The last survey on drug use among the Portuguese adult (aged more than 16 years) prison population was conducted in 2014. According to the survey, 69 % of adult prisoners reported lifetime drug use. Cannabis was the most common illicit substance, 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 substance 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 human immunodeficiency virus (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.
Prison 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-raising 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 a prisoner enters prison. Referral to treatment is encouraged in the prison setting and ensures the continuity for new prisoners of opioid substitution treatment (OST) and other treatments initiated before imprisonment and allows them to access the different interventions available in prisons. OST can also be initiated in prisons
Interventions in this area are divided into two types of responses: programmes oriented towards abstinence (Drug Free Wings and Exit Units) and medication-assisted treatment programmes (with opioid agonists and antagonists). At the end of 2016, around 1 000 prisoners were enrolled in programmes of pharmacological treatment with opioid agonists or antagonists in Portuguese prison establishments. Interventions targeting infectious diseases are also available in prison in Portugal. The legal framework for establishing a syringe exchange programme in prison was ratified by the Ministry of Health in 2007, but no activity has been reported.