Portugal Country Drug Report 2019

Harm reduction

The main priority established by the current national plan in the area of risk and harm reduction is to promote and develop the existing risk and harm reduction intervention model and adapt it to the evolving drug use phenomenon by promoting effective and integrated responses. The governance and implementation of harm reduction services and interventions occur within the framework of the Operational Plan for Integrated Responses (PORI). This plan, managed by the General-Directorate for Intervention on Addictive Behaviours and Dependencies (SICAD), relies on the assessment made by the regional health authorities, based on which regional and local intervention needs are identified. While non-governmental organisations (NGOs) were instrumental in the creation of an infrastructure of health and social service providers under Decree Law 183/2001 and continue to play an important role, harm reduction has also become an integrated part of the services provided by the national network of health service providers. The current Action Plan for the Reduction of Addictive Behaviours and Dependencies Horizon 2020 continues to promote harm reduction, and legislation to strengthen state funding for harm reduction NGOs was adopted in 2018, increasing the sustainability of their work.

Harm reduction interventions

A nationwide network of harm reduction programmes and structures, including needle and syringe exchange programmes, low-threshold substitution programmes, drop-in centres/shelters, refuges, contact units and outreach teams, has been consolidated in areas of intensive drug use with the aim of preventing drug-related risks such as infectious diseases, social exclusion and delinquency.

The National Commission for the Fight Against AIDS (Comissão Nacional de Luta Contra a SIDA), in cooperation with the National Association of Pharmacies (Associação Nacional de Farmácias), implements the national needle and syringe programme, Say No to a Used Syringe. The programme involves pharmacies, primary care health centres and NGOs, and includes several mobile units. Approximately 57 million syringes were distributed under this needle and syringe programme between its launch in October 1993 and December 2017, and the latest evaluation of the programme emphasises the important contribution made by pharmacies, drug facilities and outreach work to its delivery.

An increasing trend in the number of syringes dispensed has been observed in recent years, with more than 1.4 million syringes distributed in 2017.

Treatment for human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS) and hepatitis B and C virus infections is included in the range of services provided by the National Health Service of Portugal and is available free of charge.

Availablity of selected harm reduction responses in Europe
Country Needle and syringe programmes Take-home naloxone programmes Drug consumption rooms Heroin-assisted treatment
Austria Yes No No No
Belgium Yes No Yes No
Bulgaria Yes No No No
Croatia Yes No No No
Cyprus Yes No No No
Czechia Yes No No No
Denmark Yes Yes Yes Yes
Estonia Yes Yes No No
Finland Yes No No No
France Yes Yes Yes No
Germany Yes Yes Yes Yes
Greece Yes No No No
Hungary Yes No No No
Ireland Yes Yes No No
Italy Yes Yes No No
Latvia Yes No No No
Lithuania Yes Yes No No
Luxembourg Yes No Yes Yes
Malta Yes No No No
Netherlands Yes No Yes Yes
Norway Yes Yes Yes No
Poland Yes No No No
Portugal Yes No No No
Romania Yes No No No
Slovakia Yes No No No
Slovenia Yes No No No
Spain Yes Yes Yes No
Sweden Yes No No No
Turkey No No No No
United Kingdom Yes Yes No Yes

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Methodological note: Analysis of trends is based only on those countries providing sufficient data to describe changes over the period specified. The reader should also be aware that monitoring patterns and trends in a hidden and stigmatised behaviour like drug use is both practically and methodologically challenging. For this reason, multiple sources of data are used for the purposes of analysis in this report. Caution is therefore required in interpretation, in particular when countries are compared on any single measure. Detailed information on methodology and caveats and comments on the limitations in the information set available can be found in the EMCDDA Statistical Bulletin.