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 Desintoxication

Withdrawal treatment is mainly available in public and private (Data from private units cover only the units accredited by the IDT.) detoxification units. In 2006 there were 14 detoxification units (5 public and 9 private units) in mainland Portugal, a figure identical to 2005. In 2006, a decrease in the number of clients in detoxification units was registered 1 466 in public units and 1 205 in private units (3 237 in 2005, 3 059 in 2004).

As to the source of referral, in public units 99% of the clients came from other health services, mainly from CATs (98%) whereas in private units 84% also came from other health services, mainly CATs (81%) but 4% requested treatment due to family pressure and 2% were self-referred.

 

  Substitution treatment

In 2006, the number of clients in opioid substitution maintenance programmes represented 71% of the total active clients in the outpatient public treatment network, a 9% increase in comparison to 2005 and reinforcing the tendency of increase of previous years (66% in 2005, 64% in 2004, 57% in 2003, 50% in 2002, 40% in 2001, 36% in 2000 and 22% in 1999).

22 922 clients were registered in these programmes in 2006 (21 054 in 2005). 4 833 cases were new admissions (4 206 in 2005) and 6 087 (5 222) left the programme during the year, 16% of whom with medical release (17% in 2005).

A survey made each year on the 31st of December 2006 allows differentiation in terms of opioid substances involved in this type of treatment.

On that date, 16 835 clients were registered in the outpatient public treatment network substitution programmes, representing an increase of 8%, 9% 27%, 30%, 55%, 90%, in comparison to the same date in 2005, 2004, 2003, 2002, 2001 and 2000, respectively.

73% (71% in 2005 and 72% in 2004) were registered in methadone programmes;

27% (29% in 2005 and 28% in 2004) in buprenorphine programmes.

In comparison with the situation on the 31st of December 2005, the trend for an increase in the percentage of clients registered in buprenorphine programmes was discontinued. This was mainly due to the price of buprenorphine bought in pharmacies.

Nevertheless, buprenorphine continues to be considered a relevant option for opioid maintenance treatment, namely for pregnant women, as it is associated with less neonatal abstinence syndrome and with lesser severity and duration.

 

  Drug free treatment services

Inpatient long term drug free treatment is mainly available in public and private therapeutic communities. In 2006 there were 73 therapeutic communities (3 public and 70 private units) in mainland Portugal. In comparison to 2005 there was 1 more public therapeutic community.

Contrarily to the decreasing figure that has been registered since 2002, in 2006 the number of registered clients in both public (110 clients, 68 in 2005) and private units (4 118 clients, 4 093 in 2005) increased in comparison to previous years.

Data from the public therapeutic communities indicate that 62% of their clients (41% in 2005 and 53% in 2004) in 2006 were admitted for the first time into a TC. 98% of the admissions (93% in 2005 and 96% in 2004) resulted from a therapeutic project.

 2006 data for private therapeutic communities indicate that 48% (48% in 2005 and 50% in 2004) of the clients had been admitted for the first time in a therapeutic community in that year. 42% (38% in 2005 and 32% in 2004) of those were admitted following a referral by a therapist.

 

 

  Dual diagnosis treatment

It is made mainly by the IDT, I.P. network – namely CAT outpatient clinics, Detoxification Units and Therapeutic Communities specialized in double treatment diagnosis.

  Drug and/or alcohol and prescribing drugs

Nowadays  it is possible for patients to go to the same clinics, though in the context of PLA (Alcool Related Problems) there are 3 Special Reference Units, established at regional level,  that deal with alcool related patients and comprise out patient care (ambulatory), in patient (internment) and recidive prevention.

However, in some cases drug addicts suffering from alcohol related problems may be treated within drug addiction centres, as it is the case in smaller cities, where patiens with PLA may attend CAT outpatient clinics.