Afrontar los estragos de la heroína: evaluación de diez años de un programa integral en Barcelona.

Translated title of the contribution: Coping with the toll of heroin: 10 years of the Barcelona Action Plan on Drugs, Spain

R. Manzanera, L. Torralba, M. Brugal, R. Armengol, P. Solanes, J. R. Villalbí

Research output: Contribution to journalArticle

Abstract

INTRODUCTION: The epidemic of heroin use began in Barcelona, as in the rest of Spain, in the late 70's, to reach its peak by the end of the 80's. In a first period, responsible officers experimented difficulties to define the specific objectives of opiate control policies. This paper reviews the effects of the adoption of an explicit policy on drug dependence grounded on a wide consensus in the City of Barcelona (Catalonia, Spain). SUBJECTS AND METHODS: Over a period of twelve years, from 1986 to 1997, both demand and offer of care and harm reduction services were analyzed, as well as the evolution of the adverse effects of drug use, such as mortality from acute adverse drug reaction, human immunodeficiency virus (HIV) infection, aids incidence, and incidence of tuberculosis. Data for city residents was compared through four different stages in this period. RESULTS: Despite the lack of data in initial years, relevant changes are apparent. Treatment offer changes clearly, with significant increases in initial treatment, coverage of methadone maintenance programmes, and sterile syringes distribution. Therapeutic compliance of tuberculous intravenous drug users IVDU and risk of HIV infection improve. Emergency service use linked to heroin, overdose, or withdrawal syndrome decreases. Mortality rates decline, although this decline does not reach statistical significance. Discussion: Service offer shows a clear increase, reflected in treatment initiation, while harm reduction services expand. With the development of this process, outcome indicators change, both reflecting changes in the toll of the heroin epidemic (cases of tuberculosis and aids among IVDUs, HIV infection). and changes in a more comprehensive care (better treatment compliance of IVDUs with tuberculosis). There is a lower distortion of emergency services. These changes occur although the predominance of white heroin in Barcelona favors parenteral use.

Original languageSpanish
Pages (from-to)58-66
Number of pages9
JournalGaceta sanitaria / S.E.S.P.A.S
Volume14
Issue number1
StatePublished - Jan 2000
Externally publishedYes

Fingerprint

Heroin
Spain
Virus Diseases
Harm Reduction
Tuberculosis
Pharmaceutical Preparations
HIV
Mortality
Opiate Alkaloids
Emergencies
Therapeutics
Methadone
Incidence
Syringes
Drug Users
Drug-Related Side Effects and Adverse Reactions
Substance-Related Disorders
Consensus

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Manzanera, R., Torralba, L., Brugal, M., Armengol, R., Solanes, P., & Villalbí, J. R. (2000). Afrontar los estragos de la heroína: evaluación de diez años de un programa integral en Barcelona. Gaceta sanitaria / S.E.S.P.A.S, 14(1), 58-66.

Afrontar los estragos de la heroína : evaluación de diez años de un programa integral en Barcelona. / Manzanera, R.; Torralba, L.; Brugal, M.; Armengol, R.; Solanes, P.; Villalbí, J. R.

In: Gaceta sanitaria / S.E.S.P.A.S, Vol. 14, No. 1, 01.2000, p. 58-66.

Research output: Contribution to journalArticle

Manzanera, R, Torralba, L, Brugal, M, Armengol, R, Solanes, P & Villalbí, JR 2000, 'Afrontar los estragos de la heroína: evaluación de diez años de un programa integral en Barcelona.', Gaceta sanitaria / S.E.S.P.A.S, vol. 14, no. 1, pp. 58-66.
Manzanera R, Torralba L, Brugal M, Armengol R, Solanes P, Villalbí JR. Afrontar los estragos de la heroína: evaluación de diez años de un programa integral en Barcelona. Gaceta sanitaria / S.E.S.P.A.S. 2000 Jan;14(1):58-66.
Manzanera, R. ; Torralba, L. ; Brugal, M. ; Armengol, R. ; Solanes, P. ; Villalbí, J. R. / Afrontar los estragos de la heroína : evaluación de diez años de un programa integral en Barcelona. In: Gaceta sanitaria / S.E.S.P.A.S. 2000 ; Vol. 14, No. 1. pp. 58-66.
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