Treatment-related objectives of the ANDT place an emphasis on enhancing the quality of care based on a client-centred approach. In Sweden, drug treatment is organised by the social services in local communities (specialised outpatient clinics), hospitals (providing detoxification) and therapeutic communities. The National Board of Institutional Care provides compulsory treatment (up to a maximum of six months) in special cases.
Approximately 80 % of outpatient services are provided by municipalities, county councils or the state, while 60 % of all inpatient services are provided by municipalities in private and non-governmental organisations (NGOs).
County councils are responsible for the provision of detoxification facilities and OST and for the treatment of psychiatric comorbidities, while municipalities have overall responsibility for long-term rehabilitation through social services, for example in so-called ‘homes for care and living’ or ‘family homes’. Many of these ‘homes’ are privately operated.
Drug treatment in Sweden settings and number treated
NBYear of data 2015.
Trends in percentage of clients entering specialised drug treatment, by primary drug, in Sweden
NB Year of data 2015.
Opioid substitution treatment in Sweden proportions of clients in OST by medication and trends of the total number of clients
NB Year of data 2015.
OST can be prescribed by a medical doctor. Methadone (introduced in 1967) and buprenorphine-based medications (introduced in 1999) are the only officially recognised pharmaceutical substances used as OST; the national OST guidelines give priority to buprenorphinebased medication in OST treatment.
The majority of the total of around 38 000 treatment clients in Sweden during 2015, were treated in an outpatient setting. The number of clients treated in different treatment settings should, however, be treated with caution as it may be influenced by the availability of data. In general, the number of people entering treatment has increased in both inpatient and outpatient settings in recent years.
Treatment demand data indicate that a large proportion of people entering drug treatment are polydrug users; opioids and cannabis play an important role among drug treatment demands. It should be noted that in Sweden the treatment demand registration system has gone through several changes, which should be considered when interpreting the data.
The latest available data indicate that in 2015 a total of 3 679 clients were receiving OST in Sweden, of whom the majority received buprenorphine-based medication. OST has always been subject to strict regulation in Sweden. For example, some centres have introduced ‘zero tolerance’ against lateral illicit drug use. In cases of illicit drug use, clients are frequently referred to a different type of treatment.