Ten years after the experimental project was launched in a bid to reduce contagious infectious diseases among inmates, the prison needle-exchange programme has yet to see any kind of significant take-up.
In an interview with Lusa News Agency, João Goulão, head of the Intervention Service for Addictions and Dependencies (SICAD), said one of the main sticking points that the programme has faced since its inception is the fact it implies consumers denouncing themselves.
“Since the beginning, I and other experts have been of the opinion that it would not be effective. As far as I know there has been no change to that line”, Mr. Goulão said.
The theoretical side of the programme was launched in September 2007 in prisons in Lisbon and Paços de Ferreira.
But, despite a lack of adhesion to the programme, João Goulão said he was pleased that, according to some prison surveys, “tendencies show a very significant drop in consumption via injection, be that during the period prior to arrest or within prisons. That drop is ongoing.”
His comments came as it emerged around 18,500 people take methadone every day.
According to statistics from SICAD, around 16,000 drug addicts take methadone on a daily basis at Portuguese treatment centres and another 2,500 at other locations, as part of a damage limitation policy in place in Portugal.
In the same interview, João Goulão, praised the fact that within the Portuguese system people who had started using drugs again were allowed back onto the dependency programmes, saying: “We are lucky to have a system of treatment that has a vast range of options, including replacement therapies, using methadone, ranging up to a physical withdrawal.”
According to Goulão, there are two options: “We either completely stop taking the opiate and then the route is simply outpatient supervision with psychotherapy, with or without the support or medication, or we transfer this addictionfrom a street opiate [such as heroin], to a drug used under medical supervision, with an adjusted dose that prevents withdrawal symptoms, which can be given orally and leaves people functional and productive enough to have a perfectly normal life.”
“There are systems, particularly in northern Europe, where things are much stricter. We have a more flexible attitude of acceptance and inclusion of people in these programmes, even if things don’t go as planned,” he explained.
Portugal’s treatment centres distribute methadone to between 15,000 and 16,000 drug addicts every day. On top of that, between 2,000 and 2,500 addicts undergo therapy in other places.
In Lisbon alone there are between 1,200 and 1,400 people who take methadone every day at specific places.
“We don’t label them therapeutic programmes; they are programmes on which the demand of abstinence is not total, which is different to treatment programmes, but they are programmes of damage reduction”, Goulão added.
In December last year, it was reported that the Algarve is to become the first region in Portugal to distribute the opiate withdrawal symptom-reducing drug to foreign tourists in a bid to monitor and continue their treatment plans and reduce the risks of spreading diseases or criminal behaviour.
Speaking to Lusa at the end of 2016, the head of the ARS Algarve Regional Health Board said the project should move forward this year and aims to help drug addicts receiving methadone treatment in their home countries to continue their treatment in Portugal.
“It is a way of monitoring the treatment of foreign drug addicts who visit Portugal and also of reducing some of the risks associated with the transporting of large quantities of methadone, such as the possibility of trafficking and thefts, for example”, said João Moura Reis, head of the ARS.
The project, which falls under the competency of Algarve’s Division for Intervention in Addictive Behaviours and Dependencies (DICAD), implies that visiting addicts are duly referenced by health services in their homelands, and that information will be shared with the Algarve’s health services so that they can continue their treatment.