The National Drugs Policy puts an emphasis on synergies between service providers and other health and social professionals and institutions to ensure a multidisciplinary approach to treatment provision. There are five main drug treatment providers: three are funded by the government and two are non-governmental organisations (NGOs) partially funded by the government. These providers deliver different types of treatment, which can be classified into five main categories: (i) specialised outpatient services; (ii) low-threshold services; (iii) inpatient treatment programmes; (iv) detoxification treatment; and (v) opioid substitution treatment (OST). NGO-based outpatient services offer long- or short-term support through social work, counselling, group therapy and psychological interventions, while low-threshold programmes offer day-care services.
Five inpatient units are available in Malta, of which three are therapeutic communities. The residential programmes provide a holistic, multidisciplinary approach to therapy in a communal living environment, and aim to guide clients towards abstinence. One programme offers inpatient detoxification.
OST is provided by the Substance Misuse Outpatient Unit (SMOPU). Methadone maintenance treatment has been available in Malta since 1987, with take-home methadone prescriptions available since 2005. Buprenorphine was introduced in 2006. It is also available as a take-home treatment by prescription from either the SMOPU or a general practitioner. Dihydrocodeine is prescribed in rare instances.
Most clients entering drug treatment in 2017 were treated in outpatient settings. The majority sought treatment as a result of primary use of opioids, mainly heroin, followed by primary cocaine use. Since 2004, a steady increase has been observed in the number and proportion of primary cocaine treatment demands.
Most clients in treatment because of primary heroin use received OST. In 2017, over 1 000 clients were prescribed OST in Malta, and around 9 out of 10 of those received methadone.