Portugal has a population of 10.5 million as of 2016, and a mortality rate of 548.6 deaths per 100,000 people. The top ten most common diseases in Portugal in 2016 were ischemic heart disease, cerebrovascular disease, Alzheimer’s disease, lower respiratory infections, COPD, colorectal cancer, lung cancer, diabetes, chronic kidney disease and stomach cancer.

The rates of ischemic heart disease, cerebrovascular disease, diabetes and stomach cancer have all gone down in recent years, though they still rank in the top ten. The top ten causes of disability in 2016 were low back and neck pain, sense organ diseases, depressive disorders, migraines, skin diseases, anxiety disorders, oral disorders, diabetes, falls and other musculoskeletal issues.

Broadly speaking, the deadliest diseases are cardiovascular diseases, cancer and neurological disorders.

Addiction: A Major Success Story

While Portugal has made strides in reducing the rates of the diseases described above, its biggest success has been in tackling addiction, particularly to heroin.

In the 1980s and 1990s, a major opioid epidemic made addiction one of the most common diseases in Portugal. By the mid-1990s, over one percent of Portugal’s population was addicted to heroin, and cocaine use was also prevalent.

To address this epidemic, Portugal took the opposite approach to other countries struggling with a similar epidemic, such as the United States. Whereas the U.S. cracked down on drug use and initiated a war on drugs, Portugal completely decriminalized all drugs, including heroin, in 2001. Dealing drugs was still illegal and punishable with jail time, but users caught with less than a 10-day supply of any drug were sent to mandatory medical treatment.

This system completely bypassed the legal system, treating addiction as a health issue instead of a crime. This approach led to a 75 percent reduction in drug cases and a 95 percent reduction in drug-related HIV infections. Deaths due to overdoses or drug-related infections in Portugal are currently five times lower than the average across the European Union.

A model for change?

While any radical change in policy must be considered in the context of each country’s current legal system and culture, aspects of Portugal’s approach to addiction constitute a model that could be successfully implemented across the world.

The basis of this model are outreach programs whose employees keep track of local drug users and encourage them to quit. If they accept, they provide them with free counseling and treatment and daily methadone to wean them off the opioids. If they refuse to quit at that time, then outreach workers hand out clean needles and condoms to reduce the spread of HIV/AIDS.

This model is also economically efficient. The U.S. currently spends approximately $10,000 per household to uphold its current drug policy, while Portugal currently spends $10 per citizen.

The most common diseases in Portugal are similar to those across the European Union. What makes Portugal stand out is its reaction to one particular disease: addiction. If Portugal brings this innovation to other realms of disease prevention, it could be poised to drastically lower its disease burden in the coming decades.

– Olivia Bradley

Photo: Flickr