Topics
1. National context
Drug-related treatment in Croatia falls under the responsibility of the Ministry of Health and Social Welfare, whereas the implementation of treatment programs falls under the responsibility of outpatient services for mental health and addiction prevention, general practitioners, hospital institutions, non-governmental organisations and therapeutic communities. Treatment services which are under the state’s authority are funded by the Ministry of Health and Social Welfare, the counties and the Croatian Institute for Health Insurance. Non-governmental organisations are funded by the Office for Combating Drugs Abuse of the Government of the Republic of Croatia, the Ministry of Health and Social Welfare and the counties. In all Croatian counties, there are Services for Mental Health and Drug Addiction Prevention, which are organised within the county Institutes of Public Health. These services are obliged to collect and send data on treated persons to the Croatian Institute of Public Health.
Treatment services in Croatia can be classified into three main areas: inpatient treatment; outpatient treatment; and rehabilitation therapeutic communities. Across Croatia, there are 33 inpatient treatment centres and 23 outpatient treatment centres. Drug treatment services are provided by national agencies and NGOs. In Croatia, methadone substitution treatment was introduced in the early 1990s and is currently used within three types of treatment: short-term outpatient detoxification; extended outpatient detoxification; and long-term maintenance treatment. The substitution with Buprenoprhine was introduced in 2004 and since 2006, when the Croatian Institute of Public Health started to cover the costs of such treatment, a steadily increase in proportion of clients receiving Buprenorphine is observed. Specialised medical doctors and treatment centres order substitution treatment. However, treatment itself is predominantly provided by general practitioners. In 2006, ‘Guidelines for the use of methadone in the substitution therapy of opiate drug users’ were adopted by the Croatian government. Furthermore, in December 2006 ‘Guidelines for the use of buprenorphine in the substitution therapy of opiate drug users’ were also approved by the Commission for Combating Drug Abuse of the Government of the Republic of Croatia. In 2009 a decision was taken to introduce suboxone as an alternative substitution substance.
In 2009, the total number of clients in substitution treatment was 4 684, of whom 2 333 were on methadone and 2 292 on buprenorphine.
2. Treatment registries and monitoring systems
All individual client data from inpatient and outpatient treatment facilities have to be reported into the Register of Persons Treated for Psychoactive Drugs Misuse.
3. Treatment demand
| Clients in treatment | 2007 | 2008 | 2009 |
|---|---|---|---|
| Number of all clients entering treatment | 7464 | 7506 | 7733 |
| % of which for opioid use | 76.4 | 77.9 | 80.8 |
| % of which for cocaine use | 2.0 | 2.0 | 1.8 |
| % of which for cannabis use | 13.3 | 13.1 | 10.3 |
| % of which for stimulants use (other than cocaine) | 4.7 | 0.9 | 2.5 |
| Number of new clients entering treatment | 1779 | 1700 | 1463 |
| % of which for opioid use | 45.0 | 45.2 | 45.6 |
| % of which for cocaine use | 4.5 | 3.8 | 3.5 |
| % of which for cannabis use | 31.3 | 36.1 | 34.0 |
| % of which for stimulants use (other than cocaine) | 10.3 | 2.0 | 3.7 |
| Notes: The variation across time, in particular with regard to the absolute numbers of clients in treatment, should be interpreted with caution as coverage data may have changed over time. For further information on coverage details please refer to the relevant EMCDDA Statistical Bulletin. For an explanation of terms used, see the definitions of terms. Sources: Reitox national reports 2009 and TDI tables (ST34) V. 1.0-2007, questions 13.1.1 and 13.1.2. EMCDDA Statistical Bulletin 2009 and 2011 (Tables TDI 2 and 5). | |||
4. Treatment provision
| Type of treatment | Availability |
|---|---|
| Psychosocial out-patient interventions | N. Av. |
| Psychosocial in-patient interventions | N. Av. |
| Detoxification | N. Av. |
| Substitution/maintenance treatment | N. Av. |
| Notes: ‘N. Av.’ stands for ‘No information available’. For an explanation of terms used, see the definitions of terms. Based on question 3.1 " Please assess the current availability of the treatment interventions below in relation to the user needs, judging the degree to which treatment capacity matches the demand" of Structured Questionnaire SQ27P1 on 'Treatment programmes'. Rating Scale (level of availability):
Reitox national reports 2009, Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2008 and 2005, Standard Tables 24 (ST24) on 'Treatment availability' submitted in 2004, 2006 and 2008. | |
| Opioid substitution treatment | 2007 | 2008 | 2009 |
|---|---|---|---|
| Number of clients in opioid substitution treatment | 2016 | 2307 | 4684 |
| of which with methadone | 852 | 877 | 2333 |
| of which with buprenorphine | 1164 | 1430 | 2292 |
| Notes: For a detailed European overview please see Table HSR-3 in the EMCDDA Statistical Bulletin 2011. ‘N. Av.’ stands for ‘No information available’. For an explanation of terms used, see the definitions of terms. Sources: Reitox national reports 2009, Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2008 and 2005, Standard Tables 24 (ST24) on 'Treatment availability' submitted in 2004, 2006 and 2008. | |||
| Applied substances in opioid substitution treatment | Officially introduced in |
|---|---|
| Methadone (MMT) | 1991 |
| Buprenorphine (HDBT) | 2006 |
| Heroin assisted treatment,including as trials | N.App. |
| Slow-release morphine | N. Av. |
| Buprenorphine/naloxone combination | N. Av. |
| Notes: For a detailed European overview please see Table HSR-1 in the EMCDDA Statistical Bulletin 2011. ‘N. App.’ stands for ‘Not applicable’. ‘N. Av.’ stands for ‘No information available’. For an explanation of terms used, see the definitions of terms. Sources: Reitox national reports 2009, Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2008 and 2005, Standard Tables 24 (ST24) on 'Treatment availability' submitted in 2004, 2006 and 2008. | |
| Legal framework of opioid substitution treatment | Methadone | Buprenorphine |
|---|---|---|
| Do office-based medical doctors have the right to initiate the prescription of substitution treatment? | Yes | Yes |
| Do specialised medical doctors have the right to initiate the prescription of substitution treatment? | Yes | Yes |
| Notes: For a detailed European overview please see Table HSR-2 in the EMCDDA Statistical Bulletin 2011. For an explanation of terms used, see the definitions of terms. 'Specialised medical doctors' refers to specifically trained or accredited office-based medical doctors. Sources: Reitox national reports 2009, Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2008 and 2005, Standard Tables 24 (ST24) on 'Treatment availability' submitted in 2004, 2006 and 2008. | ||
Treatment availablity in Europe
The graphic below presents an overview of treatment provision by different types of service (psychosocial outpatient, substitution, psychosocial inpatient and detoxification) in different European countries and can be used for comparative purposes. Click on the thumbnail to view it.
Figure 1: Treatment availability in Europe, 2007
5. References and links
Related EMCDDA resources
- Health and social responses statistics
- Treatment demand statistics
- Annual report on the state of the drugs problem
- National reports for Croatia
- Country overview for Croatia
- Drug treatment responses page
- Best practice portal
- Treatment demand key indicator page
For a comprehensive overview on drug treatment systems, availability and utilisation in Europe, please consult the 2008 online report on ‘Quality of treatment services in Europe — drug treatment — situation and exchange of good practice’ published by the Directorate General for Health and Consumers.
External links
Please note that the EMCDDA is not responsible for the content of external sites.
- Croatian central bureau of statistics (HR, EN)
- Croatian national institute of public health (HR, EN)
Treatment inventories
