EMCDDA Home
  • EN
Search

Drug treatment overview for Croatia

Map of Croatia

1. National context

Drug-related treatment in Croatia is the responsibility of the Ministry of Health and Social Welfare, while certain types of treatment (such as programmes for young drug users, rehabilitation and re-socialisation of drug addicts) are the responsibility of the Ministry of Social Policy and Youth. Drug treatment in prisons is the responsibility of the Ministry of Justice. Treatment services that are under the state’s authority are funded by the Ministry of Health and Social Affairs, the counties and the Croatian Institute for Health Insurance. Therapeutic communities or some associations are funded by the Office for Combating Drug Abuse of the Government of the Republic of Croatia, the Ministry of Health, the counties and also other donors.

The central element of the Croatian drug treatment system is the provision of care through outpatient treatment facilities; at the same time, hospital-based inpatient treatment and seven therapeutic communities are also available. Across Croatia there are 33 inpatient treatment centres and 23 outpatient treatment centres. Outpatient treatment is organised through a network of services for mental health promotion, addiction prevention and county institutes of public health. These services include individual and group psychotherapy, prescription and the continuation of OST and other pharmacological treatments, and testing and counselling on a wide range of issues. In terms of modalities, medication-based treatment prevails. Inpatient treatment is provided by hospitals, and covers detoxification, adjustment of pharmacotherapy, drug-free programmes, and individual and group psychosocial treatment. Teams of general medicine physicians cooperate closely with specialised treatment programmes in particular on the continuation of OST. Therapeutic communities offer long-term rehabilitation options. Since 2009 efforts have been made to standardise and professionalise activities at therapeutic communities.

Psychosocial treatment, focused on the enhancement of interpersonal relationships and life situation of clients, can be provided as part of a drug-free treatment approach, but frequently also complements OST and other treatment forms. In order to standardise the delivery of psychosocial treatment, guidelines for the psychosocial treatment of drug users in the healthcare, social and prison system were adopted in 2014.

Methadone was introduced in 1991 and is currently used within the following types of treatment: short-term inpatient detoxification; extended outpatient detoxification; and short- and long-term maintenance treatment. Substitution with buprenorphine was introduced in 2004, and there has been a steady increase in the proportion of clients receiving buprenorphine since 2006, when the Croatian Institute for Health Insurance began covering the costs of such treatment; since 2012 more than half of the opioid substitution treatment clients received buprenorphine as a substitute. Only specialist office-based medical doctors (e.g. general practitioners) and treatment centres can prescribe substitution treatment. However, this treatment is predominantly administered by general practitioners. OST is also available in prison settings. In 2006 guidelines for the use of methadone in the substitution therapy of opiate drug users were adopted by the Croatian government. In December 2006 guidelines for the use of buprenorphine in opioid substitution therapy 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 2013 the total number of clients in substitution treatment was 6 315, of whom 2 603 were on methadone and 2 635 were on buprenorphine-based medication.

top of page

 

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. 

top of page

3. Treatment demand

Table 1: Number of clients entering treatment in Croatia by year
Clients in treatment 2009 2010 2012 2013
Number of all clients entering treatment 7733 7550  7855 7858
Number of all clients entering treatment with known primary drug     7855 7858
% of which for opioid use 80.8  81.8 81 80.4
% of which for cocaine use 1.8  1.6 2 1.5
% of which for cannabis use 10.3  11.4 13 13.3
% of which for stimulants use (other than cocaine) 2.5  1.6 1 1.3
Number of new clients entering treatment 1463 1180  1120 1126
Number of new clients entering treatment with known primary drug     1120 1126
% of which for opioid use 45.6  36.5  28 24.0
% of which for cocaine use 3.5  4.2  4 2.6
% of which for cannabis use 34.0  45.8  56 58.4
% of which for stimulants use (other than cocaine) 3.7  2.3  2 2.8
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 2014 and TDI tables.
EMCDDA Statistical Bulletin 2015.

top of page

4. Treatment provision

Table 2: Opioid substitution treatment provision in Croatia
Opioid substitution treatment 2009 2010 2012 2013
Number of clients in opioid substitution treatment 3812 5035 4565 6315
of which with methadone 1520 2686 2229 2603
of which with buprenorphine N.Av. 2349 2336 2635
Notes:
For a detailed European overview please see the EMCDDA Statistical Bulletin 2015 (HSR section).
‘N. Av.’ stands for ‘No information available’.
For an explanation of terms used, see the definitions of terms.
Sources:
Standard Table 24 (ST24) on 'Treatment availability' submitted in 2014.
Table 3: Year of official introduction of opioid substitution treatment substances in Croatia
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 the EMCDDA Statistical Bulletin 2015 (HSR section).
‘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
Table 4: Legal framework of opioid substitution treatment in Croatia
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 the EMCDDA Statistical Bulletin 2015 (HSR section).
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:
Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2014.

top of page

5. References and links

Related EMCDDA resources

 

External links

Please note that the EMCDDA is not responsible for the content of external sites.

Treatment inventories

top of page

About the EMCDDA

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the reference point on drugs and drug addiction information in Europe. Inaugurated in Lisbon in 1995, it is one of the EU's decentralised agencies. Read more >>

Contact us

EMCDDA
Praça Europa 1, Cais do Sodré
1249-289 Lisbon
Portugal
Tel. (351) 211 21 02 00
Fax (351) 218 13 17 11

More contact options >>

Page last updated: Friday, 22 May 2015