Topics
1. National context
The General Healthcare and Programme Department within the Ministry of Public Health, coordinates and manages healthcare in the treatment of problem drug users, as well as the national health programmes with therapeutic and social reintegration components. Furthermore, since 2005, the National Anti-drug Agency has coordinated activities in the drugs field at both national and local level. Drug treatment is predominately delivered in public medical units, which are financed from the public budget and are operated under the coordination of the Ministry of Public Health and starting with 2007, by the Drug Prevention, Evaluation and Counselling Centres under the coordination of the National Anti-drug Agency. In addition, a number of NGOs provide drug treatment such as counselling and methadone substitution treatment. In general, drug treatment is funded by the national health programmes, through the specific sub-programme for drug treatment.
The drug treatment system in Romania is classified into three levels of assistance and care. The first level is the main access path to integrated care for drug users and provides treatment at primary medical assistance units, emergency rooms, and general social services delivered by public, private and non-governmental organisations. The second level is called the integrated care services. These are referral centres, operated exclusively by public treatment services, which provide psychiatric units for primary or specialised care, or for mental health treatment. The third level relates to highly specialised care, and consists of inpatient detoxification treatment and residential therapeutic communities. After-care services were poorly developed, with one centre in the public network (near Bucharest) and several foundations and NGOs offering assistance. Treatment centres were financed through a special budget line in the public authority budget.
Methadone was introduced in 1998, buprenorphine followed in 2007 and the combination buprenorphine/naloxone in 2008, however there are not reported clients for the two latter substitution medication. The legal procedures for entering into substitution treatment were under revision in 2005, in order to simplify access to treatment.
However, the coverage rate is estimated to be low with 424 clients in opioid substitution treatment, of whom 187 are receiving methadone substitution treatment and 88 buprenorphine in 2009.
2. Treatment registries and monitoring systems
In 2005, the Romanian Monitoring Centre for Drugs and Drug Addiction started to implement a project aimed at improving its data collection network. The treatment centres reporting data received a computer with special software designed to collect individual data in an anonymous manner. These data are collected by the Romanian Monitoring Centre for Drugs and Drug Addiction. Collection started for Bucharest in 2005 and at a national level in 2006. The data collection fiche is fully compatible with the EU protocol and has been approved by government decision.
3. Treatment demand
| Clients in treatment | 2007 | 2008 | 2009 |
|---|---|---|---|
| Number of all clients entering treatment | 1891 | 1962 | 1689 |
| % of which for opioid use | 70.8 | 74.3 | 77.1 |
| % of which for cocaine use | 0.6 | 0.6 | 0.8 |
| % of which for cannabis use | 7.5 | 6.2 | 6.2 |
| % of which for stimulants use (other than cocaine) | 1.3 | 0.3 | 0.4 |
| Number of new clients entering treatment | 1126 | 1078 | 1008 |
| % of which for opioid use | 68.3 | 67.7 | 70.0 |
| % of which for cocaine use | 1.1 | 0.9 | 1.3 |
| % of which for cannabis use | 11.6 | 9.7 | 9.2 |
| % of which for stimulants use (other than cocaine) | 1.4 | 0.3 | 0.5 |
| 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. 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 | Limited |
| Psychosocial in-patient interventions | Limited |
| 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 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 | 639 | N. Av. | 424 |
| of which with methadone | 639 | N. Av. | 187 |
| of which with buprenorphine | 0 | 0 | 88 |
| 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) | 1998 |
| Buprenorphine (HDBT) | 2007 |
| Heroin assisted treatment,including as trials | N.App. |
| Slow-release morphine | N.App. |
| Buprenorphine/naloxone combination | 2008 |
| 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? | Yes | 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 Romania
- Country overview for Romania
- 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.
- Dependenta (RO, EN)
- Teen Challenge Romania (RO, EN)
- Foundation for Community Care Services (RO, EN)
- C.E.T.T.T. "Sf. Stelian" (RO)
- Blue Cross Romania (EN/DE)
- Asociatia Romana Anti SIDA (RO)
- Alianta pentru Lupta Impotriva Alcoolismului si Toxicomaniilor (RO)
Treatment inventories
