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Heroin Addiction and Related Clinical Problems: 2016, 18, N6 (pages: 51 - 60)

Heroin Addiction Patterns of Treatment-Seeking Patients, 1992-2013: Comparison between Pre- and Post-Drug Policy Reform in Portugal

Pombo S., and Félix da Costa N.

Summary: Background. The abuse of illicit drugs is a significant public health concern. In Portugal, a new drug policy was put into practice with the intent of preventing drug-related problems. Aim. This study was designed to evaluate the patterns of heroin addiction and drug treatment involvement in the periods of pre- and post-drug policy reform. Methods. A comparative study evaluated heroin treatment-seeking clients (N=627; 82.3% males and 17.7% females) at their first visit in one of the two periods 1992-1999 and 2002-2013. Data on drug treatment admissions were also analysed for comparison (N=2,323 cases entering treatment). Results. Comparison between the 1992-1999 and 2002-2013 periods showed that: treatment demand declined by 37%, whereas treatment engagement increased by 94%; drug users have aged, become better educated and reported more cocaine use. In general, men were more likely than women to receive treatment (82.3% to 17.7%), but the number of women accessing treatment increased (from 13.0% to 20.9%). Drug injection has decreased and heroin users are choosing to smoke heroin rather than injecting it. HIV infection decreased, too (28.0% to 19.6%). The prevalence of hepatitis C infection, alcohol use and abuse and a criminal history remain stable. Conclusions. Drug scene has changed in Portugal. The drug-use profile of heroin-addicted patients changed after the new policy on drugs was implemented. Heroin indicators are generally stable or trending downwards. Our clinical findings are discussed in view of the recent drug policy reform. Assessing trends in drug use among heroin-using patients can reinforce prevention efforts.