João Goulão: “I don't try to hide that I've smoked cannabis. And I inhaled”

For about 30 years, João Goulão, a doctor by profession, has been dedicated to the fight against drugs in Portugal. Known and cited worldwide as a reference — in particular due to the decriminalization of drugs in 2001 — the current director general of the Service for Intervention in Addictive Behaviors and Dependencies (SICAD), now cautiously awaits the impact of cannabis legalization in other countries.

The legalization of medical cannabis is something that he does not resist and would even prescribe it to his patients, as long as he had a package insert. However, despite having smoked cannabis occasionally in his youth, he admits to having difficulty accepting legalization for recreational purposes.

Cannapress was trying to understand why.

Portugal took a bold step 16 years ago with the decriminalization of drugs. Bearing in mind the current scenario, wouldn't it make sense for Portugal to be a pioneer again, becoming the first country in Europe to make a comprehensive regulation with regard to cannabis?
Let me put it this way: we had very special historical circumstances that led to us, we had a relatively late onset of drug problems in Portugal, but they spread very quickly and had a huge impact on our society, in such a way that turned into a first political priority. In the mid-90s, it was in fact such an impacting situation in the lives of citizens and families that drug and drug addiction problems were identified as the first priority. And that also led, in a way, to a window of opportunity from a political point of view, which allowed us to take the bold step you speak of. I would say that this window of opportunity, if we were to think about it today, we probably wouldn't have the possibility to use it in the same way as we did back then. Although the state was investing and trying to tackle drug-related problems as effectively as possible, the fact is that things were not working out and there was an absolute need for a paradigm shift. And that was what was done with the global proposal of the National Strategy for the Fight against Drugs, in 1999, and then with the specific measure, which was decriminalization, which turns out to be, perhaps, the most emblematic measure of this strategy, but In my view, it's not even the most important. In fact, it is important because it introduces coherence to everything else, and also because the practical way in which we implemented decriminalization has also made it possible to transform it into a prevention tool. Well, nowadays we don't really have the same pressure. The problems of drugs and drug addiction in Portugal are not resolved, but in the ranking of concerns of the Portuguese, it is behind, in 14th or 15th place. It is not a political priority at all and in the meantime, as a result of the good results we have been having, there is a broad consensus about the policies we have. On the other hand, I would say that Portugal, in taking this measure, was in fact a pioneer, paved the way for another type of reform that other countries that were facing very complicated situations took advantage of. I would say that the most visible part of this breakthrough was the shift from the centrality of the approach, in most European countries, from justice or internal administration to health. Today, most European Union countries have their national coordination based on health and this I think is a very significant gain and inspiration. I have to say that when the commission for national strategy was sworn in, in 1998, the only boundary imposed on us by the government was that Portugal should maintain itself in the spirit of the conventions to which it was a signatory. Hence, the proposal was not even for decriminalization, it was for decriminalization, maintaining administrative penalties, which keeps us in line with the conventions to which we are signatories. Nowhere in the treaties does it say that consumption should be criminalized, but sanctions are imposed for non-medical use of substances considered in those endless lists.

João Goulão during an intervention at the international conference “Lisbon Addictions 2017”, which took place last October. Photo: Laura Ramos

Also because it would perhaps be a little regrettable to lose all these years of experience and know-how that Portugal has and the advances it has made and are cited all over the world…
Yes, but I would say that we explored some territory and the Portuguese experience started almost as an outlaw by the UN bodies, the first visits we had were extremely critical. Fifteen years later, we see the national narcotics agency considering the Portuguese experience as an example of good practices or best practices in the spirit of the conventions. Other experiences that are happening in the world at the moment, and I think our responsibility is also to defend that these countries have the freedom to do so without being condemned by the UN, is what Uruguay, several of the United States of America and the Canada wants to do it too. The UN bodies have their lenses pointed and scrutinizing the entire process. I think our role at the moment is to say: “Okay, those countries have every right to try, because they are faced with very complicated situations, they also have to have a moment of rupture, which is not exactly the case that happens to us. Right now, we are not exactly at a time when we have to stir the waters, throw the stone in the pond to change and so I think we have time and space to wait for the consequences of these experiences and in particular understand the impact of legalization in some of the USA. What effect did it have on consumption among young people, for example, and at least preliminary data indicate that there has not been an increase, but nothing is lost in waiting another two or three years to really understand what these impacts are. It's curious that I sometimes feel in a situation, in short, uncomfortable. It is as if we were going to propose innovation only in the name of a supposed modernity. We work as a social laboratory, we have results to show, but there are other social and functional laboratories. Give them time to show their results, that can inspire us later too. Let's say that being a pioneer for the sake of being a pioneer is not exactly an objective and, I insist, today we have a broad political consensus. As you know, the decriminalization law in Portugal was voted against by an important part of the political spectrum. Today, nobody talks, nobody proposes to reverse this phenomenon. The governments changed and the policy was deepened and today there is a consensus. I don't think that even in the most right-wing sectors of the political spectrum there is any consistent proposal to reverse the situation. This is also a gain in civilizational terms, which in practice means that our fellow citizens have made that move on the one hand to consider substance-related issues as a health problem and not a criminal problem, and that is an important qualitative leap. In terms of health, people stopped considering addiction as a kind of sin or addiction and today they give addiction the dignity that other diseases have.

[perfectpullquote align=”right” cite=”” link=”” color=”” class=”” size=””]”We have no deaths from cannabis overdose. But from acute alcohol intoxication, we had more alcohol-related deaths than heroin-related deaths, for example”[/perfectpullquote]

But that's not the case with cannabis! For now, there is a lot of misinformation and a lot of prejudice. The heroin user has come to be seen as a sick person and the cannabis user is seen as a drug addict. Does it not seem to you that there has been a certain perversion here and even a change in roles?
Look, if we go around we actually find some perversions. For example, I would say that nowadays a tobacco smoker is almost more demonized than a weed or cannabis smoker. Right now, it seems more difficult for a smoker to smoke in a public place than for a user of another substance to do so. On the other hand, there are some balances that have not yet been reached, namely with regard to the approach to alcohol. It is also a legal substance, generating very important impacts on individual and collective health.

Alcohol, for example, is a much more problematic consumption for young people than cannabis…
If it's much more problematic… I'm not sure I agree with you on cannabis.

But does SICAD have data on alcohol poisoning, alcoholic comas?
Yes, we do, even deaths from alcohol overdoses.

[perfectpullquote align=”left” cite=”” link=”” color=”” class=”” size=””]”I never bought cannabis in my life, but it happened to me several times to be with a group of friends in which I circulated a joint and I'd have a go without any problem”.[/perfectpullquote]

What about cannabis overdose deaths?
No, we don't have that. But from acute alcohol intoxication, we had more alcohol-related deaths than heroin-related deaths, for example. But in terms of cannabis, there are a few things here that — of course I'm fully aware of who I'm talking to and what like minded of its publication — but in line with what I've always said, in relation to cannabis I would like things to be treated with a lot more seriousness than they have been. The first issue is a very clear separation between the therapeutic use of cannabis and its recreational use, because cannabis can deal with certain health conditions, which I don't dispute, because I have no ideological resistance to it. The problem with these things is that there is evidence in one direction, evidence in the other direction, and everyone gets what they want.

Yes too…
It is true! They say to me like this: yes ma'am, cannabis has undeniable benefits in dealing with certain health situations: multiple sclerosis, glaucoma, in short, a series of indications. I have no resistance to admitting this therapeutic use. What I have a hard time accepting is for someone to say to me: “You can consume this at will because it is so good that it even cures diseases, or even allows you to deal with diseases”. I also have no doubts about the usefulness of opioids…

But it won't recommend morphine to young people either...
Obviously! Not even heroin, which was first developed to be used in the war scenario, was the hero's drug, because they were legless, armless, and used heroin to alleviate and deal with pain.

In his office, still at the former IDT – Institute for Drugs and Drug Addiction, in 2006. Photo: Laura Ramos

And what has SICAD been doing to discourage consumption among young people?
We have universal prevention programs aimed at a very wide age group and especially at the level of intervention in the school context. The best known and most paradigmatic will be the program “Eu e os Outros”, which aims to develop resilience, especially in relation to peer pressure among young people. It goes through information, which as we know is just a small part of the preventive work on the real effects of the risks involved in the use of various substances. It is not done in a dissociated way from what is done in relation to alcohol, NPS, classic illicit substances. Regarding cannabis, there is generic information and the development of policies, interventions that aim to develop resilience, the ability to reflect on the choices that each one makes. Then, we have some programs more aimed at certain groups, such as selective prevention and aimed at young people and institutionalized children, young children of drug addicts or alcoholics, who have special vulnerabilities. I would say that nothing is specific about cannabis, but psychoactive substances in general. People tend to associate substances with suffering and I usually say that people use drugs because they are good. Therefore, no one uses things to suffer and one of the two: psychoactive substances are either used to enhance pleasure in certain pleasant, pleasant situations, or to combat displeasure, suffering in certain conditions. In either case, perhaps the greatest risk of using these substances is that they become the only pleasure that people are able to enjoy and that is where dependence begins, when substance use becomes the center of people's lives. That's the big risk, then everything else comes from there.

[perfectpullquote align=”left” cite=”” link=”” color=”” class=”” size=””]”It wasn't hashish, it was weed, and we all smoked and stuff and started imagining a world where people instead of having legs they had wheels, then a person broke a wheel and had to walk in a leg chair, anyway nonsense absolute." [/perfectpullquote]

The Doctor. João Goulão is a doctor. Would you prescribe medical cannabis to a patient of yours?
If you have evidence. I do not have any resistance from the start, as long as there is a filtering by the appropriate bodies, as there is with regard to any other therapeutic resource, namely by the Medicines Agency, national or European, or by medical organizations, the Ordem dos Médicos (OM), colleges of specialization , etc., who assume or not the goodness of a certain therapeutic resource in a certain circumstance. Just like when a drug is introduced and presented on the market, they present the drug, the pros, the cons, the adverse effects and that's it, it's available, it's been approved by the instance that it had to filter, it's approved for, according to your criteria. clinical, can be used or not. If I had cannabis passed through this sieve and they said to me “you can prescribe, there is a patient there with vomiting related to his therapy for HIV, or for cancer and cannabis can be useful to, on the one hand, deal with these vomiting, on the other as an appetite stimulant”, I have no resistance.

What if it's not in the form of a drug? If it's an oil, a tea, an infusion?
I have no problem doing so as long as it is a medically approved device.

And what about Sativex, which has already been approved by Infarmed but doesn't exist in pharmacies? What happened?
It was already available on the market and probably left because doctors working in the specialties that could potentially use Sativex in their strict indications have therapeutic alternatives and did not consider it essential to use the cannabis derivative.

The Portuguese government has already authorized three medicinal cannabis plantations, so it recognizes its therapeutic potential.
It has authorized production for commercialization in countries where this is already approved, but for now it has nothing to do with the domestic market. We know that there are companies in Portugal positioning themselves in this sense, to enter the market not only medicinal, but also recreational. There are adequate instances to deal with this, so I have no problems with the medicinal one, as for the recreational use I have a greater difficulty in accepting it, hence the desire to first gather experiences and results from what is already happening in other countries. When we decriminalized consumption here, one of the things they said in the UN conventions was: “will kids start using drugs at the age of 5?” and the fact is that we have seen a delay in experimentation. The darkest fears, which were raised at the time, did not materialize. Let's see what happens in these experiences, which are already in another context, in the context of liberalization, of market regulation.

[perfectpullquote align="right" cite="" link="" color="" class="" size=""]
“I would say that nowadays a tobacco smoker is almost more demonized than a weed or cannabis smoker.”[/perfectpullquote]

But it took so much risk at the time and now Portugal is positioning itself on the “let’s wait a little longer”…
I will give you an explanation. When we did that, we were in a situation where we had to hit the pond, something different had to be done. At the present time, when indicators are generally evolving in a positive direction, this is not exactly a moment of urgency.

And don't you think that seeing all this happening worldwide, in Canada, Uruguay, Germany, Italy, Spain… Are we not here, perhaps, already missing the boat and getting a little behind and isolated? Are we not going to miss out on financial, industrial, pharmaceutical, medicinal and even recreational opportunities, even if this is the last step to take?
We have some things, even financial opportunities, that scare me a little. We see, in general, that there is a cross, in short, perfectly justified given the impacts on individual and collective health in relation to tobacco, and we see how tobacco consumption is decreasing, because we have fewer smokers, in Portugal not so much, but we also see how tobacco companies are positioning themselves for this new market. In some cases this appears as an alternative for survival and to continue to ensure their profits. In this regard, I feel the need to keep some distance. There are some enthusiasms that frighten me. There are movements and lobbies that are behind this, and in fact, we see the incidence of points of view on the progress of some countries, in some cases arising from a certain argument used by some parties of the left, extreme left and such, and often coinciding with measures proposed by other right-wing parties, with another argument. Therefore, I personally choose, and having the responsibility of national coordinator, among other things, to advise the government on a certain position. I can say, it is no secret to anyone, that last year, in the preparation of the UNGASS (special session of the General Assembly of the United Nations), we had some meetings to fix the official political position of the Portuguese State. Incidentally, this was even before the change of government, it was still in the government of Dr. Passos Coelho, and therefore we assume the different Ministries in presence, the MNE, the MJ, the MS, and we assume this cautious attitude. Therefore, it is not my attitude, so to speak, this was the position taken and that seems to me perfectly prudent and correct. We took steps, we proved, it is possible, we had a good evolution, the situation remains. let's let out the outputs of the other experiences for us to see.

PHOTO: DR

The Doctor. Goulão was recently in Canada. Were you able to take a closer look at how the regulation specifically in relation to Cannabis is working?
I was in Vancouver, where four people die a day from overdoses, mainly related to Fentanyl, and I saw a reality that I didn't imagine could exist in a country like Canada. I saw a Ventoso Couple from other times amplified by 10, with situations of degradation that I never imagined I would ever find, a drug addict sitting on the floor and another injecting him in the neck, in short… social institutions, a huge investment concentrated there in a square kilometer or a little more, and the way in which these institutions, most of them subsidized NGOs, paid by the piece, how they communicated poorly with each other. And instead of having citizen-centered policies, as is ours, in which the citizen flows from one response to the other according to the moment of his life and his circumstances, there, it is as if the institutions caught a client. and they won't let go of him anymore, because as long as he's there they're being paid. So my trip to Canada was not really about cannabis, although I had been there two years ago with politicians and the committee that is preparing legislation in Canada, but I have no experience. What I've been doing is actually sharing our experience with the model we have, not speculating on models I'm not familiar with. I am in the same expectation that I was telling you, to see what these experiences will lead to.

[perfectpullquote align="right" cite="" link="" color="" class="" size=""]
“I have no problem prescribing cannabis as long as it is a medically approved device”[/perfectpullquote]

In an interview with a Canadian newspaper, asked what the answer to problems like Fentanyl would be, Dr. João Goulão said that “the legalization and regulation of markets, controlling the quality of substances and access in specific and appropriate places, would be positive” and “probably” the answer to the problem. In other words, this regulation of substances, in the sense that they have better quality and are accessible in public places…

We are talking about Fentanyl, which is a medicine, prescribed by doctors…

But does this scenario applied to cannabis make sense or not?
Again, it might make sense. There are experiments going on, let's see what they give, more than two years or a little more they have, see how this works, what impacts it has. I think that we have an appreciable trivialization of the use of cannabis and a very high social complacency about this use.

I think it's more about alcohol...
Also. Our cultural drug is alcohol. But as far as cannabis is concerned, there are new developments through genetic manipulations or cultivation techniques, in short I don't know this in detail, but I know that there are some things here that, among other things, alter the natural balance of the plant itself and the modulation that was exerted in THC and other cannabinoids. So, there was an effect and its opposite, that when manipulated, stimulating the production of THC without touching the others, maybe we let a horse run free and we have an incidence of psychotic outbreaks in cannabis users that maybe has a lot to do with it.

These psychotic outbreaks can also happen with other substances and it is not forbidding that people will stop consuming.
The fact is that we have many more episodes related to cannabis today than we had in the past, which is certainly not unrelated to such changes in the plants (genetic refinement) or to the addition of synthetic cannabinoids, which also happens. In some cases, the products are sold, circulate around and that's it, what we are told by colleagues from mental health hospitals is the occurrence of psychotic outbreaks with great frequency in hospital emergency rooms and in which only the use of cannabis is reported. I mean, isolated cannabis, I don't know if with the so-called perlimpimpim dust of synthetic cannabinoids, possibly added without the user's own knowledge. This too can happen.

Brendan Kennedy, CEO of Tilray — which was recently authorized to plant medical cannabis in Portugal — said that he traveled around the world for two years, visited 18 countries and made more than 35 miles to reach the conclusion that Portugal is the country with the most better conditions for growing medical cannabis. Are Portuguese investors, farmers, companies that eventually want to invest, not missing out on a business opportunity here?
Eventually it will be a business opportunity, I'm not an expert in this area, I'm a specialist in the health area. We, for example, have opium poppy plantations for medicinal use, also with excellent climate and sun conditions.

[perfectpullquote align=”left” cite=”” link=”” color=”” class=”” size=””]”People use drugs because they are good. Either they are used to enhance pleasure or to combat suffering. The great risk of substance use is that it becomes the only pleasure that people are able to enjoy and that is where dependence begins”[/perfectpullquote]

Last year, he told Visão magazine that most people who look for the national network of Commissions for the Deterrence of Drug Addiction (CDT) are cannabis users. Do you think that the existing model is responding in the best way to the phenomenon of consumption? How are these numbers justified?
What happens is that cannabis is by far the most commonly used illicit substance. DTCs only work with users of illicit substances and cannabis is an illicit substance in our framework. People are present at CDTs by police intervention, they are intercepted by the police in a public place using or transporting the illicit substance. The overwhelming majority are cannabis carriers or users, these are the major customers of the CDTs and they do not arrive on their own initiative, nor are commissions going out into the street looking for them, it is the police that refer them. What is the virtuality of this system? There is an opportunity for health professionals to discuss this use with the user. Otherwise, the overwhelming majority of cannabis users either get a scare as one of those psychotic breaks, or else they realize that the use is interfering too much with their daily life, with studies, work or whatever. . Or, quite simply, they do not have any instance where they discuss this use with health professionals. The usefulness, in these cases of deterrence commissions, is to have this instance, where the person can be confronted and look at himself, look at his consumption with a more critical way. If a boy or a girl is stopped by the police with a joint in their pocket, it doesn't come much harm to the world, but if in conversation with the CDT it is clear that, for example, the parents are in the process of divorce or one of the parents has lost their job or if you realize that there is some internal psychological conflict, this gives an opportunity to refer these people and provide them with support. It is not in a drug addiction centre, but another type of support that can prevent consumption, coexisting with a certain problematic situation, from evolving towards a greater complication. And this is in fact one of the great virtues, the prevention that interrupts a path that could become more complicated in the future. In practice, what happens is that the policemen who walk on the street know the addicts perfectly, people who have a long history, and they usually don't bother them too much. The activity and referral to the deterrence committee focuses, particularly, on these people with more initial consumption, in order to have such an instance of information and discussion. It makes perfect sense to me that this is so. I would say that the treatment response network is already sufficiently publicized: those who need it know where to go and what the circuits are like; those who don't need it and, in short, are on their honeymoon with the substances, then maybe it makes more sense to have an instance where they are informed, where they have a kind of yellow card "stop and think", and then do the your choices.

[perfectpullquote align="right" cite="" link="" color="" class="" size=""]
“Our cultural drug is alcohol. But when it comes to cannabis, there are new developments through genetic manipulations or culture techniques”[/perfectpullquote]

In the 2015 SICAD report, it says that 10.380 offenses for drug use were filed, 85 percent of which related to cannabis use. Why is it that there are still so many cases of people being caught with plants at home and continuing to be arrested, clogging up the courts and being sentenced?
This is part of a legislative package that could be revised but at the moment growing for own consumption is illegal.

Would it make any sense to you to legalize self-cultivation for medicinal purposes? Is this because of the issue of jurisprudence, which is happening in several countries, such as Germany or Brazil? 
We are still on the upstream side of all this, that is, the adoption or not, the acceptance or not of cannabis for medicinal purposes. Then, the question of self-cultivation, one of the grounds is also quality control and strict monitoring of development. Self-cultivation is perhaps not compatible with medicinal use.

Why?
Who does this control, who makes sure that the little flower I have is in good condition?

The person himself, in the interest of defending his health. Imagine I had multiple sclerosis or some other disease and I tried this plant. I would investigate myself and find out which one is the most suitable for my condition, with what levels of THC and CBD.
This will have to be regulated if it is accepted and introduced for medicinal purposes. The possibility of people replicating their medicine and making it at home doesn't seem to me… nor do I see the thousands of multiple sclerosis patients cultivating their medication.

I was just trying to find out if that was very strange for you or if it would make any sense, because the right to health protection is enshrined in Art. 64 of the Constitution of the Portuguese Republic.
If the drug's stability is in fact guaranteed and if the plant's replication is stable, I don't see anything against it, but I also don't know enough about the subject to be categorical.

[perfectpullquote align="left" cite="" link="" color="" class="" size=""]
“I don't see the thousands of MS patients growing their medication. But if you guarantee the stability of the drug and if the plant's replication is stable, I don't see anything against it… but I also don't know enough about the subject to be categorical”[/perfectpullquote]

Nowadays you hear about the increase in THC levels and the possibility of this causing more schizophrenia or more psychoses. Could it be that with the regulation it is not possible to control and know exactly what is the level of THC in a plant? It's just that, being illegal, no one really knows what they consume...
I think the move towards regulation has something to do with that. There are certainly advantages. I take a pack of tobacco and see what the percentage of nicotine and tar is there and I know I'm not making a mistake. With a product resulting from a regulated process this would be possible. But it still leads us to the question that, in my view, is upstream. Is there an advantage? There is not? How does consumption actually evolve? I don't think anyone is trying to encourage increased consumption by 11 or 12 year olds, but what impact does this have? It is regulated from a certain age and certain conditions, but does availability have an impact on the increase in consumption by younger people or not? It is for this evolution that I continue to defend some distance and rigorous observation, factual and scientific monitoring of the evolution of the countries that have adopted this path.

I just wanted to talk to you about Israel, which is the most advanced country in terms of medical cannabis. Medical cannabis has been legal since 1998, and this year a neurologist is carrying out the first clinical trial in children with autism. This doctor had many families asking him for medical cannabis and initially he said: “no, I can't, they are children, it's not scientifically proven”, but he ended up agreeing and doing a first study with 70 children. The results were so promising that he decided to do this experiment with 120 autistic children and young people by the end of 2018. Autism and epilepsy are, nowadays, a major concern for many Portuguese families. Can't this discovery be almost revolutionary?
I have told you several times that I have no resistance to adopting therapeutic measures that have been proven to be effective and cost-effective. I'm not talking in economic terms, but in terms of health gains and losses. If it's frankly positive, I don't have any resistance, I need, just like prescribing an aspirin, to have a leaflet.

Do you have any predictions of how many years it will take for medical cannabis to be legal in Portugal?
Not. Notice, I've been insisting on this idea that this is a matter that goes through other circuits than SICAD, it's not our responsibility.

But your opinion is quite valid...
I am aware of this, but I have invariably said what I am saying to you: INFARMED and the appropriate bodies, the Medical Association (OM) and specialty colleges, etc. is that they have to decide. The current chairman of the OM, shortly after taking office, made statements in the sense of his openness to the regulation of the use of therapeutic cannabis. We will probably be asked to give an opinion in this regard, so no resistance, as I wouldn't put any resistance to the use of heroin in a guy who steps on a mine and loses a leg and is there suffering. What is the therapeutic resource we have to alleviate pain or to mitigate suffering? It's the one, it's the one we give. Are there others with less risk available there, in a theater of war? Good medical practice might dictate that I, instead of heroin, give morphine or another type of medication.

[perfectpullquote align=”right” cite=”” link=”” color=”” class=”” size=””]”There was an escalation in which each one imagined something dumber than the other and I remember reaching the end hungry and with cramps in my face, is the image I have of it”[/perfectpullquote]

The Doctor. Did João Goulão ever smoke cannabis?
I smoked many years ago, yes I did.

Was it casual or did you smoke in your youth?
Not. I don't know, I can tell you that I've never bought cannabis in my life, for example. But it happened to me several times to be with a group of friends in which a joint circulated and took a pass without any problem.

How was your experience?
I remember getting cramps in my face from laughing at things that, I don't know, on a heroic night — heroic here is a bit excessive — but I was about 21 years old, it was in the early years of college. A group of friends and I had rented some chalets in Costa de Caparica, some wooden houses along the Transpraia route, to go to study, or to go with girlfriends, and I remember we were there one night when one of them showed up with weed. It wasn't hashish, it was weed, and we all smoked and stuff and we started to imagine a world where people instead of having legs had wheels, then a person broke a wheel and had to walk in a leg chair, anyway nonsense absolute. There was a climb where each one imagined something dumber than the other and I remember reaching the end hungry and with cramps in my face, that's the image I have of it. Interestingly, I lost track of some of these friends and the one who always seemed more eager when we met and asked “does anyone have anything?” he died a few years later of a heroin overdose. He was the type who had the most urge to consume anything, so he already had an addictive behavior. All the others followed their routes, as far as I know none of them had any problems, but I don't know if they smoke or not. No, it was not something that continued over time, I would say that in my life I smoked five or six times, no more than that, and so in this context of joking, in a group of people where there is something going around.

And what, in your opinion, differentiated your attitude from that of your friend, who showed an addictive behavior?
This is what I was saying earlier, the story of enjoying pleasure. People either have alternatives and other things that give them pleasure or not. I, for example, was a medical student at that time and came from the small land to the big city. At the time I lived in Portalegre and when I came to college I lived the 25th of April. I was lucky enough to get involved in political activity and to be the director of the Student Association of the Faculty of Medicine, so I had many things that filled me up and that gave me pleasure, that gave me pleasure, while other people seemed to have a life a little more empty and that's it, they filled that void with other things. But in fact, there are personalities more or less predisposed to follow a certain path than others, there are genetic components, environmental components… Now I don't deny it at all, nor am I ashamed or try to hide it. I smoked. And I inhaled (laughs).