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Drug treatment overview for Finland

Map of Finland

1. National context

The provision of drug treatment falls under the responsibility of the regions and municipalities and is regulated by the Act on Welfare for Substance Abusers, the Social Welfare Act, the Mental Health Act and a Decree governing detoxification and substitution treatment for opioid addicts.

Specialised services are mainly provided by social welfare, while a trend to move drug treatment to primary health is increasingly noticeable. In particular this can be observed in the provision of opioid substitution treatment (OST), which has increasingly been transferred to health centres or pharmacies. Drug treatment is mainly funded by the public budget of the communities and delivered by NGOs or foundations, or public treatment agencies; however, long waiting times, the attitude of primary health providers and the distance to a specialised service are mentioned as obstacles for accessibility of treatment services.

Problem alcohol use is a much greater problem in Finland than is illicit drug use. Thus, there are more generic addiction treatment facilities than specific facilities, and this is the case for both outpatient and inpatient facilities. Drug treatment can be divided into five main categories: outpatient clinics; short-term inpatient care; long-term rehabilitation units; support services; and peer support activities. Outpatient services provide treatment for all kinds of addictions, and also include specialised youth outpatient services and outpatient services for problem drug users. They provide an assessment of mental and somatic status, counselling, individual, family or group therapy, referrals, detoxifications or OST. Short-term inpatient care refers to inpatient detoxification treatment, which is usually arranged in rehabilitation units, detoxification units or specialised healthcare services. The duration of the detoxification period varies from 24 hours to four weeks. Long-term rehabilitation includes residential psychosocial treatment for problem drug users, residential services for youth and psychiatric services for problem drug users. Support services include rehabilitative day-care centres and housing services. In addition, income-related activities, living and employment assistance are provided to facilitate treatment and recovery. Specialised medical care for addiction is also provided in emergency clinics and mental health services. It should be noted that available treatment is often focused on the needs of opioid users, while long-term treatment options for amphetamine users remain limited. The care guideline on the treatment of drug abuse was updated in 2012 and now incorporates guidelines for the treatment of users of new psychoactive substances and cannabis, emergency care cases, pregnant women, and ADHD and intoxicants users.

OST is provided in inpatient and outpatient settings. It is typically initiated in specialised inpatient units, after which clients are transferred to social outpatient services or health centres. General practitioners and pharmacies are increasingly involved in the provision of these services. Methadone was introduced in Finland in 1974 and buprenorphine became available in 1997. The buprenorphine/naloxone combination was introduced in 2004, making Finland the first country in Europe where this substitution medication became available.

In 2011 a total of 2 439 clients were reported to be receiving OST, of which 931 were on methadone and 1 508 were on buprenorphine-based medication.

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2. Treatment registries and monitoring systems

As part of the national drug treatment information system at STAKES, client data are collected on a voluntary and anonymous basis by the centres for prevention and treatment of illegal drug addiction. There is no other monitoring system or register of clients in treatment. 

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3. Treatment demand

Table 1: Number of clients entering treatment in Finland by year
Clients in treatment 2010 2011 2012 2013
Number of all clients entering treatment 1364 1443 1486 1099
Number of all clients entering treatment with known primary drug 1364 1443 1486 1099
% of which for opioid use 54.3 62.2 62 64.2
% of which for cocaine use 0.4 0.1 0 0.1
% of which for cannabis use 17.9 13.4 18 14.6
% of which for stimulants use (other than cocaine) 17.0 14.4 12 11.8
Number of new clients entering treatment 284 249 265 161
Number of new clients entering treatment with known primary drug 284 249 265 161
% of which for opioid use 33.5 43.8 38 40.4
% of which for cocaine use 0.4 0.0 0 0.0
% of which for cannabis use 44.0 32.9 43 34.2
% of which for stimulants use (other than cocaine) 12.3 12.4 10 13.0
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.

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4. Treatment provision

Table 2: Opioid substitution treatment provision in Finland
Opioid substitution treatment 2010 2011 2012 2013
Number of clients in opioid substitution treatment N.Av. 2439 N.Av. N.Av.
of which with methadone N.Av. 931 N.Av. N.Av.
of which with buprenorphine N.Av. 1508 N.Av. N.Av.
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 Finland
Applied substances in opioid substitution treatment Officially introduced in
Methadone (MMT) 1974
Buprenorphine (HDBT) 1997
Heroin assisted treatment,including as trials N.App.
Slow-release morphine N.App.
Buprenorphine/naloxone combination 2004
Notes:
For a detailed European overview please see the EMCDDA Statistical Bulletin 2015 (HSR section).
‘N. App.’ stands for ‘Not applicable’.
For an explanation of terms used, see the definitions of terms.
Sources:
Reitox national reports.
Table 4: Legal framework of opioid substitution treatment in Finland
Legal framework of opioid substitution treatment Methadone Buprenorphine
Do office-based medical doctors have the right to initiate the prescription of substitution treatment? N.App. N.App.
Do specialised medical doctors have the right to initiate the prescription of substitution treatment? N.App. N.App.
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.

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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

Treatment research centres

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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 >>

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Page last updated: Friday, 22 May 2015