Topics
1. National context
In Latvia, the national coordination body for drug treatment is the Riga Centre of Psychiatry and Addiction Disorders, which is responsible for delivery, accreditation, monitoring and evaluation of drug treatment. Drug treatment is mainly delivered by the Riga Centre of Psychiatry and Addiction Disorders, together with hospitals which operate under the supervision of the Ministry of Health and are funded by the state budget of the Health Payment Centre. Long-term inpatient drug treatment (rehabilitation) for children is provided through funds from the Ministry of Welfare. Drug treatment is also delivered by private, profit-making organisations.
Drug treatment services are available in outpatient and inpatient clinics, and in addiction units at general medical treatment institutions which are either publicly or privately funded. Increasingly, different private organisations are providing drug treatment services, both on an outpatient and inpatient basis. Furthermore, the Riga Centre of Psychiatry and Addiction Disorders provides inpatient detoxification for problem drug users and residential psychosocial treatment. Since 1996, the Riga Centre of Psychiatry and Addiction Disorders has been providing methadone maintenance treatment, and since 2005, maintenance treatment has been offered using buprenorphine.
Since 1996, the Riga Centre of Psychiatry and Addiction Disorders has been providing methadone maintenance treatment, and since 2005, maintenance treatment has been offered using buprenorphine. In 2009, the total number of clients in substitution treatment was 189, of whom 139 were on methadone and 50 on buprenorphine. An increase in the total number of clients compared to 2008 data is noted, due to the expansion of the methadone maintenance programme beyond the Centre in Riga.
2. Treatment registries and monitoring systems
Individual client records from inpatient and outpatient treatment facilities are traditionally kept by the State Addiction Agency (SAA). Treatment agencies are required by law to provide client data in the standardised format of patient registration cards to this centralised national register where they are entered and processed. Private sector facilities provide their records in aggregated form.
3. Treatment demand
| Clients in treatment | 2007 | 2008 | 2009 |
|---|---|---|---|
| Number of all clients entering treatment | 816 | 803 | N. Av. |
| % of which for opioid use | 65.7 | 60.0 | |
| % of which for cocaine use | 1.1 | 0.0 | |
| % of which for cannabis use | 5.7 | 18.8 | |
| % of which for stimulants use (other than cocaine) | 18.3 | 15.4 | |
| Number of new clients entering treatment | 1016 | 1146 | 474 |
| % of which for opioid use | 55.6 | 42.3 | 37.0 |
| % of which for cocaine use | 0.8 | 0.2 | 0.6 |
| % of which for cannabis use | 9.1 | 16.9 | 19.9 |
| % of which for stimulants use (other than cocaine) | 23.5 | 24.5 | 29.2 |
| 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. "All clients" data refer only to inpatient treatment units. ‘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 2005, 2007 (Tables TDI 4 and 5) 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 | Limited |
| 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 2008, 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 | 230 | 164 | 189 |
| of which with methadone | 100 | 103 | 139 |
| of which with buprenorphine | 130 | 61 | 50 |
| 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) | 1996 |
| Buprenorphine (HDBT) | 2005 |
| Heroin assisted treatment,including as trials | N.App. |
| Slow-release morphine | N.App. |
| Buprenorphine/naloxone combination | N. Av. |
| Notes: For a detailed European overview please see Table HSR-1 in the EMCDDA Statistical Bulletin 2010. ‘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 Latvia
- Country overview for Latvia
- 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.
Treatment inventories
