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City-level drug policies in Portugal: the Covid-19 pandemic as an analyzer of harm reduction responsiveness in Porto and Lisbon

datacite.subject.sdg03:Saúde de Qualidade
dc.contributor.authorPires, Cristiana Vale
dc.contributor.authorCurado, Adriana
dc.contributor.authorFuertes, Ricardo
dc.contributor.authorCarvalho, Maria Carmo
dc.contributor.authorValente, Helena
dc.date.accessioned2025-03-27T15:39:21Z
dc.date.available2025-03-27T15:39:21Z
dc.date.issued2025-03-12
dc.description.abstractBackground: The COVID-19 pandemic health crisis and its potential implications for people who use drugs (PWUD) created permissive conditions toward social innovation and experimentation. Still, it also exposed gaps in harm reduction approaches. Harm reduction responsiveness was informed by the priorities defined at the local level, so it was not applied uniformly in different regions. This paper intends to contribute to the analysis of harm reduction responsiveness during the COVID-19 outbreak by comparing the adaptations and implementation of harm reduction and municipal services to support street-involved (SI) PWUD in two Portuguese cities– Porto and Lisbon. This study aims to shed light on the city-level implementation of drug policies in Portugal. Methods: This study is based on a comparative qualitative analysis based on the experiences of PWUD and Harm Reduction (HR) professionals regarding the implementation of harm reduction responses during the COVID-19 pandemic in Porto and Lisbon. The study is based on interviews with SI PWUD (n = 22, 12 in Porto and 10 in Lisbon) and online focus groups with harm reduction professionals (N = 12, 6 in Porto and 6 in Lisbon). Results: Harm reduction teams in Porto and Lisbon implemented contingency plans and proactive adaptations to respond to the pandemic-related emerging needs. However, the study revealed contrasting experiences in the city-level support to harm reduction and responsiveness to the impacts of COVID-19 among SI PWUD in Porto and Lisbon. There were relevant differences in the support they received from the City Council and the city-level responses implemented to support SI PWUD. While the approach in Porto was described as restrictive and zero-tolerance towards drug use, Lisbon´s strategy was harm reduction-focused and inclusive. The study participants revealed better results in Lisbon regarding the harm reduction responsiveness to the pandemic health crisis and the accessibility and adherence of SI PWUD to services. Conclusion: The pandemic constraints and adaptations must be contextualized in the ongoing city-level debates regarding drug policies and harm reduction in Portugal. Moreover, city-level drug policies and local support are crucial to map the opportunities and challenges of implementing the Portuguese Drug Decriminalization Model in different contexts.eng
dc.identifier.doi10.1186/s12954-025-01179-y
dc.identifier.eid105000058065
dc.identifier.issn1477-7517
dc.identifier.pmid40075419
dc.identifier.urihttp://hdl.handle.net/10400.14/52834
dc.identifier.wos001443233900001
dc.language.isoeng
dc.peerreviewedyes
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.subjectCovid-19
dc.subjectHarm reduction
dc.subjectCity-level drug policies
dc.subjectComparative analysis
dc.titleCity-level drug policies in Portugal: the Covid-19 pandemic as an analyzer of harm reduction responsiveness in Porto and Lisboneng
dc.typeresearch article
dspace.entity.typePublication
oaire.citation.titleHarm Reduction Journal
oaire.citation.volume22
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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