EMCDDA Home
  • EN
Search

Standards and guidelines for practices

This page contains a listing of national drug treatment guidelines in Europe. The title, the methodological basis and the types of treatment covered by each guideline are provided, along with a download link where available. The guidelines were collected in three phases in 2008, 2009, and 2010. See background information below for more details.

Treatment guidelines in Europe
Country Name of the guideline in English — if available — and year of publishing Language and download link (if available) Interventions covered Basis of the guideline (where known)
Belgium 1. Maintenance treatment of opiate addicts with buprenorphine (2005) Download document (Flemish, PDF) 2 Evidence based
2. Guidelines for the treatment of opiate addiction (2000) Download document (French, PDF) 2, 3, 6 Evidence and expert consensus
3. Guidelines for the prescription of benzodiazepines to illegal drug users (2008) Download document (Flemish, PDF)    
Bulgaria 1. Consensus regarding good practice in addiction treatment - (2002) Bulgarian 3 Expert consensus and evidence
2. Consensus regarding good practice in rehabilitation of addictions (2005) English 1
3. Guidelines for good practice in psychosocial rehabilitation of addictions Bulgarian 1, 4
 4. Guidelines for good practice in substitution treatment - (2008) Bulgarian 2
Croatia 1. Guidelines for the use of methadone in the substitution therapy of opiate drug users (2006) Download document (Croatian, PDF) 2  
2. Guidelines for the use of buprenorphine in the substitution therapy of opiate drug users (2006) Download document (Croatian, PDF) 2  
3. Standards for therapeutic communities (2009) Download documents (1 - 2 , Croatian, PDF)    
4. Guidelines for the psychosocial treatment of drug addiction in the health social and penal system (2014) Download documents (Croatian, PDF and English abstract) 2, 6  
Czech Republic 1. General standard and specialized standards (2003) Download documents (Czech and English, Word) 1, 2, 3, 4, 5, 6 Expert consensus and evidence
2. General standard and specialized standards for out-patient treatment (2003) Download document (Czech, Word) 1, 5
3. General standard and specialized standards for in-patient treatment (2003) Download document (Czech, Word) 1, 4, 5
4. General standard and specialized standards for lowthreshold facilities and treatment facilities (2003) Download document (Czech, Word) 1, 5
5. General standard and specialized standards for detoxification (2003) Download document (Czech, Word) 3
6. General standard and specialized standards for substitution treatment Download document (Czech, Word) 2
7. Standards for substitution treatment (2008) Download document (Czech, Word) 2
8. General standard and specialized standards for aftercare and treatment facilities (2003) Download document (Czech, Word) 1, 4, 5
9. Standards for drug dervices in prison provided by external subjects (applied since 2004) Download document (Czech, Word) 1, 4, 5
Denmark 1. Guidance no. 42 on medical treatment of drug abusers in substitution treatment for opioid dependence (2008) Danish, English (download, PDF) 1, 2, 3, 5, 6 Expert consensus and evidence based
2. Prescription of injectable diacetylmorphine (heroin) in case of opioid dependence; Rules of guidance no. 9240, May 11th 2009 Danish, English (download, PDF) 1, 6
Estonia 1. Guidelines for the treatment of drug addiction (2001) Download document (Estonian, PDF) 1, 2, 3, 4, 5 Expert consensus
Germany 1. Acute treatment of opiate use disorders (2003) Download document (German, PDF) 1, 3 Expert consensus and evidence
2. Postacute treatment of opiate abuse and dependence (2004) Download document (German, PDF) 1, 2, 3, 4, 5
3. Treatment for cannabis use disorders (2004) Download document (German, PDF) 3
4. Treatment of disorders related to cocaine, amphetamines, ecstasy and hallucinogens (2004) Download document (German, PDF) 2, 3, 5
5. Standards for substitution treatment of opiate addicts (2002) Download document (German, PDF) 2
6. Guidelines for opioid substitution treatment (2010) Download document (German, PDF) 2
Ireland 1. Review of the methadone treatment protocol (2005 and 2010) Download documents - 2005 and 2010 (English, PDF) 2, 3, 6, 7 Expert consensus
2. Working with opiate users in community-based primary care (2003 and the 2008 update) Download documents 2003 and 2008; (English, PDF) 2 Expert consensus and evidence based
3. Keeping drugs out of prisons: drug policy and strategy (2008) Download document (English, PDF)  6  Unclear
4. Benzodiazepines: good practice guidelines for clinicians (2002) Download document (English, PDF)  5  Expert consensus
5. National drugs rehabilitation framework document (2010) Download document (English, PDF)  4, 5, 6  Expert consensus and evidence
6. Community detoxification protocols: methadone (2011) Download document (English, PDF)  3  Expert consensus
7. Quality framework for mental health services in Ireland (2005) Dowload document (English, PDF)  5 Evidence and consensus
8. Clinical practice guideline: methadone prescribing and administration in pregnancy (2013) Dowload document (English, PDF) 2, 7
Greece No information available.
Spain 1. Manual de buena pratica para la atencion a drogodependientes en los centros de emergencia (2003) Download document (Spanish, PDF)  5, 6  Evidence
2. Intervención sobre drogas en centros penitenciarios (2006) Download document (Spanish, PDF) 2, 3, 4, 6
3. Guia clinica de intervencion psicologica en addiciones (2008) Download document (Spanish, PDF) 1  Evidence and expert consensus
4. Guía para el tratamiento de la dependencia de opiáceos (2007) Download document (Spanish, PDF) 2, 6, 7  Evidence
France 1. Modalités de sevrage chez les toxicomanes dépendant des opiacés Conférence de consensus des 23 et 24 avril 1998 - Texte long des recommandations Download document (French, PDF) 3, 6  Expert consensus
2. Conférence de consensus Stratégies thérapeutiques pour les personnes dépendantes des opiacés: place des traitements de substitution 23 et 24 juin 2004 Texte des recommandations Download document (French, PDF) 1, 6
3. Initiation et suivi du traitement substitutif de la pharmacodépendance majeure aux opiacés par buprénorphine haut dosage (2011) Download document (French, PDF)    
4. Les pratiques professionnelles concernant les traitements de substitution aux opiacés (T.S.O.) dans les CSAPA (2010) Download document (French, PDF)  2, 6  Consensus and evidence
5. Strategies of care for cocaine users (2010) Download documents (1 -2, French, PDF)  5, 6  Evidence
6. Reducing the misuse of opiate substitution medication (2004) Download document (French, PDF)  2  Expert consensus and evidence
7. Abuse, addiction and polydruguse: strategies of care (2007) Download document (French, PDF)  5
8. Recommandations de bonnes pratiques professionnelles: la participation des usagers dans les établissements médico-sociaux relevant de l’addictologie  (2009) Download document (French, PDF) 5 Consensus
Italy No guidelines exist so far.
Cyprus 1. Treatment guidelines (2010) Download document (Greek, PDF) 1, 2, 3, 4, 5  
Latvia 1. Clinical guidelines for psychosocially assisted pharmacological treatment with methadone and buprenorphine of persons dependent on opioids (2009) Latvian 2 Expert consensus and evidence
2. Clinical guidelines for drug and alcohol addiction treatment (2005) Download document (Latvian, PDF) 1, 2, 3, 5
3. Guidelines for the treatment of misuse and dependence on sedative medications Latvian  
Lithuania 1. Early diagnostic and treatment for children who are using drug, psychotropic and another psychoactive substances in primary health care institutions (2009) Download document (Lithuanian, PDF) 1, 5 Expert consensus and evidence based
2. Addictive disorders treatment with antagonist naltrexone (for opioid users) (2008) Download document (Lithuanian, PDF) 1, 2, 5 Evidence based
3. Addictive disorders treatment for opioid users with methadone (2009) Download document (Lithuanian, PDF) 1  
4. Addictive disorders treatment for opioid users with buprenorphine and buprenorphine/naltrexone (2009) Download document (Lithuanian, PDF) 1  
Luxembourg 1. Guidelines of good practice in substitution treatment (1998) Download document (French, PDF) 2 Expert consensus
2. Decree of the 30 January 2002 determining the modalities of treatment of addicts with substitution Download document (French, PDF) 2
Hungary 1. Professional guideline for community care for addicts (2008) Download document (Hungarian, PDF) 1, 4, 5 Expert consensus
2. Professional guideline for low threshold services in the scope of the basic social care for addicts (2006) Download document (Hungarian, PDF) 1, 5
3. Professional protocol for addicts' day care centres in the scope of basic social care (2006) Download document (Hungarian, Word) 5
4. The methodological letter of the Ministry of Health on methadone treatment (2008) Download document (Hungarian, PDF) 2, 3 Evidence based
5. Professional treatment protocol of the Ministry of Health for opiate use related problems (2008) Download document (Hungarian, PDF) 1, 2, 3, 4, 5
6. Professional treatment protocol of the Ministry of Health for amphetamine use related problems (2008) Download document (Hungarian, PDF) 1, 4, 5
7. Professional treatment protocol of the Ministry of Health for cannabis use related problems (2008) Download document (Hungarian, PDF) 1, 4, 5
Malta No information available.
The Netherlands 1. Guideline for outpatient and inpatient detoxification (2004) Download document  (Dutch, PDF) 3 Expert consensus and evidence
2. Guideline for the treatment of opiate addicts (RIOB -2006) Download document  (Dutch, PDF) 2
3. Richtlijn medicamenteuze zorg aan gedetineerde verslaafden (2008) Download document  (Dutch, PDF) 2, 3
Austria 1. Guideline for drug facilities which are registered and financed according to the Narcotic Act (2004) Download document (German, PDF) 1, 3 Expert consensus
2. Decree for new regulations on substitution treatment (2007) Download document (German, PDF) 2 Political consensus
3. Amendment to the decree for new regulations on substitution treatment (2009) Download document (German, PDF) 2 Political consensus
Note: These documents are not consistent with an international definition or understanding of 'national treatment guidelines' but they are included here because they define some organisational as well as treatment-related issues on a national level in Austria.
Poland 1. Standards for pharmacological treatment (M. Jaremy: "Standardy farmakoterapii zaburzeń psychicznych", Via Medica, Gdańsk 2011, all copy rights reserved) Download document (Polish, PDF) 1, 5  
Portugal 1. Circuito do utente ambulatório (2008) Download document (Portuguese, Word) 1, 5 Expert consensus and evidence based
2. Regulations for inpatient treatment in private institutions and their governmental financial support (2008) Download document (Portuguese, PDF) 1, 4, 5, 6 Expert consensus
3. Normas orientadoras dos programas terapeuticos com agonistas opiaceos em Portugal (2006) Download document (Portuguese, Word) 2, 7 Expert consensus and evidence
4. Manual de orientações tecnicas para a implementação de programas de substituição opiacea de baixo limiar de exigencia (not yet published) Portuguese 2
5. Manual de boas praticas em reinsercao (2007) Download document (Portuguese, Word) 4, 5
6. Colaboracao entre IDT e Instituto de Seguranca Social e a Santa Casa da Misericordia (2007) Download document (Portuguese, Word) 4, 5, 6
Romania No guidelines exist so far.
Slovenia 1. Social work in the field of addiction (1995) English, Slovenian 1, 4 Expert consensus
Slovakia 1.Professional regulation of standards for diagnostic and treatment in the drug dependence specialisation (2003) Download document (Slovakian, PDF)    
2. Methodical instruction on the provision of MMT maintenance treatment for patients with dependece on opiates and with chronic course of the disease (2004) Download document (Slovakian, PDF)    
Finland 1. Treatment of substance abusers (2006) Download document (English, PDF)  1, 4  Expert consensus
Sweden 1. Nationella riktlinjer for missbruks- och beroendevård (2007) Download document (Swedish, PDF) 1, 5 Evidence
2. Läkemedelsassisterad behandling av heroinmissbrukare (2004) Download document (Swedish, PDF) 3
3. Läkemedelsassisterad underhållsbehandling vid opiatberoende (2009) Download document (Swedish, PDF) 2
United Kingdom 1. Drug misuse and dependence: UK guidelines on clinical management (2007) Download document (English, PDF) 1, 2, 3, 5, 6, 7 Expert consensus and evidence
2. Drug misuse: psychosocial interventions (2007) Download document (English, PDF) 1, 6, 7
3. Naltrexone for the management of opioid dependence (2007) Download document (English, PDF) 3, 6
4. Drug Misuse: opioid detoxification (2007) Download document (English, PDF) 3, 6, 7
5. Methadone and buprenorphine for the management of opioid dependence (2007) Download document (English, PDF) 2, 6
6. Models of care for treatment of adult drug misusers: update (2006) Download document (English, PDF) 4, 6
7. Models of residential rehabilitation for drug and alcohol misusers (2006) Download document (English, PDF) 4, 6
8. Young people's substance misuse treatment services, essential elements (2007) Download document (English, PDF) 1
9. Planning, commissioning and delivering the training and employment pathway for problem drug users (2009) Download document (English, PDF) 1, 4, 5 Expert consensus
10. Non-medical prescribing, patient group directions and minor ailment schemes in the treatment of drug misusers (2007) Download document (English, PDF) 4, 6, 7
11. Renewed guidance for treating heroin addicts in prison (2010) Download document (English, PDF) 2, 6  
12. Guidance and training protocol for the development of the introduction of take home Naloxone (Wales) (2010) Download document (English, PDF)  6, 7  Consensus
13. Treatment of offenders (Wales) (2009) Download document (English, PDF) 5, 6, 7  Evidence and consensus
14. Guidance for the pharmacological management of substance misuse among young people in secure environment (2009) Download document (English, PDF) 1, 2, 5, 6, 7 Expert consensus and evidence
15. Towards successful treatment completion - a good practice guide (2009) Download document (English, PDF) 2, 5, 6  Consensus and evidence
16. NTA Policy on involvement of users and family members (2008) Download document (English, PDF) 4  Unclear
17. Supporting and involving carers (2008) Download document (English, PDF) 4 Expert consensus and evidence
18. Guidance for the planning and provisions of substance misuse services to children and young people in the care of youth offending services (2009) Download document (English, PDF)  5
19. Substance misuse service and system improvement - national core standards for substance misuse services in Wales (2009) Download document (English, PDF)  5  Evidence
20. Prisons integrated drug treatment system: continuity of care guidance (2009) Download document (English, PDF)  6
21. Undertaking needs assessment: drug treatment. Recovery and reintegration in the community and prisons (2009) Download document (English, PDF)  4, 6
22. Clinical governance in drug treatment: a good practice guide for providers and commissioners (2009) Download document (English, PDF)  5, 6  Consensus
23. Residential drug treatment service: a summary of good practice (2009) Download document (English, PDF)  2  Expert consensus, best practices
24. Residential drug treatment services: good practices in the field (2009) Download document (English, PDF)  2, 6
25. Commissioning for recovery drug treatment, reintegration and recovery in the community and prisons: a guide for drug partnerships (2010) Download document (English, PDF)  4, 5, 6
26. Routes to Recovery: psychosocial interventions for drug misuse. A framework and toolkit for implementing NICE-recommended treatment interventions (2010) Download document (English, PDF)  1  Expert consensus and evidence
27. Substance misuse detainees in police custody guidelines for clinical management (2011) Download document (English, PDF)  6, 7

 Expert consensus

28. Safer prescribing in prisons guidance for clinicians (2011) Download document (English, PDF)  6  Expert consensus and evidence
29. Hepatitis B and C: ways to promote and offer testing to people at increased risk of infection (2012) Download document (English, PDF)  5, 6
30. Delivering quality care for drug and alcohol users: the roles and competencies of doctors (2012) Download document (English, PDF)  5  Expert consensus
31. Standards for integrated care pathways for mental health (2007) Download document (English, PDF) 5 Evidence
32. Alcohol dependence and harmful alcohol use quality standard - NICE (2011) Download document (English, PDF) 5 Evidence and consensus
33. Pregnancy and complex social factors: a model for service provision for pregnant women with complex social factors – NHS/NICE (2010) Download document (English, PDF) 5 Evidence
34. Routes to Recovery via the community, Mapping user manual (Public Health England, 2013) Download document (English, PDF) 5  
Note: The downloadable documents include some of the most recent (from 2007) clinical treatment guidelines. A number of national framework service-oriented guidelines have been developed in the UK and they are available at the NTA website.  
Turkey No information available.
Norway 1. Guidelines on opioid substitution treatment (2009) Download document (Norwegian, PDF) 1  
International 1. Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence (WHO, 2009) Download the document (English, PDF) 2, 6, 7  Expert consensus and evidence
2. Practice guidelines for opioid substitution treatment in New Zealand (Ministry of Health, 2008) Download the document (English, PDF)  2, 6, 7  Evidence and consensus
3. National pharmacotherapy policy for people dependent on opioids (Intergovernmental Committee on Drugs, Australia, 2007) Download the document (English, PDF)  2, 6, 7
4. Practice Guidelines for the treatment of patients with substance use disorders (American Psychiatric Association, 2006) Download the document (English, PDF)  1, 5, 7
5. Service standards for addiction therapeutic communities (Community of Addiction Therapeutic Communities, 2006) Download the document (English, PDF)  5, 6
6. UNODC, Community based treatment  (2008) Download the document (English, PDF)  5, 6, 7
7. UNODC, Interventions for drug users in prison (2008) Download the document (English, PDF)  6
8. UNODC, Sustained recovery management (2008) Download the document (English, PDF)    
9. European Union, European Minimum Quality Standards (EQUS, 2012) Download the document (English, PDF) 5 Evidence and consensus
10. African Union, Proposed continental minimum quality standards for treatment of drug dependence (2012) Download the document (English, PDF) 5 Consensus
11. UNODC/WHO, Principles of drug dependence treatment (2008) Download the document (English, PDF) 5 Evidence
12. Service delivery for people with co-existing mental health and addiction (New Zeland, Ministry of Helath, 2010) Download the document (English, PDF) 5 Evidence and consensus
13. NIDA, Principles of drug addiction treatment (USA, 2012) Download the document (English, PDF) 5, 7 Evidence
14. Guidelines for the identification and management of substance use and substance use disorders in pregnancy (WHO, 2014) Download the document (English, PDF) 1, 2, 3  Expert consensus and evidence

Legend for interventions covered

  • 1 : Psychosocial interventions
  • 2 : Opioid substitution/maintenance treatment
  • 3 : Detoxification
  • 4 : Social reintegration
  • 5 : Responses to alcohol and drug (in general)
  • 6: Prison (explicit reference)
  • 7: Overdose prevention

Background information

The guidelines were collected in three phases in 2008, 2009, and 2010.

2008: A structured questionnaire filled in by the Reitox national focal points, was used to identify 72 treatment guidelines which had been developed in the 27 reporting countries.

2009: A consultant study (Executive summary) involving 29 European countries (27 European Member States, Norway and Turkey) obtained a further 17 guidelines which were then checked for double counting: 

2010: A further 10 guidelines were obtained during a 'Reitox academy meeting' organised to draft a selected issue on national treatment guidelines, during which 28 Countries participated (including, for the first time, Bosnia Herzegovina, Albania, Montenegro).

2011: The National Reports 2010 of the 30 European countries contained a devoted chapter on the description of National Treatment Guidelines and a compilation of these chapters is available here. Furthermore, in November 2011 the EMCDDA Selected Issue "Guidelines for the treatment of drug dependence: a European perspective" has been published.

top of page 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Page last updated: Tuesday, 23 September 2014