In 2001, Portugal became the first country to decriminalise the possession and consumption of all illicit substances. Rather than being arrested, those caught with a personal supply might be given a warning, a small fine, or told to appear before a local commission – a doctor, a lawyer and a social worker – about treatment, harm reduction, and other support services. The opioid crisis stabilised, and the ensuing years saw dramatic drops in problematic drug use, HIV and hepatitis infection rates, overdose deaths, drug-related crime and incarceration rates. Despite enthusiastic international reactions, local harm-reduction advocates criticise the state for dragging its feet on establishing supervised injection sites and drug consumption facilities.