Slovenia Country Drug Report 2019

Treatment

The treatment system

In Slovenia, the current national drug strategy stipulates that drug treatment must be comprehensive, ensure continuity of care and be accessible to all drug users. Responsibility for implementing treatment lies predominantly at the national level, and drug treatment is provided by various health and social care systems and civil society organisations.

The Health Insurance Institute of Slovenia funds drug treatment in the health sector, and treatment is free of charge to the client. Treatment programmes delivered through the social care system are mainly funded by the Ministry of Labour, Family, Social Affairs and Equal Opportunities and the municipalities, or by other external resources, and may require a co-payment from clients.

Drug-related outpatient treatment is available through the national network of public Centres for the Prevention and Treatment of Illicit Drug Addiction (CPTDAs) and from the Centre for the Treatment of Drug Addiction at the Ljubljana Psychiatric Hospital. The latter also provides inpatient treatment. Other psychiatric hospitals and psychiatric outpatient units within the primary healthcare system can also provide drug treatment. Non-governmental organisations, within the framework and funding of social welfare programmes, are involved mainly in the provision of treatment communities and non-hospital-based residential treatment programmes.

The available treatment approaches include detoxification; psychosocial interventions; opioid substitution treatment (OST) and other medically assisted treatments; individual or group counselling with a sociotherapy or psychotherapy component, including assistance with rehabilitation and social reintegration; and links to home nursing, therapeutic communities and self-help groups. An integrated treatment programme for drug users with mental comorbidities is available at the Ljubljana Psychiatric Hospital.

OST is provided only by CPTDAs and is free of charge to clients. Methadone was first introduced in 1990, while buprenorphine was registered in 2004, slow-release morphine in 2005 and buprenorphine/naloxone in 2007.

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Treatment provision

In Slovenia, the majority of clients who received drug treatment in 2017 were treated in outpatient settings, with low-threshold facilities playing an important role as a first point of access to specialised treatment services for high-risk drugs users.

The majority of clients who entered specialised treatment in 2017 did so as a result of opioid, mainly heroin, use, although treatment requests linked to opioid use have dramatically decreased since 2009. An increasing share of patients who have problems with opioids otherwise prescribed as substitution treatment have been reported in 2017.

Opioid users remain the main client population of the Slovenian treatment system, and in 2016 the majority received OST. The latest available data indicate that more than 3 000 clients received OST in 2016; methadone remains the most commonly used OST medication.

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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.