Topics
1. National context
The implementation of drug treatment is the responsibility of the Slovakian Government, and falls under the responsibility of the Ministry of Health. Treatment is mainly delivered through public specialised Centres for Treatment of Drug Dependencies, psychiatric hospitals, and psychiatric wards at university hospitals and general hospitals. Drug treatment is also provided by private providers. In Slovakia, drug treatment is funded by public health insurance.
Specialised health services tailored to the emerging need for drug dependence treatment have been established in Slovakia since 1989. During the second half of the 1990s, private facilities also began to operate. Centres for treatment of drug dependencies are the main provider of all types of drug treatment. Drug treatment can be divided into four phases: (i) pre-clinical treatment (ii) detoxification treatment (iii) psychosocial treatment and (iv) social reintegration. Outpatient treatment, as a systematic therapeutic service, is provided by physicians and psychologists, nurses and psychotherapists. Residential drug treatment is delivered in inpatient departments, at specialised dependency treatment departments of psychiatric hospitals, and in specialised psychiatric institutes, known as Centres for Treatment of Drug Dependencies. Detoxification treatment is available in outpatient and inpatient treatment centres. Services concerning aftercare and social reintegration for drug-dependent persons are provided by non-governmental organisations outside the healthcare sector, in residential facilities or as self-help groups.
Substitution maintenance treatment is provided by specialised drug addiction treatment offices. Methadone maintenance treatment is available since 1997 and buprenorphine since 1999. In 2008, the buprenorphine/naloxone combination was introduced and it may be prescribed by psychiatrists with an additional licence for treatment of drug dependencies or by psychiatrists working at Centres for the Treatment of Drug Dependencies.
In 2010, a total of 610 clients were in substitution treatment, 460 of whom were on methadone.
2. Treatment registries and monitoring systems
All the healthcare facilities in Slovakia including out- and inpatient treatment services and treatment in prison are obliged by law to report a treatment of drug addicts according to the Treatment Demand Indicator (TDI) protocol. (100% coverage). However, this protocol does not distinguish whether the client receives medically-assisted or drug-free treatment. Therefore, no special register exists for clients in medically-assisted, drug-free or substitution treatment.
3. Treatment demand
| Clients in treatment | 2008 | 2009 | 2010 |
|---|---|---|---|
| Number of all clients entering treatment | 2056 | 1909 | 2266 |
| % of which for opioid use | 45.5 | 42.3 | 38.2 |
| % of which for cocaine use | 0.6 | 0.6 | 0.8 |
| % of which for cannabis use | 16.5 | 18.8 | 19.4 |
| % of which for stimulants use (other than cocaine) | 29.1 | 30.5 | 35.4 |
| Number of new clients entering treatment | 937 | 893 | 1087 |
| % of which for opioid use | 30.8 | 29.4 | 25.7 |
| % of which for cocaine use | 0.9 | 0.9 | 1.2 |
| % of which for cannabis use | 22.9 | 28.9 | 26.8 |
| % of which for stimulants use (other than cocaine) | 39.1 | 34.8 | 41.0 |
| 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. For an explanation of terms used, see the definitions of terms. Sources: Reitox national reports 2011 and TDI tables (ST34) V. 1.0-2007, questions 13.1.1 and 13.1.2. EMCDDA Statistical Bulletin 2011 and 2012 (Tables TDI 2 and 5). | |||
4. Treatment provision
| Type of treatment | Availability |
|---|---|
| Psychosocial out-patient interventions | Full |
| Psychosocial in-patient interventions | Full |
| Detoxification | Full |
| Substitution/maintenance treatment | Full |
| 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):
Structured Questionnaire on 'Treatment programmes'(SQ27P1), submitted in 2011. | |
| Opioid substitution treatment | 2008 | 2009 | 2010 |
|---|---|---|---|
| Number of clients in opioid substitution treatment | 600 | 700 | 610 |
| of which with methadone | 480 | 500 | 460 |
| of which with buprenorphine | N.Av. | N. Av. | 150 |
| Notes: For a detailed European overview please see Table HSR-3 in the EMCDDA Statistical Bulletin 2012. ‘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 2011. | |||
| Applied substances in opioid substitution treatment | Officially introduced in |
|---|---|
| Methadone (MMT) | 1997 |
| Buprenorphine (HDBT) | 1999 |
| Heroin assisted treatment,including as trials | N.App. |
| Slow-release morphine | 2005 |
| Buprenorphine/naloxone combination | 2008 |
| Notes: For a detailed European overview please see Table HSR-1 in the EMCDDA Statistical Bulletin 2012. ‘N. App.’ stands for ‘Not applicable’. For an explanation of terms used, see the definitions of terms. Sources: Reitox national reports. | |
| 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 2012. 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 2011. | ||
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 Slovakia
- Country overview for Slovakia
- 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.
- Centre for Treatment of Drug Dependencies in Bratislava (SK)
- Centre for treatment of Drug dependencies in Predna Hora (SK)
- Public Health Authority of Slovak Republic in Banská Bystrica (SK, EN)
- Public Health Authority of Slovak Republic in Galanta (SK)
- Public Health Authority of Slovak Republic in Prešov (SK)
- National Monitoring Centre for Drugs (SK, EN)
Treatment inventories
- Infodrogy.sk (SK, EN)
Treatment research centres
