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, the community, workplaces, road safety and prisons. The scope of prevention has been broadened to cover addictions without substance use and related behavioural issues. At the national level, prevention is a task of the Division of Prevention and Community Intervention of the General-Directorate for Intervention on Addictive Behaviours and Dependencies (SICAD), while the regional health administrations have a further role in the operational health policies.
In the context of the national plan, the Operational Plan for Integrated Responses (PORI) is an intervention framework targeted at drug demand reduction and is organised at the local/regional level. In each of the 163 specific geographical areas identified for the development of integrated intervention responses, an intervention may address specific local needs by bringing together relevant partners working in different settings. In 2017, 20 integrated prevention projects were implemented within this framework.
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 substance use problems and indicated prevention focuses on at-risk individuals.
In the area of environmental prevention, in 2015 Portugal adopted a new legal instrument regulating the sale of alcohol and tobacco to and their consumption by minors.
The Ministry of Home Affairs ensures the continuity of a proximity policing programme, Safe School, to improve safety near schools through the Public Security Police and the National Republican Guard. Its main objectives are to (i) raise awareness, (ii) advise on good practices, (iii) collect information and statistical data, and (iv) conduct studies about violence, insecurity and victimisation in the educational community. Universal drug prevention is part of the Portuguese school curriculum. Several prevention actions and projects have been developed nationally in the school setting, both from the broader perspective of health promotion and with a specific focus on aspects of addictive behaviours and dependencies.
Universal prevention strategies, such as the Me and the Others programme, have been preferred to less structured approaches. The Me and the Others programme has been implemented across various educational settings and focuses on promoting the healthy development of children. The programme is evaluated annually using a pre-post design, and the evaluations suggest an increase in self-efficacy among the participants. School-based prevention is also implemented by the Ministry of Education, responsible for the inclusion of health promotion and substance use prevention, and the Ministry of Health (through SICAD and regional health administrations), responsible for the prevention component of PORI. Other standardised school-based prevention programmes are available at regional and local levels. Some workplace prevention programmes operate in some municipalities, in the private and public sectors.
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. Indicated prevention consultations are carried out in integrated response centres by multidisciplinary teams. More than 20 000 prevention consultations were carried out under PORI, targeting almost 3 000 young people using psychoactive substances, including psychosocial support and referral.