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Drug treatment overview for Lithuania

Map of Lithuania

1. National context

Drug treatment in Lithuania is provided mostly by public and private agencies. Coordination, implementation and provision of drug treatment are conducted at the local level. The main funding bodies of the different treatment services are the national budget, national health insurance and municipal budgets. Four regional counties and one municipality financed specialised treatment centres (Centres for Addictive Disorders) at the regional level until end of 2012; however, in 2013 the cost of these centres’ operation was transferred to the state budget.

Outpatient drug treatment is provided by 282 public mental health centres, primary healthcare institutions and through private medical institutions that have obtained a special licence. Outpatient drug treatment is also provided in Centres for Addictive Disorders. There are five regional public specialised Centres for Addictive Disorders, which are located across the country and provide outpatient and inpatient services. These centres offer treatment of one to three months by group psychotherapy, acupuncture and counselling, and they also provide methadone maintenance treatment. Inpatient treatment, such as withdrawal treatment and residential treatment, is delivered by the specialised Centres for Addictive Disorders, while detoxification services are available through toxicological units in general hospitals or in private toxicology centres. Special treatment programmes are available for children who are dependent on psychoactive substances, including two long-term rehabilitation communities. In addition, 22 long-term rehabilitation centres and seven day centres are operating across the country.

Opioid substitution treatment (OST) with methadone has been implemented since 1995, and treatment commenced in three cities in 1996. Buprenorphine treatment has been available since late 2002 throughout specialised mental healthcare institutions, and Suboxon is also registered in the country. The provision of OST is guided by Order No. 702 of the Ministry of Health, which restricts the implementation of methadone and buprenorphine treatment to treatment centres. In 2011 the Order from the Ministry of Health further amended Order No 702, clarifying criteria and procedures for the application of OST, and proposed a procedure for an annual assessment of OST’s effectiveness for clients. OST has been prescribed by a decision of a consultative commission since its initiation in Lithuania; however, in 2014 a decree was adopted that will allow psychiatrists to issue a prescription for the treatment based on indications. As of 1 January 2013 there were 19 healthcare institutions in 12 cities providing the treatment. In 2013 some 592 clients received OST, of which 518 were in methadone maintenance treatment and 74 received buprenorphine-based treatment. Methadone maintenance is continued for clients in police custody; however, it is discontinued if a client is transferred to prison. OST is not available in Lithuanian prisons.

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2. Treatment registries and monitoring systems

Client data are collected from 74 treatments centres out of 268 which have a licence to provide treatment to drug addicts, and reported to the State Mental Health Centre. The Centre for Addictive Disorders in Vilnius runs since 1995 a national registry which contains the names of clients in methadone substitution treatment.

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3. Treatment demand

Table 1: Number of clients entering treatment in Lithuania by year
Clients in treatment 2010 2011 2012 2013
Number of all clients entering treatment N. Av. N. Av. N.Av. 2209
Number of all clients entering treatment with known primary drug   251   2209
% of which for opioid use   72.1   86.8
% of which for cocaine use   0.8   0.6
% of which for cannabis use   3.6   2.9
% of which for stimulants use (other than cocaine)   2.0   3.8
Number of new clients entering treatment 328 251 212 341
Number of new clients entering treatment with known primary drug 328 251 212 341
% of which for opioid use 78.6 72.1 66 62.8
% of which for cocaine use 0.3 0.8 0 1.8
% of which for cannabis use N.Av. 3.6 3 11.7
% of which for stimulants use (other than cocaine) 2.8 2.0 6 10.9
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.
Limited comparability with TDI standards.
‘N. Av.’ stands for ‘No information available’.
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 Lithuania
Opioid substitution treatment 2010 2011 2012 2013
Number of clients in opioid substitution treatment 904 798 687 592
of which with methadone 904 798 636 518
of which with buprenorphine 0 0 0 74
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 Lithuania
Applied substances in opioid substitution treatment Officially introduced in
Methadone (MMT) 1995
Buprenorphine (HDBT) 2002
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 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 Lithuania
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