It was great to connect with President of GAT João Santa Maria and Director Luis Mendão who founded the Portuguese Activist Group in 2001. The GAT advocates for legal and policy changes that positively affect the health, rights, ad quality iof life of people living with HIV or at risk of becoming infected. We are very much appreciative of their comprehensive reporting on the history of harm reduction in Portugal.
In 1995, there were over 100,000 chronic users of heroin in Portugal which is about 1% of the total population. Today there are less than 20,000 injectable users. 70% of HIV transmission was through intravenous drug users, costing over 1000 lives annually. Today, the intravenous drug use is responsible for less than 2% of all HIV transmission in the country.
The government considers harm reduction measures to be a response to a human rights issue in the midst of a national emergency. When I asked what these two international experts would recommend to address Canada's toxic drug overdose public health emergency, their response was to "be bold, make it easy to access safer substances and substitution replacement therapy, scale it up rapidly, remove barriers and create a national action plan".
Substitution replacement therapy is considered to be an "exit drug" in this country, an instrumental policy element. How do compare? Portugal has an overdose death rate per million of 6; B.C. is 430 and in the Alberni Valley, it is 1030 (for ages 19 to 44), it is 2100). B.C. alone currently has double the number of substance users per capita that Portugal had in 1995 at the height of its emergency. In just two years, they went from 200 patients using methadone to 35,000. Lives have been saved in Portugal, as a result. Sadly, lives are being lost in Canada without this kind of bold action. It is time to abandon our federal government's incremental and piecemeal process and take the essential actions that countries like Portugal have taken.