The Portuguese National Plan for the Reduction of Addictive Behaviours and Dependencies 2013-20 recognises a need for age-specific prevention in the context of family, school, recreational and sports settings, community, workplaces, road safety and prisons. At the national level, prevention is a task of the Division of Prevention and Community Intervention of SICAD, while the Regional Health Administrations have a further role in the operational health policies.
In the framework of the National Plan, the Operational Plan of Integrated Responses (PORI) is an intervention framework targeted at drug demand reduction and is organised at the local/regional level. In each specific geographical area, an intervention may address specific local needs by bringing together relevant partners working in different settings. Within PORI, the most vulnerable geographical areas have been mapped in order to prioritise them for resource and intervention allocation. In continental Portugal, 163 geographical areas were identified for the development of integrated intervention responses at various levels (prevention, treatment, harm and risk reduction, and reintegration). In 2015, 18 integrated response projects were implemented in the framework of the Operational Plan with an estimated coverage of 21 143 people; 16 projects from 2014 were continued and two were new.
Prevention interventions encompass a wide range of approaches, which are complementary. Environmental and universal strategies target entire populations, selective prevention targets vulnerable groups that may be at greater risk of developing drug use problems and indicated prevention focuses on at-risk individuals.
In terms of environmental prevention, in 2015, the main initiative was the adoption of a new legal instrument that changed the legal framework for tobacco and alcohol, regulating their sale to and consumption by minors.
Universal drug prevention is part of the Portuguese school curriculum and is mainly implemented in sciences, biology and civic education classes. Throughout 2015, several prevention actions and projects were developed nationally in the school setting, either from an overall perspective of health promotion or focusing on specific aspects of addictive behaviours and dependences. Activities were developed by teachers, with the involvement of students, and often of other stakeholders in this area: public health care centres, municipalities, SICAD and civil society organisations.
Universal prevention strategies such as Me and the Others have been preferred to less structured approaches. The Me and Others programme has been implemented across various educational settings since 2006 and focuses on promoting children’s healthy development. The programme is evaluated annually using a pre-post design only, and the evaluations suggest an increase in self-efficacy among the participants, which might be a result of the programme. Other standardised school-based prevention programmes are available at regional and local levels. Drug prevention activities in the workplaces, the military, communities and with families have also taken place.
Different types of selective prevention interventions including community-based interventions for vulnerable groups, family-based interventions for vulnerable families and interventions for vulnerable neighbourhoods have been carried out. Kosmicare, an intervention to tackle crisis events related to the use of psychoactive substances at music festivals, was continued in 2016.
Indicated prevention consultations are carried out in integrated response centres by multidisciplinary teams, mainly targeting teenagers and young people who have already started using psychoactive substances. This indicated prevention service provides psychosocial support and referral to other services.
Several large media campaigns have been implemented in recent years to complement awareness-raising and information activities targeting young people. There has been a growing interest in the application of new technologies to support preventative interventions and health promotion, particularly in the recreational context.
Provision of interventions in schools in Portugal (expert ratings)
NBYear of data 2015.