Increasing Availability of Opioid Substitution Treatment in the EU

"The most common type of treatment for opioid dependence in Europe is substitution treatment, typically integrated with psychosocial care and provided at specialist outpatient centres. Sixteen countries report that it is also provided by general practitioners. In some countries, general practitioners provide this treatment in a shared-care arrangement with specialist treatment centres. The total number of opioid users receiving substitution treatment in the European Union, Croatia, Turkey and Norway is estimated at 709,000 (698 000 for EU Member States) in 2010, up from 650,000 in 2008, and about half a million in 2003(101). The vast majority of substitution treatments continue to be provided in the 15 pre?2004 EU Member States (about 95% of the total), and medium-term trends (2003–10) show continuous increases (Figure 14). The greatest increases in provision among these countries were observed in Greece, Austria and Finland, where treatment numbers almost tripled.
"An even higher rate of increase was observed in the 12 countries that have joined the European Union since 2004. In these countries, the number of substitution clients rose from 7,800 in 2003 to 20,400 in 2010, with much of the increase occurring after 2005. Proportionally, the expansion of substitution treatment in these countries over the seven-year period was highest in Estonia (sixteenfold from 60 to over 1,000 clients, though still reaching only 5% of opioid injectors) and Bulgaria (eightfold). The smallest increases were reported in Lithuania, Hungary and Slovakia.
"A comparison of the estimated number of problem opioid users with the number of clients in substitution treatment suggests varying coverage levels in Europe. Of the 18 countries for which reliable estimates of the number of problem opioid users are available, nine report a number of clients in substitution treatment corresponding to about 50% or more of the target population(102). Six of those countries are pre?2004 EU Member States, and the remaining countries are the Czech Republic, Malta and Norway."


European Monitoring Centre for Drugs and Drug Addiction, "Annual report 2012: the state of the drugs problem in Europe" (Luxembourg: Publications Office of the European Union, November 2012), Catalog No. TDAC12001ENC, doi:10.2810/64775, p. 75.