Topics
1. National context
The provision of drug treatment falls under the responsibility of the regions and municipalities. More than half of drug treatment is delivered by NGOs, and actively purchased by the public services of the municipalities. Public treatment agencies and NGOs — operating mostly regionally — provide opioid substitution treatment and detoxification. Drug treatment is mainly funded by the public budget of the communities.
A description of drug treatment in Finland should take into account that problem alcohol use is a much greater problem in Finland than illicit drug problems. 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, namely: outpatient clinics, short-term inpatient care, long-term rehabilitation units, support services and peer support activities. Outpatient treatment covers outpatient treatment for all kinds of addictions, youth outpatient services, and outpatient services for problem drug users. 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 periods 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. However, a trend to move drug treatment to primary health is increasingly noticeable.
Substitution treatment is provided in inpatient and outpatient settings. It is typically provided through specialised units, although general practitioners are also allow to provide such treatment with only a few being reported to be involved. Methadone was introduced in Finland in 1974 and buprenorphine became available in 1997. The buprenorphine/naloxone combination was introduced in 2004, the first country in Europe were this substitution medication became available.
In 2009, it was estimated that approximately 1 800 clients were reported to be receiving opioid substitution treatment, 40 % of whom were on methadone and 60 % on buprenorphine.
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.
3. Treatment demand
| Clients in treatment | 2007 | 2008 | 2009 |
|---|---|---|---|
| Number of all clients entering treatment | 2221 | 1993 | 1907 |
| % of which for opioid use | 53.4 | 55.5 | 60.0 |
| % of which for cocaine use | 0.2 | 0.4 | 0.1 |
| % of which for cannabis use | 12.5 | 12.3 | 12.2 |
| % of which for stimulants use (other than cocaine) | 23.2 | 19.8 | 17.3 |
| Number of new clients entering treatment | 407 | 336 | 303 |
| % of which for opioid use | 36.4 | 35.4 | 37.0 |
| % of which for cocaine use | 0.3 | 1.2 | 0.0 |
| % of which for cannabis use | 27.9 | 26.8 | 33.3 |
| % of which for stimulants use (other than cocaine) | 24.1 | 24.4 | 18.1 |
| 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. Since 2004 the number of units covered by the TDI data collection has decreased. ‘N. Av.’ stands for ‘No information available’. 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 2007 (Tables TDI 4 and 5), 2009 and 2011 (Tables TDI 2 and 5). | |||
4. Treatment provision
| Type of treatment | Availability |
|---|---|
| Psychosocial out-patient interventions | Full |
| Psychosocial in-patient interventions | Extensive |
| Detoxification | Full |
| Substitution/maintenance treatment | Limited |
| Notes: 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 | 1200 | N. Av. | 1800 |
| of which with methadone | 540 | N. Av. | 720 |
| of which with buprenorphine | 660 | N. Av. | 1080 |
| 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) | 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 Table HSR-1 in the EMCDDA Statistical Bulletin 2011. ‘N. App.’ stands for ‘Not applicable’. 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? | 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 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 Finland
- Country overview for Finland
- 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.
- National Research and Development Centre for Welfare and Health (STAKES) (FI, SE, EN)
- A-Clinic Foundation (FI, SE, EN)
- Helsinki Deaconess Institute (FI, SE, EN)
- Kalliolan setlementin (FI)
- Kuopion Seudun Päihdepalvelusäätiö (FI)
- Myllyhoitoyhdistys (FI)
- The Finnish Blue Ribbon (FI, EN, RU)
- Academy of Finland (FI, SE, EN)
Treatment inventories
Treatment research centres
- The Alcohol and Drug Research Group produces information on social issues and problems of current interest related to alcohol and drugs (FI, SE, EN)
