Treatment in Latvia 2017

Latvia Country Drug Report 2017

Treatment

The treatment system

Another pillar of the current national drug strategy is the development of new treatment options and increasing the quality of and expanding provision of existing treatment services. The national coordination body for drug treatment in Latvia is the Riga Centre of Psychiatry and Dependencies, which is responsible for the delivery, accreditation, monitoring and evaluation of drug treatment. Drug treatment is mainly delivered by institutions that operate under the supervision of the Ministry of Health and are funded by the state budget of the National Health Service. Long-term social rehabilitation is also provided through funds from the Ministry of Welfare. Drug treatment may also be delivered by private, profit-making organisations and is regulated by the Medical Treatment Law.

 

Drug treatment is available in outpatient and inpatient clinics. Outpatient drug treatment services are provided by narcologists in specialised public or private treatment centres and the services usually address all forms of dependencies. Although several low-threshold services provide some psychosocial interventions and counselling to drug users, they are not classified as drug treatment facilities in Latvia. Inpatient treatment is provided by specialised psychiatric hospitals and by regional and local multi-profile hospitals, which are either publicly or privately funded. If treatment is provided by private institutions or practices, the client must fully cover all the costs of the service. Outpatient services provide mainly psychosocial intervention, cognitivebehavioural therapy, motivational interventions and opioid substitution treatment (OST), while inpatient facilities offer emergency care in the event of an overdose, detoxification and short-term psychosocial interventions. Two specialised psychiatric centres provide long-term rehabilitation based on the principle of the ‘therapeutic community’.

OST with methadone has been available since 1996, while use of buprenorphine was allowed in 2005. In recent years, the availability of OST has expanded beyond the capital city, and it can be prescribed at any inpatient clinic provided that it has a Council of Physicians including at least two narcologists. Methadone is provided free of charge by the state, while buprenorphine is available at the patient’s expense.

Drug treatment in Latvia: settings and number treated

NB Year of data 2015.

 

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

NB Year of data 2015.

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

NB Year of data 2015.

 

Treatment provision

In 2015, almost 3 000 people received treatment as a result of drug use, and most of them were treated in outpatient settings.

Treatment demand data cover less than 70 % of all those who received drug treatment in Latvia. In 2015, primary use of opioids, mainly heroin, remained the principal reason for treatment entry among all clients admitted to treatment, although a decline in the number and proportion of opioid-related treatment demands has occurred in the last decade. In 2015, around half of treatment entries were attributable to primary opioid use. Cannabis was the second most common primary substance, reported by around 2 out of 10 people entering treatment. In 2014, approximately two thirds of primary cannabis users entering treatment had used synthetic cannabinoids; however, in 2015, the proportion of treatment entries reportedly attributable to these substances declined. The proportion of amphetamine clients among all treatment entrants has remained relatively stable over the years; however, the number of clients entering treatment for primary amphetamine use has decreased

The geographical expansion of OST and changes in the legal framework contributed to a substantial increase in the number of OST clients between 2006 and 2015, although OST coverage in Latvia remains among the lowest in the EU. In 2015, 609 clients received OST, mainly with methadone


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