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detractors of the reforms has not materialized. On the other hand, heroin users in Lisbonreport that the supply of heroin is much lower than the demand; this could suggest thatpolicing operations have been equally or more effective than the prevention and dissuasionmeasures. The outcome either way is positive.An unquestioned achievement is the change in how heroin is used. Currently, it ismore often smoked than injected. This development has contributed to a positive “sideeffect:” a decrease in the percentage of drug consumers who are HIV-positive. Such successmay be attributed to the policy of prevention and harm reduction, and, above all, to informationabout the risk of injecting heroin and to the increased availability of needle and syringeexchange programs.Portuguese Drug Policy in the European Union andthe Broader International ContextAn EMCDDA official interviewed for this study noted that the trend toward depenalization,and even decriminalization, is rising in many EU countries (e.g., Austria, Germany, Luxembourg,the Netherlands, and Spain). However, only Portugal (and since 2010, the CzechRepublic) has changed its approach toward drug use in a systemic way, that is by revisingall relevant legislation, policy, and practice; other countries, meanwhile, have merely madeadjustments.Harm reduction policy is also gaining support. As one EMCDDA document states: 39Historically, the topic of harm reduction has been more controversial. This is changing,and harm reduction as a part of a comprehensive package of demand reductionmeasures now appears to have become a more explicit part of the European approach.This is evident in the fact that both opioid substitution treatment and needle andsyringe exchange programmes are now found in virtually all EU Member States.Likewise, in Drug Decriminalization in Portugal 40 , Glen Greenwald notes that “In 10years, the availability of harm-reduction measures, such as opioid substitution treatment,has increased tenfold across the EU.”Many interviewees referred to examples of repressive policies abroad, such as in the39. EMCDDA, 2007, The State of the Drug Problem in Europe, p. 12.40. Greenwald, G. (2009), Drug Decriminalization in Portugal. Lessons for Creating Fair andSuccessful Drug Policies, Cato Institute, p. 11.DRUG POLICY IN PORTUGAL 41