Time trends in Portuguese addiction intervention services by addiction pattern

Background: In Portugal, there are health care services dedicated to patients with addiction disorders. These services include local intervention in the community, with multidisciplinary teams, in the prevention, treatment and reintegration of people with such disorders.

We aimed to assess the provision of care of the Portuguese addiction services according to the addiction pattern (alcohol, substance use and behavioural) during between 2016 and 2023.  

Methods: A retrospective national observational study was carried out based on the analysis of secondary data related to the activity of addiction intervention services. We analysed the monthly number of new users (users with addictions who have used the services for the first time), monthly readmitted users (users with addictions who had already used addiction services previously) and monthly number of consultations. The period of analysis was from January 2016 to December 2023. 

Results: During the period analysed, 53,487 new users were admitted, and 23,123 users were readmitted. Alcohol addictions were the main factor in the admission of new users to addiction treatment services (22,933; 43%), followed by behavioural addictions. In turn, in the case of readmitted users, users with problems related to substance use accounted for the vast majority (12,289; 53%). 

In terms of the number of consultations, more than half were for people with substance use disorders (3,315,395; 66%), followed by those with alcohol use disorders (1,377,300; 27%).  

Conclusions: The evaluation of addiction intervention services is essential to reflect on the current addiction situation. In Portugal, addiction services were initially created to solve the problem of substance use. According to this analysis, a third of new patients admitted to these services have behavioural addictions. People with behavioural addictions need quite different types of interventions, and services have to adapt and respond to their needs. Despite this trend, it was found that the vast majority of consultations are dedicated to people with substance addictions and this type of addiction is the one with the highest number of readmissions. In future studies, it would be important to assess if the current needs of addiction patients are being covered.