Estonia Country Drug Report 2019

Treatment

The treatment system

The National Health Plan 2009-20 defines 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), with the remainder allocated to 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 to provide inpatient and outpatient treatment for dependency. According to the Mental Health Act (RT I 1997, 16, 260), only psychiatrists can provide 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. Other available treatment interventions include detoxification, drug-free treatment and inpatient rehabilitation programmes. Special drug treatment programmes for children, adolescents and people with a dual diagnosis are also available, although treatment options for these groups and for people who inject amphetamines remain limited.

In 2017, methadone maintenance treatment was offered at eight treatment sites in five regions.

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Treatment provision

In 2017, 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). Most of those who entered treatment received OST, with methadone being the most commonly prescribed OST medication in Estonia. Although the coverage of OST is not known, it is assumed to be relatively low.

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Estonia main page

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.