Intended for healthcare professionals

Rapid response to:


Drug decriminalisation in Portugal

BMJ 2010; 341 doi: (Published 10 September 2010) Cite this as: BMJ 2010;341:c4554

Rapid Response:

Drug decriminalisation in Portugal

Dr Keegan has suggested that the figures for mortality due to drug
use given in our article were wrong.
In fact we did make an error in the figures we quoted in our original
article - which we correct below - but the main point to make is that Dr
Keegan's data and our data come from different sources and they are not
counting the same thing.
Firstly, may we correct the error. There is a mistake in the number of
drug-related deaths we quoted for 2001. In 2001, according to data from
the National Statistics Institute (INE), there were 76 drug-related deaths
rather than the 131 we quoted. (These data are for drug dependence, ICD 9
- International Statistical Classification of Diseases and Related Health
Problems, which includes all codes F11 to F16 and F18 to F19 four digits).
In 2008, we confirm that the same source reports 20 drug-related deaths
(EMCDDA Protocol, which includes the following ICD 10 codes: F11 to F12,
F14 to F16, F19 and X42, X62, Y12 (combining the last three codes with the
codes t40.0-9) and X41, X61 and Y11 and Y12 (combining the last three
codes with the code T 43.6)).

These data from the Statistics Portugal /National Statistics
Institute (INE) are the official national mortality numbers.
Dr Keegan quotes information from the National Institute of Legal
Medicine. This information from the National Institute of Legal Medicine
until 2007 concerns only the "positive toxicological results cases
(illicit substances) post mortem" in the context of the autopsies made by
the National Institute of Legal Medicine and is presented only as
additional information, as an indication of a relatively recent drug use
and not as "drug related deaths"; these results are only one part of the
information that is considered by the pathologist who analyses the cause
of death; so, a great proportion of these cases are not considered "drug
related deaths" in the death certificate.
Finally, this year, for the first time, data will be published from these
specific registries (from the National Institute of Legal Medicine)
concerning specifically overdoses and not "cases with positive
toxicological results (illicit substances) post-mortem", data which will
be available in our "Annual Report - 2009 about the Country Status
concerning Drugs and Drug Addiction".

Competing interests: No competing interests

10 December 2010
Paula V. Andrade
Harm Reduction Coordinator
Ludmila Carapinha
Institute on Drugs and Drug Addiction