In this article, Wharton adjunct professor of management and senior fellow at Wharton Center for Leadership and Change Management Gregory Shea breaks down the unraveling of Portugal’s controversial drug policy, updating prior insights into organizational change from a case study in his book with Cassie Solomon, Leading Successful Change: 8 Keys to Making Change Work.
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n 1999, Lisbon carried the moniker of the “heroin capital of Europe.” Consequential diseases such as HIV infection reached an all-time high in 2000, with 104.2 new cases per million people. A multi-partisan party coalition backed sweeping and coordinated change. Portugal redefined the problem of addiction and correspondingly envisioned a very different approach to addressing it compared to other countries, an approach that de facto followed the change model presented in Leading Successful Change.First and foremost: Portugal defined addiction as an illness. Second, Portugal eliminated the distinction between hard and soft drugs. Third, Portugal concentrated on an individual’s unhealthy relationship with drugs and the likely accompanying frayed connections between the addict, others, and the world at large.
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By 2018, Portugal’s number of heroin addicts had dropped from 100,000 to 25,000. Portugal had the lowest drug-related death rate in Western Europe, one-tenth of Britain and one-fiftieth of the U.S. HIV infections from drug use injection had declined 90%
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The number of Portuguese adults who reported prior use of illicit adult drugs rose from 7.8% in 2001 to 12.8% in 2022 — still below European averages but a significant rise nonetheless. Overdose rates now stand at a 12-year high and have doubled in Lisbon since 2019. Crime, often seen as at least loosely related to illegal drug addiction, rose 14% just from 2021 to 2022. Sewage samples of cocaine and ketamine rank among the highest in Europe (with weekend spikes) and drug encampments have appeared along with a European rarity: private security forces.