Denmark Country Drug Report 2018

Treatment

The treatment system

The main goals of Danish drug treatment policy are to achieve a reduction in drug use or to attain full abstinence through enhanced use of psychosocial interventions and systematic follow-up of treatment and to tackle problems other than those of illicit drug use. The municipalities are responsible for organising both the social and medical treatment of drug users, while the regions are responsible for psychiatric, primary and public healthcare. However, the Danish Health Authority and the National Board of Social Services bear responsibility at the central level for advising service providers on balanced and effective treatment interventions. The municipalities are responsible for referrals for medical and social treatment for drug use, and the preparation of a treatment plan is a mandatory action according to the Social Services Act.

Access to drug treatment is guaranteed within 14 days of the first contact or request from drug users over the age of 18 and, in some cases, for users who are under 18. People who are entitled to treatment may choose between public and private treatment programmes within the framework of a prescribed treatment plan, which is free of charge to the client. Drug treatment includes medical and social interventions and is delivered in close cooperation between the health and social sectors.

The most prevalent approaches to treatment in Denmark are cognitive, socio-educational and solution focused. Opioid users are predominantly treated in opioid substitution treatment (OST) programmes, in which pharmacological treatment is accompanied by psychosocial counselling. Outpatient treatment is available through specialised drug treatment centres, in drop-in centres and in low-threshold services. Inpatient treatment services mainly provide assessment for OST, focus on detoxification and provide non-hospital-based residential treatment programmes (such as ‘halfway houses’). Many inpatient units are privately owned. In recent years, new initiatives, such as a cannabis and cocaine project in Copenhagen, have been developed to address a specific demand for the treatment of cannabis and cocaine users, and several initiatives for socially marginalised drug users, drug users with concurrent mental disorders and underage young people are also supported.

 

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Treatment provision

Most clients admitted for treatment in 2015 were treated in outpatient settings, and the number of clients treated in inpatient settings has decreased significantly over the years. Nevertheless, the Danish treatment system permits flexibility and a client may be referred for day or inpatient treatment if a change in environment and/or a more structured intervention is needed.

Most clients admitted to treatment in 2015 were treated for primary cannabis use. Moreover, approximately half of clients entering treatment reported the use of more than one illicit drug. The provision of OST decreased slightly over the period 2010-14, while some increase was reported for 2015.The majority of clients in OST are treated with methadone. However, among new OST clients, the proportions treated with methadone and with buprenorphine-based medication are about equal. Approximately 450 people were admitted for treatment with medically prescribed heroin in 2015.

 

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Methodological note: Analysis of trends is based only on those countries providing sufficient data to describe changes over the period specified. The reader should also be aware that monitoring patterns and trends in a hidden and stigmatised behaviour like drug use is both practically and methodologically challenging. For this reason, multiple sources of data are used for the purposes of analysis in this report. Caution is therefore required in interpretation, in particular when countries are compared on any single measure. Detailed information on methodology and caveats and comments on the limitations in the information set available can be found in the EMCDDA Statistical Bulletin.