In April 2009, the Cato Institute published a comprehensive case study of the decriminalization of drugs in Portugal. Empirical data from that report indicate that decriminalization has had no adverse effect on drug usage rates. However, drug-related pathologies - such as sexually transmitted diseases and deaths due to drug usage - have decreased dramatically. In 1999, Portugal had the highest rate of HIV amongst injecting drug users in the European Union. The number of newly diagnosed HIV cases among drug users has decreased to 13.4 cases per million in 2009 but that is still high above the European average of 2.85 cases per million.
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