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Drug treatment overview for Malta

Map of Malta

1. National context

Drug treatment in Malta is delivered by Sedqa, the national agency against drugs and alcohol abuse, and the Substance Misuse Outpatient Unit (both of which are under the remit of the Ministry for Family and Social Solidarity) and the Substance Abuse Therapeutic Unit in the prison system; and the Dual Diagnosis Unit (DDU) with a special ward for female clients within Mount Carmel Hospital. These services are fully funded by the government. Two NGOs, Caritas and the OASI Foundation, which are partially funded by local government, also provide drug treatment in Malta, with the OASI Foundation active in Gozo.

These treatment providers deliver different types of treatment, which can be classified into several main categories: outpatient and low-threshold services, rehabilitation residential programmes, detoxification treatment and substitution maintenance treatment. NGO-based outpatient services offer long- or short-term support through social work, counselling, group therapy and psychological interventions, while low-threshold programmes offer day-care services.

There are three main residential rehabilitation programmes: a DDU within Mount Carmel Hospital, which offers help to drug users with mental health issues; a two-year programme provided by Caritas; and an 18-month programme provided by Sedqa. All programmes offer a holistic, multidisciplinary approach to therapy in a communal living environment and aim to guide clients towards abstinence. The OASI Foundation provides a short-term residential programme followed by continuing care sessions, and also offers day programmes. Detoxification is offered through an in-patient unit run by Sedqa.

A centralised methadone treatment unit in Malta, the Substance Misuse Outpatient Unit (SMOPU), provides substitution treatment. The Craig Hospital in Gozo also offers methadone treatment. Methadone maintenance treatment was introduced in 1987. In 2005 take-home methadone prescriptions were introduced, and in 2006 treatment with buprenorphine began, in addition to methadone. Buprenorphine is given as a take-home dose, and is available by prescription from either SMOPU or a general practitioner. However, the treatment is mainly initiated and administered by treatment centres, and only a few general practitioners offer substitution treatment. Opioid substitution treatment (OST) is also available in prisons. In 2013 a total of 1 078 clients were in OST, of which 976 received exclusively methadone. The remaining patients in substitution treatment switched medication, including buprenorphine-based medications and dihydrocodeine, during the year.

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2. Treatment registries and monitoring systems

The Maltese National Focal Point at the Ministry of Family and Social Solidarity collects the data on drug users in treatment. All Maltese treatment centres are covered by the Treatment Demand Indicator (TDI).

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3. Treatment demand

Table 1: Number of clients entering treatment in Malta by year
Clients in treatment 2010 2011 2012 2013
Number of all clients entering treatment 1936 1862 1874 1834
Number of all clients entering treatment with known primary drug 1907 1821 1869 1807
% of which for opioid use 80.9 78.7 75 74.8
% of which for cocaine use 11.4 12.5 13 14.4
% of which for cannabis use 5.6 6.7 8 7.9
% of which for stimulants use (other than cocaine) 0.6 0.9 0 2.2
Number of new clients entering treatment 313 203 266 220
Number of new clients entering treatment with known primary drug 306 183 264 199
% of which for opioid use  57.8 45.4 35 33.7
% of which for cocaine use  24.2 28.4 28 32.2
% of which for cannabis use  14.1 20.8 29 25.1
% of which for stimulants use (other than cocaine)  1.3 1.6 0 7.0
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.
‘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 Malta
Opioid substitution treatment 2010 2011 2012 2013
Number of clients in opioid substitution treatment 1119 1107 1094 1078
of which with methadone 1069 1013 1013 976
of which with buprenorphine N.Av. 37 32 3
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 Malta
Applied substances in opioid substitution treatment Officially introduced in
Methadone (MMT) 1987
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 Malta
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. 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.

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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

  • Sedqa (EN) - National agency against drugs and alcohol abuse

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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