“Reducing the harms of drug use requires painstakingly building and sustaining a system that connects people with treatment, healthcare and social support.”
By Karyn Sporer and Robert Glover, University of Maine via The Conversation
Nearly 70,000 Americans died of a drug overdose in 2025. While that is a decline from the nearly 108,000 deaths recorded in 2022, these grim figures distinguish the U.S. from other high-income countries. At the peak of the opioid crisis, the U.S. overdose death rate was 68 percent higher than Canada’s and nearly five times that of Australia.
And death is only the starkest indicator: Substance use disorder imposes hundreds of billions of dollars in healthcare, criminal justice and lost productivity costs each year—to say nothing of the incalculable disruption to families and communities.
For decades, U.S. drug policy has aimed to reduce drug use by disrupting supply, punishing possession and use and promoting abstinence.
But this isn’t the only approach to addressing drug use.
2026 marks the 25th anniversary of Portugal’s landmark decision to decriminalize the possession of all drugs for personal use. This is one of the world’s longest-running efforts to center public health and harm reduction in national drug policy.
As a
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