Treatment in Estonia 2017

Estonia Country Drug Report 2017


The treatment system

The National Health Plan 2009-20 and its implementation plans define the main objectives in the area of drug treatment. Treatment in the public sector is funded by the state budget allocated by the Ministry of Social Affairs; almost half of the budget funds opioid substitution treatment (OST), while the remaining budget is allocated for detoxification and drug-free programmes. Some larger municipalities also fund drug treatment.

Traditionally, drug treatment in Estonia is provided through hospitals, which need to obtain a licence for mental health services in order to provide inpatient and outpatient treatment for problem drug users. According to the Mental Health Act (RT I 1997, 16, 260), only psychiatrists can provide drug treatment, although they are not required to be specialised in drug treatment. In general, drug treatment is primarily provided in outpatient treatment units and inpatient treatment services remain limited. OST is the most widely available treatment option in Estonia. The other available treatment interventions include detoxification, drug-free treatment and inpatient rehabilitation programmes. Special drug treatment programmes for children, adolescents and persons with a dual diagnosis are also available, although treatment options for those groups and for amphetamine injectors, whose prevalence among drug users seems to be on the increase, remain limited.

OST with methadone was officially introduced in 2001, but it has been used on a significant scale only since 2003 with the opening of a specialised centre. In 2015, methadone maintenance treatment was made available in all treatment centres.

Drug treatment in Estonia: settings and number treated

NBYear of data 2015.


Trends in percentage of clients entering specialised drug treatment, by primary drug in Estonia

NBYear of data 2015.

Opioid substitution treatment in Estonia: proportions of clients in OST by medication and trends of the total number of clients

NBYear of data 2015.

Treatment provision

In 2015, most clients who entered treatment in Estonia were treated in outpatient settings.

Among clients entering treatment, 9 out of 10 reported opioids as the primary drug of use (mostly fentanyl, but also methadone or heroin).

Considering the Estonian drug treatment system, which mainly addresses the needs of opioid-using clients, most

of those who entered treatment in 2015 received OST, with methadone being the most commonly prescribed OST medication in Estonia.

Although the coverage of OST is not known because of the lack of an estimate of the size of the opioid-using population, it is assumed to be relatively low (< 20 % of the target population).

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