EMCDDA Home
  • EN
Search

Drug treatment overview for Portugal

Map of Portugal

1. National context

Healthcare for drug users is organised in Portugal mainly through the public network services of treatment for illicit substance dependence, under Regional Health Administrations of the Ministry of Health. In addition to public services, certification and protocols between non-governmental organisations (NGOs) and other public or private treatment services ensure a wide access to quality-controlled services encompassing several treatment modalities. The public services are provided free of charge and are accessible to all drug users who seek treatment.

Drug treatment in Portugal can be classified into four main categories: (i) outpatient drug treatment; (ii) day-care centres; (iii) detoxification units; and (iv) therapeutic communities. Treatment teams, mainly in outpatient units, are usually entry points for the clients, where a client’s situation is assessed and the treatment plan is designed. From there, referrals are made to public or private detoxification units or therapeutic communities. All centres provide both psychosocial and substitution treatment. Day-care centres offering outpatient care are provided by public and non-governmental services. Withdrawal treatment is available in public and private detoxification units. Inpatient psychosocial treatment mostly consists of therapeutic communities and is mainly available in private services. Short-term and long-term residential psychosocial drug treatment is also available. There are 61 specialised treatment facilities (public and certified private therapeutic communities), eight detoxification units, 78 public outpatient facilities and eight accredited day-care centres. Although treatment of opioid addiction remains a main focus of the drug treatment system, during the period 2005–10 special programmes for cannabis and cocaine users have also been created.

Continuous efforts are also taken to systematise the best practice experience and promote new treatment approaches. Thus in 2011 guidelines defining the early treatment of youth at risk and adolescent users and on treatment and rehabilitation in a therapeutic community were published.

Opioid substitution treatment (OST) is widely available in Portugal through public services such as specialised treatment centres, health centres, hospitals, pharmacies, NGOs and non-profit organisations. Methadone has been available since 1977, buprenorphine since 1999, and the buprenorphine/naloxone combination has recently been approved for use.

Decree Law 183/2001 Article 44.1 and Decree Law 15/93 Article 15.1–3 stipulate that methadone treatment can be initiated by treatment centres, and that buprenorphine treatment can be initiated by any medical doctor, specialised medical doctors and treatment centres. The provision of buprenorphine in pharmacies started in 2004.

In 2013, some 16 858 clients were registered in opioid substitution programmes (29 325 in 2010), 67 % of whom were in methadone maintenance treatment and the remaining 33 % in high-dosage buprenorphine treatment. OST is also available in prison settings.

top of page

3. Treatment demand

Table 1: Number of clients entering treatment in Portugal by year
Clients in treatment 2010 2011 2012 2013
Number of all clients entering treatment 5179 4388 4388 4138
Number of all clients entering treatment with known primary drug 3157 3764 3764 3007
% of which for opioid use 64.7 70.1 70 54.3
% of which for cocaine use 12.1 10.5 11 12.9
% of which for cannabis use  15.9 13.9 14 26.8
% of which for stimulants use (other than cocaine)  0.2 0.1 0 0.3
Number of new clients entering treatment 3120 2265 2265 1983
Number of new clients entering treatment with known primary drug 2180 1800 1800 1392
% of which for opioid use 56.0 54.4 54 27.3
% of which for cocaine use 14.0 14.4 14 17.2
% of which for cannabis use 21.3 25.4 25 48.4
% of which for stimulants use (other than cocaine) 0.3 0.3 0 0.6

Notes:
The variation across time, in particular with regard to the absolute numbers of clients in treatment, should be interpreted with caution as coverage data may have changed over time. For further information on coverage details please refer to the relevant EMCDDA Statistical Bulletin.
In 2010 a new national information system was implemented.
‘N. Av.’ stands for ‘No information available’.
For an explanation of terms used, see the definitions of terms.
Sources:

Reitox national reports 2014 and TDI tables.
EMCDDA Statistical Bulletin 2015.

top of page

4. Treatment provision

Table 2: Opioid substitution treatment provision in Portugal
Opioid substitution treatment 2010 2011 2012 2013
Number of clients in opioid substitution treatment 29325 26351 24027 16858
of which with methadone 23067 N.Av. 20395 11256
of which with buprenorphine 6258 N.Av. 3632 5602
Notes:
For a detailed European overview please see the EMCDDA Statistical Bulletin 2015 (HSR section).
‘N. Av.’ stands for ‘No information available’.
For an explanation of terms used, see the definitions of terms.
Sources:
Standard Table 24 (ST24) on 'Treatment availability' submitted in 2014.
Table 3: Year of official introduction of opioid substitution treatment substances in Portugal
Applied substances in opioid substitution treatment Officially introduced in
Methadone (MMT) 1977
Buprenorphine (HDBT) 1999
Heroin assisted treatment,including as trials N.App.
Slow-release morphine N.App.
Buprenorphine/naloxone combination N. Av.
Notes:
For a detailed European overview please see the EMCDDA Statistical Bulletin 2015 (HSR section).
‘N. App.’ stands for ‘Not applicable’.
‘N. Av.’ stands for ‘No information available’.
For an explanation of terms used, see the definitions of terms.
Sources:
Reitox national reports.
Table 4: Legal framework of opioid substitution treatment in Portugal
Legal framework of opioid substitution treatment Methadone Buprenorphine
Do office-based medical doctors have the right to initiate the prescription of substitution treatment? N.App. Yes
Do specialised medical doctors have the right to initiate the prescription of substitution treatment? Yes Yes
Notes:
For a detailed European overview please see the EMCDDA Statistical Bulletin 2015 (HSR section).
For an explanation of terms used, see the definitions of terms.
'Specialised medical doctors' refers to specifically trained or accredited office-based medical doctors.
Sources:
Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2014.

top of page

5. References and links

Related EMCDDA resources

 

External links

Please note that the EMCDDA is not responsible for the content of external sites.

Treatment inventories

top of page

About the EMCDDA

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the reference point on drugs and drug addiction information in Europe. Inaugurated in Lisbon in 1995, it is one of the EU's decentralised agencies. Read more >>

Contact us

EMCDDA
Praça Europa 1, Cais do Sodré
1249-289 Lisbon
Portugal
Tel. (351) 211 21 02 00
Fax (351) 218 13 17 11

More contact options >>

Page last updated: Friday, 22 May 2015