Projecte Vida Demands Clear Relapse Protocols for Andorra's UCA Addiction Services

**Projecte Vida calls for clear protocols on addiction relapse management amid ongoing debate over UCA services**

The Andorran addiction support group Projecte Vida has demanded explicit clinical protocols for handling relapses among patients at the Unitat de Conductes Addictives (UCA), part of the Servei d'Atenció a les Addiccions i la Salut Mental (SAAS). The organisation argues that relapses—common in addiction treatment—represent moments of peak vulnerability requiring intensified therapeutic support, rather than reduced assistance or a shift to primarily pharmacological care.

The push follows a tense parliamentary exchange last Thursday in the Consell General. Social Democrat deputy Pere Baró questioned Health Minister Helena Mas about rising patient loads per UCA professional, suggesting declining mental health service quality. Mas defended the approach, stating that treatment adjustments aim to tailor support to individual needs, not abandon patients. Without naming Projecte Vida, she accused the group of seeking to undermine UCA's reputation.

In a detailed technical response, Projecte Vida—led by Eva Tenorio—rejected claims of discrediting staff or services. It stressed the absence of defined relapse management criteria, systematic data collection, and alignment with international guidelines or Andorra's own Pla Integral de Salut Mental i Addiccions (PISMA). "Transparency, scientific evidence, and care continuity are essential to address clinical vulnerability and maintain public health trust," the group stated.

Projecte Vida highlighted unanswered parliamentary queries, such as evidence justifying transitions from intensive therapy to daily medication dispensing plus weekly psychology and psychiatry visits. It noted that medication alone constitutes a limited intervention, insufficient for relapse risks, where evidence calls for bolstered therapy. The organisation said it raised these issues collaboratively for nearly four years via institutional channels before going public.

It also criticised UCA's operating hours, mainly 8:30am to 4pm or 4:30pm, as creating access barriers for working adults, precarious women, and students, despite limited evening extensions.

Professionals echoed calls for nuance. Psychiatrist Josep Maria Fàbregas, director of Spain's CITA clinic, urged case-by-case analysis to distinguish relapses stemming from inability, lack of knowledge, or unwillingness, emphasising patient accountability without system expulsion. Psychologist Claudia Luján of Institut de la Ment described addiction as overwhelming the individual, viewing relapses as treatment opportunities rather than failures, provided they prompt therapeutic reflection.

The Col·legi de Psicòlegs de les Valls del Nord stressed that measures like temporary day-hospital exclusion must serve clinical or protective goals, based on assessments of function and prognosis—not punishment—given limited public resources. Relapses, while expected, demand non-linear change strategies.

Mas clarified that UCA day-hospital pauses do not end overall treatment but allow reconfiguration. The debate underscores tensions between empathy-driven continuity and resource constraints in Andorra's public addiction services.