In the 1990s, Portugal faced a staggering opioid crisis. Roughly 1 in 10 individuals was using heroin; 1 percent of the population was addicted. Portugal’s prisons brimmed with those convicted of drug-related crime. High-risk behaviors produced public health crises, exploding HIV and hepatitis infection rates, homelessness and violent crime. One person I spoke to there described the period as “nightmarish.”

Since 2001, bold decriminalization and harm reduction measures have turned Portugal’s opioid crisis around. The United States, and Maine particularly, can learn from their approach.