Tag Archive for: drugs

Dependency

‘In Portugal, every half hour at least one person dies from smoking’

Despite restrictions imposed in recent years, the prevalence of tobacco consumption in Portugal increased from 48% to 51% and that of alcohol consumption from 49% to 56% in the past five years, according to the 5th National Survey on Psychoactive Substance Use in the General population.

Tobacco is the second most widespread psychoactive substance (after alcohol), with about half of the adult population declaring to have smoked at some point in their lives. However, the good news is, that young adults between 15 and 35 don’t seem to be keeping up with the upward trend. In this age group tobacco consumption fell from 37 to 28%, and in girls even to 20%.

More than 80% of the Portuguese consider themselves exposed to tobacco smoke outdoors, a percentage that places Portugal among the EU countries with the highest level of exposure, according to a study by the University of Beira.

These figures come at a time when the government has approved a proposal to amend the Tobacco Law, equating heated tobacco with conventional tobacco, limiting the points of sale and places where smoking is permitted, banning smoking on hospital and school grounds, outside cafés and restaurants and on covered terraces.

‘Our tobacco law proposal is not prohibitionist’, declared Margarida Tavares, State Secretary for Health in Parliament. ‘What we want is to regulate and help those who want to quit smoking.’ Unfortunately, the definitive elimination of smoking will – according to the proposed law – only come into force in 2030! ‘We’ll give business time to adapt’, she said.

Contrary to a decrease in smoking, alcohol consumption is rising in youngsters. Nine out of ten 18-year-olds say they have taken alcohol in the 12 months prior to a survey carried out by the Addictive Behaviour and Addiction Intervention Service (SICAD). For the first time consumption among girls surpassed that of boys.

Although the prevalence of binge drinking (rapid and excessive consumption of alcoholic beverages to reach drunkenness at least once in the last year), has remained stable (around 10% in the general population), more than one-third of the 18-year-olds admitted to having drunk alcohol in a ‘binge’ way in the past 12 months.

Furthermore, the survey points to an significant increase in dependent alcohol consumption (from 2% to 3.5%) in the past five years. ‘We must detect these patients and treat them,’ said Joana Teixeira, a psychiatrist at Lisbon Psychiatric Hospital, to avoid an increase in diseases attributable to alcohol, such as liver cirrhosis, vascular diseases, and certain types of cancer (i.e. breast cancer in women).

But despite the increase in alcoholic consumption, the government maintains its resistance against public health warnings on the labels of alcoholic beverage bottles just like the Republic of Ireland has done. According to the Ministry, such warnings are ‘incompatible’ with EU regulations and against the interest of the national wine sector, since the export of Portuguese wine is worth almost one billion euros per year.


Enjoy your week                   Aproveite a semana      (pic PĂșblico/Sapo)
















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Supervised

In 2001, under the leadership of former prime minister AntĂłnio Guterres – nowadays UN’s Secretary-General – Portugal became the first country to decriminalize the possession and consumption of drugs.


Twenty years later, the first controlled drug consumption room – also known as the ‘chuto’ (shot) room – opened in Lisbon. In six months nearly 900 drug addicts – 200 of whom attend the premises daily – were registered, three times as much as expected!



‘These numbers were surprising because we had initially assumed that around 300 consumers would circulate in this neighborhood”, says Elsa Belo, technical director of Ares do Pinhal, an association dedicated to the recovery of drug addicts and manager of the premises, located in the Vale de AlcĂąntara area. ‘Users come here to smoke or inject drugs under the supervision of a health team, who provide them with sterilized material and help them in case of an ‘overdose’.


Reducing damage is important. On the one hand by the distribution of aseptic material to prevent disease transmission and on the other by supervised consumption. ‘It is these conditions and the acceptance without judgment, that make you return’, says a 47-year-old user. I feel very safe and comfortable here’.


Most users are men (85%), one third are homeless. The average age is 44 years (range 20-70). In three out of four cases drugs are inhaled. After consumers enter the space for the first time, the health team begins a process of rapprochement, that may lead to screening tests (HIV, hepatitis, tuberculosis) or simple nursing procedures (e.g. changing dressings).


As soon as you pass through the main entrance there is café Conforto, where you can watch TV, have a coffee, and keep your pets. There are also changing rooms, laundry services, a cloth bank, and areas for psychosocial care and clinic consultations. Besides users, there are also homeless visitors, who only come to take a shower, wash their clothes or look for a dignified place to eat.



Upon entering the consumption room, the nurse asks what drug is going to be used, what drugs are taken in the last 24 hours, and what regular medication users are on (e.g. methadone).


‘The room is always full’, explains InĂȘs Pereira, a psychologist, who together with a nurse monitors consumption from a glass space from which they observe who is smoking drugs, on one side, and who is injecting, on the other. All the material used by consumers is provided within the space and substances they bring from the street are registered.


There can be up to 10 people in the two rooms at the same time. Users have 30 minutes to inject, 40 minutes to smoke, and another 20 minutes to ‘recover’.


Control of the type and quality of substances that users are going to take is not yet being carried out, but Ares do Pinhal is finalizing a protocol on this. A necessary move considering for instance the continuous increase in cannabis potency (i.e. the percentage of THC – the psychotropic component of the plant) in the last couple of years, increasing the risk of psychotic effects.


In view of its success, the City Council plans the construction of a second supervised consumption room this year in Lumiar, close to the Cruz Vermelha neighborhood.


Enjoy your week          Aproveite a sua semana                (pic Sapo/PĂșblic)















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