Illicit Drug Use, Health Care and Justice: An Outreach Intervention

Background

This communication aims to present the results of the “Adição.Sem" Project developed in partnership: Health Ministry - Lisbon and Tagus Valley Division for  Intervention on Addictive Behaviours and Dependencies (DICAD), Justice Ministry – two institutions: General Directorate of Social Rehabilitation and Prison Services, and the Public Prosecutor's Office of Lisbon Local Court for Minor Criminal Offenses. It was intended for defendants indicted for the crime of possession of psychotropic substances for personal use, exceeding the quantity deemed necessary for the average individual consumption over a period of 10 days, as stipulated by the decriminalization law, and hadn’t criteria to be referred to the Commission for the Dissuasion of Drug Addiction (CDT). This project aimed to create favorable conditions for the application of the "Adição.Sem" component, within the scope of Temporary Suspension of Judicial Proceedings. 

Methods

In this context, DICAD professionals conducted an individual health assessment interview, in the court facilities. The interview had an initial framing moment of the project, followed by application of the alcohol, smoking and substance involvement screening test (ASSIST) and the discussion of its results with the interviewee, based on a motivational approach. The contents explored were the context that led to the risk behaviour, illicit drugs in possession, purity/potency of illicit drugs and quantity (number of doses and weight in grams), education for drug use and risk reduction strategies, health resources information, possible referral to specialized treatment and assessment of motivation for change.

Results 

Between 2018 and 2023 we interviewed 860 people, with the preliminary results being as follows: about 1/3 of people were 19 years old or younger and the majority were male; the main contexts of drugs seizure were recreational settings and alone; the most seized illicit drug was cannabis; the majority had a low to a moderate risk pattern in relation to psychoactive substance use; around 44% were indicated for treatment referral, 33% were referred and/or advised to maintain treatment and 62% of these accepted the referral proposal.

Conclusions

This project made possible to increase health accessibility through an informative and counselling intervention for those who meet the criteria for referral to treatment. In September 2023, new legislation came out, that changed the sanctioning regime relating to the crime of drug possession. In this sequence, the Public Prosecutor's Office of Lisbon Local Court archived the pending cases and the situations of defendants who were identified as possessing for drug use are being sent to the CDT. Those who are detained on suspicion of trafficking proceeds through the court route. However in the light of this new changes, we recommend that different courts align their legal approach regarding the sanctioning regime relating to the drugs possession versus drug trafficking.