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Punishment, Decriminalization, and Treatment

When someone needs help with substance use, an argument about how strict the law should be can displace a more immediate question: will this person reach appropriate care? Punishment, decriminalization, and treatment answer different questions.

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When someone needs help with substance use, an argument about how strict the law should be can displace a more immediate question: will this person reach appropriate care? Punishment, decriminalization, and treatment answer different questions. Law assigns consequences to an act in a particular place and at a particular time. Clinical assessment considers a person's condition. Access also depends on an appointment, language, cost, transport, consent, and an available place. None of these steps proves that the next one has happened.

Three decisions often treated as one

The first decision is how the law classifies an act: a crime, an administrative violation, or conduct outside that particular prohibition. The second is what follows a contact with authorities: a procedure, commission, referral, or other measure. The third is what care the person needs and actually receives. A legal classification does not diagnose a substance use disorder; a clinician does not decide a criminal classification from one symptom. A service address or referral is not a completed appointment.

This distinction matters to relatives too. One can want an act to have consequences while helping the person seek medical assessment. One can question punishment without calling substance use harmless. A rule in one country is not a promise to someone in another: offences, institutional duties, consent rules, and the availability of care differ.

Portugal: decriminalization is not a legal market

Under the consolidated Portuguese Law No. 30/2000, personal use, acquisition, and possession of the specified substances constitute an administrative offence. The decriminalization provision took effect on 1 July 2001. The framework includes police, a territorial commission, and, in particular circumstances, health services; sanctions and procedural decisions remain possible. This does not describe a legal market or guarantee an absence of police contact. The official site itself cautions that its consolidated text does not replace the original enactments.

Law No. 55/2023 clarified how the purpose of acquisition or possession is considered when a statutory reference point is exceeded. It does not create a simple rule in which one number automatically decides every case. Establishing facts and reaching a legal conclusion belong to the competent authorities. This article therefore offers no advice about amounts, storage, or dealing with police. A person with a specific case needs qualified local legal advice; a need for medical care cannot wait on legal advice.

The Portuguese framework treats a request for health care, the commission's work, and consent to treatment as distinct matters. Even a carefully defined referral does not tell us whether the person attended, whether the service was suitable, or whether they could reach and continue it. The law alone supports neither “everyone is treated” nor “no one is treated.” Those conclusions need different evidence.

Oregon: one law, different dates and pathways

An official Oregon Criminal Justice Commission briefing dated 11 June 2025 distinguishes the general effective date of HB 4002, 1 April 2024, from the effective date of the reclassification of possession of user amounts, 1 September 2024. For the latter, it uses unranked Drug Enforcement Misdemeanor. Calling that an ordinary Class A misdemeanor or assigning the April date to that reclassification would misstate the briefing.

A “deflection” pathway can connect law enforcement with behavioral-health or community social-service organizations. Oregon Revised Statutes §137.687 names possible paths to treatment, recovery support, housing, case management, and other services. It requires a tracking system and standards to be developed no later than 1 February 2027. A future deadline does not show that one uniform route already works in every county. “Can refer” is not “a clinician has seen the person,” and a program's name is not a person's outcome.

What the audit shows, and what it could not measure

The Oregon Secretary of State audit landing page, published in December 2025 describes an audit of the Oregon Health Authority's coordination of Measure 110 over 2021 through July 2025. The accessible official summary reports fragmentation between the new provider network and the wider care system, uneven county implementation, and insufficient information about the number served and their outcomes. These are serious implementation concerns. Yet the audit is not an experiment establishing that one law caused every change in substance use, or that care “worked” or “failed” for every person.

Arrest and referral counts in the commission briefing require similar care. Its fingerprinted-arrest data do not include every police encounter; a referral records a system event, not a clinical outcome. Looking at those counts alone can obscure a person who could not obtain care and can attribute recovery to someone who has not yet reached a clinician.

One person may need several routes at once

Imagine an adult facing a legal procedure, sleeping poorly after a change in substance use, and at risk of losing housing. They may need local legal advice about rights and deadlines, a medical conversation about symptoms and a possible disorder, and housing support as separate steps. A legal case does not prove a diagnosis. A program referral does not pay the fare, arrange an interpreter, or create an available appointment. Symptoms may have another cause that should not be assigned to a substance without assessment.

A prescribed medicine, its benefit, physical adaptation to it, and a substance use disorder are also different. Using antidepressants as an example, the Royal College of Psychiatrists distinguishes stopping symptoms from addiction. No one needs to stop prescribed treatment on their own to “prove readiness” for help. If alcohol is involved and withdrawal symptoms have occurred, the NHS warns that abrupt stopping can be dangerous when physically dependent. A safe plan belongs in a medical conversation, not in a home protocol or a relative's demand.

Check actual access without making care a penalty

Outside an emergency, a useful first step is to find a current local medical or social-care contact and check whether it can receive the person now. Ask whether it serves this age group and need; which language is available and whether an interpreter is safe; what an appointment and the journey cost; whether there is a wait or an out-of-hours route; which documents and data are needed; what may be shared with other agencies; how consent works; and who can confirm an actual appointment. “We gave you a number” is not a handover of care. A clinician or local service may help identify another route if the first is unavailable, but this article cannot promise one exists.

With consent, a relative may offer transport, accompaniment, or child care if they can actually provide it. A child must not translate an adult conversation, monitor substance use, hold medication, carry messages between services, or become the adult caregiver. When a parent or caregiver goes to an appointment, a capable adult must actually care for the child; a phone number or booking is not supervision. Threats and abuse call for a separate safe protection route, not a joint conversation to elicit a confession: the NHS explains that help need not wait for an emergency. Privacy, reporting duties, and protection rules must be checked locally; there is no blanket promise here.

Medical urgency comes before a legal debate

If someone suddenly becomes confused, that alone calls for immediate contact with local emergency medical services; do not wait for “severe” confusion or another symptom. The NHS treats new sudden confusion as a reason for immediate medical help. If poisoning is suspected, contact local emergency medical services immediately even before symptoms appear: symptoms may start later. A commission, legal consultation, or debate about punishment must not delay that contact.

Outside an emergency, the useful question is less “Which system will solve everything?” than “What real next step can this person take today, and who will check that it happened?” The answer may involve legal protection, medicine, and social support together. Assessing a law requires evidence about implementation and access; assessing treatment requires clinical and human outcomes. Neither can be replaced by a slogan for punishment or decriminalization.

Sources and limits

Tags

punishment, decriminalization, addiction treatment, Portugal, Oregon, access to care, legal consequences, service referral, medical assessment, consent, privacy, family safety

About the authors

Andrey Zarinsh is the author and founder of United Wisdom. He explores inner transformation, the unity of traditions, intercultural dialogue, and contemporary spiritual discipline. Instagram: @andrey.zarinsh.

Maria Evilkut is a co-author of United Wisdom. Alongside her research, she seeks to test these ideas in practice and observe how the principles of unity and mutual understanding work in real life among people and cultures. Instagram: @ilkutki.

Content date

15 October 2026. English version.

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