Topics
1. National context
At the national level, drug-related treatment is regularly provided by different systems of health, social and civil society non-government organisations (NGOs). 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 funder of 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 delivers most drug-related treatment, primarily medically assisted treatment. However, some drug-related treatment (mainly psychosocial interventions) is also delivered by NGOs, supported by public funding. In terms of government funding for new treatment methods, priority is given to abstinence-based treatment, or treatment that reduces harmful health consequences related to drug use.
Drug-related treatment is available within the framework of the public health national service network. Treatment takes place primarily at one of the 19 Centres for the Prevention and Treatment of 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 are defined in four laws: the Law on the Prevention of Illicit Drug Use and Treatment of Drug Users; the Law on Health Care and Health Insurance; the Law on Drugs and Medicine Accessories; and the Law on the Health Service. To provide inpatient treatment, the government has established a public health centre — the Centre for the Treatment of Drug Addicts — at the Ljubljana Psychiatric Clinic. All treatment programmes 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 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 has four categories: (i) outpatient treatment; (ii) inpatient treatment; (iii) detoxification; and (iv) substitution maintenance treatment. Outpatient treatment is used for the majority of treated drug users, and the most frequent treatment is substitution treatment. It also includes psychosocial interventions, medically assisted treatment, individual or group counselling and a socio- or psychotherapy component, including assistance in rehabilitation and social reintegration, links to home nursing, therapeutic communities and self-help groups. 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 sessions may last six to eight weeks. In 2009, an integrated treatment for drug users with mental co-morbidities was made available at the Psychiatric Clinic of Ljubljana.
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 practise at the CPTDAs.
Buprenorphine was registered in 2004, and slow-release morphine in 2005. These two medications have contributed to the increased diversification of opioid maintenance treatment options. Treatment with naltrexone is also available. The buprenorphine/naloxone combination was introduced in 2007.
In 2011 the total number of clients in opioid substitution treatment was estimated to be 3 557, of which 2 446 were on methadone maintenance, 811 received buprenorphine-based substitution treatment (476 of them suboxone) and 300 received short-release morphine.
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 | 2009 | 2010 | 2011 |
|---|---|---|---|
| Number of all clients entering treatment | 916 | 797 | 521 |
| Number of all clients entering treatment with known primary drug | 913 | 794 | 521 |
| % of which for opioid use | 87.5 | 90.9 | 86.6 |
| % of which for cocaine use | 4.6 | 2.5 | 3.5 |
| % of which for cannabis use | 6.5 | 5.4 | 8.4 |
| % of which for stimulants use (other than cocaine) | 0.5 | 0.4 | 0.6 |
| Number of new clients entering treatment | 371 | 277 | 207 |
| Number of new clients entering treatment with known primary drug | 370 | 275 | 207 |
| % of which for opioid use | 80.5 | 83.3 | 74.9 |
| % of which for cocaine use | 4.9 | 3.6 | 3.9 |
| % of which for cannabis use | 12.7 | 11.3 | 18.8 |
| % of which for stimulants use (other than cocaine) | 1.1 | 0.8 | 1.0 |
| 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 2012 and TDI tables (ST34) V. 1.0-2007, questions 13.1.1 and 13.1.2. EMCDDA Statistical Bulletin 2013 (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 | 2009 | 2010 | 2011 |
|---|---|---|---|
| Number of clients in opioid substitution treatment | 3324 | 3545 | 3557 |
| of which with methadone | 2498 | 2615 | 2446 |
| of which with buprenorphine | N. Av. | 674 | 811 |
| Notes: For a detailed European overview please see Table HSR-3 in the EMCDDA Statistical Bulletin 2013. ‘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) | 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 2013. ‘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? | Yes | Yes |
| Notes: For a detailed European overview please see Table HSR-2 in the EMCDDA Statistical Bulletin 2013. 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 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
