Indicators available continue to suggest effective responses at treatment level (increase in the number of clients involved in both drug free and substitution programmes) and at harm reduction level (levelling off of infectious diseases).

The number of active clients in the outpatient public treatment network increased though first treatment demands continue to decrease.

Heroin continues to be the main substance associated to health consequences and specifically in the sub-population of drug users that seek access to different treatment structures but references to cocaine and cannabis in this setting are increasing.

 First treatment demands in CAT'S (IDT 2006)

The availability of substitution programmes continues to increase and the number of clients in buprenorphine substitution treatment has been increasing steadily since this substance was introduced (in 1999);

 

In 2005, treatment clients were again mainly from the male gender and reporting a mean age of 30-35 in all treatment settings, confirming the ageing trend of this population, already perceptible in previous years. In outreach work settings, most individuals were younger (aged 26-35) than in the treatment settings;

 

The decreasing trend in the percentage of drug users in the total number of notifications of AIDS cases continues to be registered. Concerning HIV infection in the treatment setting, data on HIV positive cases remained stable in comparison to previous years though data from therapeutic communities and active outpatient clients registered a slight decrease in comparison to 2004. Concerning hepatitis, data collected since 2000 continues to register a decreasing trend for hepatitis B and, in 2005, decreases were also registred for hepatitis C;

 

The stabilisation of the global rates of positive HIV tests may be related, amongst other factors, to the implementation of harm reduction measures, which may be leading to a decrease in intravenous drug use (also visible in data concerning administration route in first treatment demands), or to intravenous drug use in better sanitary conditions, as indicated by the number of exchanged syringes in the National Programme “Say no to a second hand syringe”;

 

In 2005, an increase was registered on drug-related mortality in the Special Register (156 cases in 2004, 152 in 2003, 156 in 2002), but the General Mortality Register continues to register a decrease. Although data from these two sources are not directly comparable, both registered a decreasing trend until 2003. 46% of the positive cases with information on the presumed aetiology in the Special Register were considered possible acute drug related deaths, a higher percentage than the one reported in 2003 (44%) but inferior to the ones registered in 2004 (51%) and 2002 (58%). Opiates continued to be the most referred substance associated with these cases but its relative importance continues to decrease;

 

The national outreach network continues to be implemented, targeting particularly problematic drug users. In 2004 and 2005, special attention was given to instruments and procedures for data collection and reporting.