Alcohol Dependence Nearly Quadrupled in a Decade, and Portugal's Addiction Chief Puts Treatment at One Patient in Five

Alcohol dependence in Portugal has nearly quadrupled in ten years, and only about one person in five who needs treatment is getting it, the head of the country's addiction institute has warned. "That is serious. It is very serious," Joana Teixeira told the Lusa news agency in an interview published on Sunday.

Teixeira has been president of the ICAD (Instituto para os Comportamentos Aditivos e as Dependências, the Institute for Addictive Behaviours and Dependencies) since 1 January, when she succeeded João Goulão. She told Lusa that in recent years Portugal "has not managed to put in place the measures needed" either to bring down drinking or to treat the people who are dependent.

Where the quadrupling comes from

The figure comes from the national general population survey on psychoactive substances, run in 2012, 2016 to 2017 and 2022 among people aged 15 to 74. ICAD's annual report on alcohol, published in February, sets out the trend: the share showing symptoms of dependence rose from 0.3 percent in 2012 to 0.8 percent in 2017 and 1.1 percent in 2022.

The same survey found that 3.1 percent of the population had high-risk or harmful drinking patterns, and that 20 percent of all respondents drank daily or almost daily. Dependence was far more common among men (2.2 percent) than women (0.1 percent) and was highest among people aged 45 to 54. ICAD's report says that, although more people now abstain, most indicators did not improve between 2017 and 2022.

Teixeira did not say how the one-in-five treatment estimate was calculated.

More people in treatment

The treatment numbers are rising. In 2024, 14,762 people were treated in public outpatient services for alcohol-related problems, up 4 percent and the fourth annual increase in a row. Of the 5,250 who started treatment that year, 3,448 were new patients and 1,802 were returning. Readmissions grew 13 percent, to their highest level in ten years.

Another 865 people were admitted to alcohol and detoxification units, and 1,249 to therapeutic communities.

Hospital figures point in two directions. There were 3,824 hospital admissions with alcohol as the main diagnosis in 2024, two thirds of them for alcoholic liver disease, down 8 percent and the lowest in six years. Counting admissions where alcohol was a secondary diagnosis, the total was 40,899, a number that has been rising since 2021.

According to INE (the National Statistics Institute), 2,442 people died in 2023 from diseases attributable to alcohol, 2.05 percent of all deaths and the lowest figure in five years. Deaths from alcohol poisoning recorded by the national forensic medicine institute rose 74 percent in 2024.

What the institute plans

Teixeira said ICAD's first priority has been to strengthen its alcohol treatment units. It is restructuring them with new treatment programmes, "some more flexible and others more structured", in place of a single standard course. It also wants earlier detection, closer work with the local health units (ULS) that run hospitals and health centres, and more training for health professionals.

Among young people the picture is better. ICAD's surveys show teenage drinking falling, although girls now report drinking more than boys on some measures. Teixeira's main concern there is binge drinking, which she said is often linked to psychological distress. "Alcohol is neurotoxic," she said, and any drinking while the brain is still developing is "particularly serious".

ICAD also runs Portugal's response to gambling addiction, where its first public clinic took in 50 patients in its first three months.