Topics
1. National context
Drug treatment in Malta is delivered by Sedqa, the National Drugs Agency, the Substance Abuse Therapeutic Unit, the Dual Diagnosis Unit and the Corradino Correctional Facility. These four services are fully funded by the government. Furthermore, two NGOs, namely Caritas and OASI Foundation, which are also partially funded by the local government, provide drug treatment in Malta, with the latter being active in Gozo.
These six treatment providers deliver different types of treatment, which can be classified into four main categories: outpatient community services, rehabilitation residential programmes, detoxification treatment and substitution maintenance treatment.
There are seven community outpatient services, which offer long- or short-term support through social work, counselling, group therapy and psychological interventions to persons with a drug problem. In terms of rehabilitation programmes, there are two main residential programmes, a two-year programme provided by Caritas, and an 18-month programme provided by Sedqa. Both programmes offer a holistic, multi-disciplinary approach to therapy in a communal living environment and aim to guide clients towards abstinence. Furthermore, the OASI Foundation provides a short-term residential programme followed by continued care sessions. The same foundation also offers day programmes.
Substitution treatment is provided by a centralised methadone treatment unit in Malta, the Substance Misuse Outpatient Unit (SMOPU). The Craig Hospital in Gozo also offers methadone treatment. Methadone maintenance treatment was introduced in 1987. Furthermore, 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. In 2009, there were a total of 1 099 clients in opioid substitution treatment, 977 of them receiving methadone, and 42, buprenorphine. In Malta, substitution treatment is mainly initiated and administered by treatment centres, and only a few general practitioners offer substitution treatment.
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).
3. Treatment demand
| Clients in treatment | 2007 | 2008 | 2009 |
|---|---|---|---|
| Number of all clients entering treatment | N. Av. | N. Av. | 1792 |
| % of which for opioid use | 83.4 | ||
| % of which for cocaine use | 10.0 | ||
| % of which for cannabis use | 5.5 | ||
| % of which for stimulants use (other than cocaine) | 0.8 | ||
| Number of new clients entering treatment | N. Av. | N. Av. | 250 |
| % of which for opioid use | 46.3 | ||
| % of which for cocaine use | 30.9 | ||
| % of which for cannabis use | 19.5 | ||
| % of which for stimulants use (other than cocaine) | 1.6 | ||
| 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 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 | N. Av. |
| Psychosocial in-patient interventions | N. Av. |
| Detoxification | N. Av. |
| Substitution/maintenance treatment | N. Av. |
| Notes: ‘N. Av.’ stands for ‘No information available’. 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 | N. Av. | N. Av. | 1099 |
| of which with methadone | N. Av. | N. Av. | 977 |
| of which with buprenorphine | N. Av. | N. Av. | 42 |
| 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) | 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 Table HSR-1 in the EMCDDA Statistical Bulletin 2011. ‘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 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. | Yes |
| 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 Malta
- Country overview for Malta
- 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
- Sedqa (EN) - National agency against drugs and alcohol abuse
