers to reduce drug use.

DENTON (UNT), Texas – There was a skyrocketing heroin problem in Portugal in the 80s and 90s – an estimated 1 percent of the population was addicted to the drug. The epidemic led to authorities making a drastic and controversial decision – the decriminalization of the personal use and possession of all illegal drugs. Over the winter semester, University of North Texas students traveled to Lisbon as part of a two-week faculty-led Study Abroad program to study the country’s radical approach to providing harm reduction services to individuals with substance abuse disorders.

“As students learned more about the impact of decriminalization and harm reduction on Portugal's drug users, they realized the value of treating substance use disorders as a de-stigmatized, health-related community concern instead of a criminal one – this approach allows individuals to seek treatment when they are ready and at a time when their treatment will be most successful,” said Dr. Rachita Sharma, senior lecturer in the College of Health and Public Service (HPS) Department of Rehabilitation and Health Services and clinical director of UNTWELL. “Thus, students got an opportunity to experience firsthand the importance of removing stigma so that people who use drugs can reach their drug-free goals.”

Fifteen students from HPS and the College of Liberal Arts and Social Science kept journals as they visited governmental and non-governmental organizations to learn more about the country’s harm reduction policies and services. In Lisbon, they visited the European Drug Monitoring Center, which is responsible for tracking drug use patterns across all of the EU nations. They even spoke one-on-one with Dr. João Goulão, the creator of the controversial decriminalization approach to treating substance use that has been implemented in countries around the world.

“Depending on the type of offense, offenders are given a warning, have to pay a fine or they have three days to appear before a health commission comprised of healthcare workers like counselors, mental health and drug addiction specialists, doctors and nurses, social workers and even lawyers – basically a healthcare court,” said Wendy Mincer-Summers, doctoral student and counselor for UNTWELL. “They talk to the offender and offer them drug treatment options, available support options and most importantly, harm reduction free of charge. That was one of the take-aways for me – unless we provide help that is truly attainable and free of charge, nothing will really change. Drug addiction is a mental health issue and not only are good counselors hard to find, ones that work for free are non-existent.”

Upon completion of the study abroad course, students wrote a paper about what they learned and how it could apply to the United States. Mincer-Summers says what she learned on the trip has forever changed her opinion on drug addiction.

“Where most of the other students discussed how this type of change would never happen based on our healthcare system, understanding harm reduction has led me to seek out other types of support systems here in the U.S.,” she said. “Peer support specialists are up and coming and we have a program at UNT that exemplifies that. Basically, I have a different take on evidenced-based practices because I saw unconventional ones that work far better than some that exist currently.”

HPS Dean Neale Chumbler says experiences through the UNT International Study Abroad Office provide students with immeasurable insight into other cultures and practices and gives them unique learning opportunities.

“This is an excellent example of students being able to develop new ideas based on experiences they wouldn’t be able to have here in the U.S.,” Dr. Chumbler said. “They were able to witness an innovative approach to harm reduction and not only get an in-depth look at Dr. Goulão’s plan in action, but even spoke with him themselves. It’s just another way HPS provides excellence in education.”