Topics
1. National context
In Slovenia, on the national level drug-related treatment is regularly provided by different systems of health, social and civil society organisations (NGOs). Implementation of treatment is carried out on a formal legal basis under two acts: the Health Care and Health Insurance Act (Official Gazette 9/92); and the Prevention of the Use of Illicit Drugs and Dealing with Consumers of Illicit Drugs Act (Official Gazette 98/99).
The main financial actor in funding drug-related treatment in the health sphere is the Health Insurance Institute of Slovenia. Responsibility for implementing treatment lies predominantly at the national level. The public sector is the main actor involved in the delivery of drug-related treatment, mainly medically-assisted treatment. However, some drug-related treatment is also delivered by NGOs, which are supported by public funding.
Drug-related treatment is available within the framework of the public health national service network. Treatment takes place primarily at one of 18 Centres for the Prevention and Treatment of Illicit Drug Addiction (CPTDAs), which are run as a franchise or as a public health service. The legislative basis of the work of CPTDAs, and the provision of drug related health services, is defined in four laws: the Law on the Prevention of Illicit Drug Use; the Law on Health Care and Health Insurance; the Law on Drugs and Medicine Accessories; and the law on the Health Service. To provide hospital and treatment at special clinics, the government has established a public health institute — the Centre for the Treatment of Drug Addicts — at the Ljubljana Psychiatric Clinic. Hospital treatment includes hospital detoxification, psychosocial-therapeutic treatment, prolonged treatment and health rehabilitation. Hospital and clinical programmes of treatment, and maintenance with methadone and other substitution medication, are under the supervision of the Health Council.
The Commission for Controlling the Work of the CPTDAs, appointed by the Minister of Health, oversees the treatment centres. This commission checks, amongst other items, the documentation, human resources and equipment of the centres, the scope of work performed, their methadone maintenance programmes and consultation-based treatment.
The treatment system in Slovenia can be classified into four categories: (i) outpatient treatment, (ii) inpatient treatment, (iii) detoxification, and (iv) substitution maintenance treatment. Outpatient treatment involves the majority of treated drug users, and the most frequent treatment is substitution treatment (mostly with methadone). It also includes psychosocial interventions, medically-assisted treatment, individual or group counselling and a socio- or psychotherapy component. Inpatient drug treatment consists mainly of psychosocial interventions, yet may also be pharmacologically-assisted in terms of withdrawal treatment. Detoxification treatment may take place in inpatient or outpatient settings. Inpatient treatment offerings include detoxification and treatment lasting six to eight weeks.
Substitution treatment with methadone, which was introduced in 1990, is provided either by the doctors employed in these outpatient clinics or by general practitioners, who practice at the CPTDAs, although not commonly.
Buprenorphine was registered in 2004 and in 2005 slow-release morphine became also available. These two medications have contributed to the increased diversification of opioid maintenance treatment options. Treatment with naltrexone is also possible in the framework of the CPTDAs network or the CTDA. The buprenorphine/naloxone combination was introduced in 2007.
In 2007, the total number of clients in opioid substitution treatment it was estimated to be 1 032. According to data of the coordination of the CPTDA and CTDA, the total number of clients in opioid substitution treatment in 2007 was 2 901.
2. Treatment registries and monitoring systems
There is no national register of drug users, but CPTDAs adhere to a national monitoring system and report individual client data to the national Institute of Public Health, protecting the anonymity of clients through the use of a special code. However, the personal data of treated clients are not reported to the national Health Insurance institute.
3. Treatment demand
| Clients in treatment | 2003 | 2005 | 2007 |
|---|---|---|---|
| Number of all clients entering treatment | 1485 | 634 | 689 |
| % of which for opioid use | 88.0 | 91.1 | 95.8 |
| % of which for cocaine use | 0.8 | 1.3 | 0.9 |
| % of which for cannabis use | 10.4 | 7.0 | 3.1 |
| % of which for stimulants use (other than cocaine) | 0.5 | 0.3 | 0.1 |
| Number of new clients entering treatment | 504 | 342 | 276 |
| % of which for opioid use | 79.4 | 77.6 | 92.8 |
| % of which for cocaine use | 1.0 | 1.1 | 0.4 |
| % of which for cannabis use | 18.3 | 19.6 | 6.5 |
| % of which for stimulants use (other than cocaine) | 1.0 | 1.2 | 0.4 |
| 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 2008 and TDI tables (ST34) V. 1.0-2007, questions 13.1.1 and 13.1.2. EMCDDA Statistical Bulletin 2005, 2007 (Tables TDI 4 and 5) and 2009 (Tables TDI 2 and 5). | |||
4. Treatment provision
| Type of treatment | Availability |
|---|---|
| Psychosocial out-patient interventions | Extensive |
| Psychosocial in-patient interventions | Extensive |
| Detoxification | Limited |
| 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):
Reitox national reports 2008, 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 | 2003 | 2005 | 2007 |
|---|---|---|---|
| Number of units providing substitution treatment | 19 | 19 | N. Av. |
| Number of clients in opioid substitution treatment | N. Av. | N. Av. | 1032 |
| of which with methadone | N. Av. | N. Av. | N. Av. |
| of which with buprenorphine | N. Av. | N. Av. | N. Av. |
| Notes: For a detailed European overview please see Table HSR-3 in the EMCDDA Statistical Bulletin 2009. ‘N. Av.’ stands for ‘No information available’. For an explanation of terms used, see the definitions of terms. Sources: Reitox national reports 2008, 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) | 1990 |
| Buprenorphine (HDBT) | 2005 |
| Heroin assisted treatment,including as trials | N.App. |
| Slow-release morphine | 2005 |
| Buprenorphine/naloxone combination | 2007 |
| Notes: For a detailed European overview please see Table HSR-1 in the EMCDDA Statistical Bulletin 2009. ‘N. App.’ stands for ‘Not applicable’. For an explanation of terms used, see the definitions of terms. Sources: Reitox national reports 2008, 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 office-based specialised medical doctors have the right to initiate the prescription of substitution treatment? | Yes | Yes |
| Notes: For a detailed European overview please see Table HSR-2 in the EMCDDA Statistical Bulletin 2009. 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 2008, 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 Slovenia
- Country overview for Slovenia
- 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
Treatment research centres