Drug use in prisons has always been a major concern in Portugal.
According to a survey on drug use among the adult prison population (older than 16 years) carried out in 2014, 69 % of adult prisoners report lifetime drug use. Cannabis was the most common illicit drug, with 56 % reporting having used it at some point during their lifetime and 28 % reporting having used it during imprisonment, followed by cocaine (39 % lifetime use and 8 % during imprisonment) and heroin (26 % lifetime use and 8 % during imprisonment).
Having ever injected an illicit drug was reported by 14 % of prisoners, with 4 % reporting injecting drugs during their current period of imprisonment. In addition, a survey of young offenders (aged 12-16 years) in custody conducted in 2015 found that almost 89 % of those who responded had lifetime drug use experience.
The prevalence of HIV infection among those receiving treatment for drug dependence in prison is reported to be 17 %; the majority of HIV-infected prisoners receive antiretroviral therapy. All prisoners are screened for infectious diseases on entry to prison and tests are repeated at least once a year.
Prisoner healthcare is managed by health services under the responsibility of the Ministry of Justice in partnership with the National Health System.
All prisons make detailed yearly plans for health promotion and disease prevention, which include initiatives (awareness and training actions) to tackle infectious diseases, drug dependency and addictive behaviours focusing on the relationship between these two phenomena.
The detection of addictive behaviours and dependences is part of the evaluation protocol when the prisoner enters prison. Referral to treatment is encouraged in the prison setting and ensures the continuity for new prisoners of OST and other treatments initiated before imprisonment and allows them to access the different interventions available in prisons.
Interventions in this area are divided into two types of responses: programmes oriented towards abstinence (Drug Free Wings and Exit Units) and medicationassisted treatment programmes (with opioid agonists and antagonists). The General-Directorate of Reintegration and Prison Services (DGRSP), with 49 prison establishments, coordinates these treatment programmes. Medicationassisted treatment programmes can be provided in each prison by internal clinical staff, or by the appropriate regional health administrations.
69 % of prisoners report lifetime drug use