Revista espanola de salud publica
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Rev Esp Salud Publica · Sep 2006
Comparative Study Historical Article[More than thirty years of illicit drugs in Spain: a bitter story with some messages for the future].
The phenomenon of illicit drug use in Spain during the last thirty years has been marked by the extremely serious consequences of heroin use (mainly injecting). More than 300,000 persons were treated for heroin dependence, 20,000-25,000 died from overdose, 100,000 became infected with HIV through drug injection and quite more with hepatitis virus. Some of these consequences can be attributed to the delay in the implementation of effective interventions, such as methadone maintenance treatment (MMT). ⋯ Nowadays there are more than 100,000 weekly cocaine users, 25.000 persons are annually treated from cocaine abuse or dependence, and cocaine has an important impact on medical emergency services, while its impact on mortality is unknown. Both cannabis use and related problems are increasing too (there are half a million of daily users). We propose to maintain and to strengthen harm reduction programs (MMT, syringe exchange, save-use and injection rooms, hepatitis A and B vaccination, etc.), to urgently develop specific strategies targeted to reduce overdose mortality and cocaine related problems, and to re-evaluate the effectiveness of preventive and supply control strategies.
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Rev Esp Salud Publica · Sep 2006
Historical Article[The "Instituto de Salud Carlos III" and the public health in Spain. Origin of laboratory medicine and of the central laboratories and research in public health].
The "Instituto de Salud Carlos III" is the Central Public Health Laboratory in Spain with an important component of scientific research in health related areas, such as cancer, cardiovascular diseases, infectious diseases and environmental health. The article describes the development of the Public Health Institutes. arising from the introduction and development of scientific and laboratory based medicine and the introduction of vaccination and sanitation with the control of water and food. At about the same time, the discoveries in microbiology and immunology were produced, being the research activities incardinated with the practical advances in the control of products. ⋯ At the same time. colonization of countries specially in Africa, South East Asia and explorations in Central America confront the Europeans with new diseases and the need of laboratories where to study them. These circumstances gave rise to the birth of the Central Public Health Laboratories and the National institutes of Health at the beginning of the XX century in many countries. In Spain, the Spanish Civil War was a breaking point in the development of such an institution that finally was reinvented with the creation of the Instituto de Salud Carlos III, in 1986, incorporating research and epidemiological surveillance and control of diseases and also the responsibilities of the Food and Drug Control, lately separated from it.