Croatia Country Drug Report 2019

Treatment

The treatment system

The National Strategy on Combating Drug Abuse 2012-17 and the related action plan emphasise the enhancement of treatment quality to meet clients’ needs. In Croatia, treatment is primarily implemented in the healthcare system and certain forms of psychosocial treatment are also available through the social welfare system, in therapeutic communities and associations, and in the prison and probation systems. In addition, treatment of minors or young adults is also provided in homes for children without adequate parental care and for children and young people with behavioural disorders.

Treatment services carried out under the authority of the state are funded by the Ministry of Health, the counties and the Croatian Institute for Health Insurance.

The central element of the Croatian drug treatment system is the provision of care through outpatient treatment facilities and primary healthcare, although hospital-based inpatient treatment and therapeutic communities are also available. Outpatient treatment is organised through a network of services for mental health promotion and dependence prevention at county institutes of public health. These services include individual and group psychotherapy, prescription and continuation of opioid substitution treatment (OST) and other pharmacological treatments, testing and counselling on a wide range of issues. Medication-based treatment is the most common treatment modality. Outpatient drug treatment is also provided by some associations that provide psychosocial treatment alongside social reintegration interventions and by units in general hospitals. Inpatient treatment is provided by hospitals and covers detoxification, drug-free programmes, and individual and group psychosocial treatment. Therapeutic communities offer long-term rehabilitation options.

OST using methadone was introduced in 1991, buprenorphine was introduced in 2004 and Suboxone was introduced in 2009. Only specialised office-based medical doctors and treatment centres can prescribe OST; however, it is predominantly administered by general practitioners.

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Treatment provision

In 2017, over 7 100 people were treated in Croatia, mostly in outpatient settings. Opioids, mainly heroin, remain the most common primary problem drug among all clients entering treatment, and OST is the most common treatment. In 2017, half of the clients enrolled in OST were prescribed buprenorphine-based medications and the other half were prescribed methadone.

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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.