Portugal's 2001 decision to decriminalize the use of all drugs appears in the book as a concrete counterexample to treating addiction chiefly as a crime. The reform joined decriminalization with housing, food, and job assistance, and redirected resources from prosecution and imprisonment toward treatment—a shift Bryan Stevenson cited while discussing the barriers facing people with addiction in the United States.

Policy Shift

Stevenson placed Portugal's choice against the American turn, beginning in the 1970s, to address drug addiction and dependence as a criminal rather than a health problem. He described that turn as politically popular because it made a new community of people available for criminalization, amid the politics of fear and anger. In his account, the resulting criminal framing helped make the public indifferent to other possible responses and contributed to barriers to treatment.

Portugal offered a different allocation of public resources. Rather than devoting them to prosecuting and imprisoning people who use drugs, the country funneled them into treatment. The reform also included assistance with housing, food, and employment, placing practical support alongside the change in legal approach.

Reported Outcomes

As Stevenson presented it, Portugal had the European Union's lowest drug-use rate and significantly lower rates of drug-related HIV and overdose deaths. The book uses these outcomes to show why the reform mattered in its argument: drug policy could be organized around treatment and support rather than punishment. The account does not provide figures, specify a measurement period, or detail the mechanisms behind each reported outcome.

Contrast with Treatment Barriers in the United States

The reform's significance is sharpened by the book's account of how difficult it could be to turn an American request for help into actual care. In Roanoke, the Hope Initiative sought to connect people with treatment through trained volunteers, but its first month brought 22 people through the door and not one entered residential treatment; only a handful obtained outpatient medication-assisted treatment. Staff faced limited treatment capacity and shortages of providers and beds, while coordinating transfers could require repeated intervention by volunteers and families.

That contrast is not presented as a direct comparison of measured outcomes between the two places. It instead illuminates the difference between redirecting resources toward treatment as a policy commitment and trying to arrange care amid local shortages and administrative obstacles. Portugal functions as evidence, in Stevenson's argument, that the criminal-justice response was a choice rather than the only available way to address drug use.

Place in the Book's Argument

The reform enters through Stevenson's critique of mass incarceration and his proposal to invest some of the money saved by reducing imprisonment in treatment. Portugal gives that argument a national example: decriminalization accompanied by social assistance and a transfer of resources toward care. Its role is therefore less a detailed account of how the policy was implemented than a point of comparison that exposes the consequences of defining addiction as a criminal-justice problem instead of a public-health problem.