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Table HSR-1. Year of introduction of methadone maintenance treatment (MMT), high-dosage buprenorphine treatment (HDBT), buprenorphine/naloxone combination, heroin-assisted treatment and slow-release morphine

CountryNotes MMTSources HDBTSources Buprenorphine/ naloxone combinationSources Heroin assisted treatment (including pilots)Sources Slow-release morphineSources
Belgium(1)1994320036n.a.201119n.a.
Bulgaria19968n.a.(2008)4n.a.200613
Czech Republic(2)199832000620084n.a.n.a.
Denmark1970519996:20084n.a.
Germany(3)19925, 1220006n.a.20033n.a.
Estonia20017(2003)6n.a.n.a.n.a.
Ireland19925(2002)3(2007)4n.a.n.a.
Greece199352002920063n.a.n.a.
Spain(4), (5), (6)19905(1996)10:20033n.a.
France1995519966n.a.n.a.:
Italy1975519996200714n.a.:
Cyprus:20073200817n.a.n.a.
Latvia1996720053:n.a.n.a.
Lithuania1995820026:n.a.n.a.
Luxembourg1989520026:n.a.20063
Hungary19957n.a.20073n.a.n.a.
Malta19871120063:n.a.:
Netherlands(7)1968519996:19983:
Austria198751999620083n.a.19981
Poland19937n.a.(2008)15n.a.n.a.
Portugal1977519996:n.a.n.a.
Romania19987(2007)3200817n.a.n.a.
Slovenia1990720056, 320074n.a.20051
Slovakia19978(1999)3200817n.a.20052
Finland197451997620041n.a.n.a.
Sweden(8)1967519996n.a.n.a.n.a.
United Kingdom(9)1968519996200631920s1n.a.16
Croatia(10)199118200418200918n.a.:
Turkeyn.a.n.a.2009n.a.n.a.
Norway1998320016:n.a.n.a.
 

Notes:

n.a. indicates that the treatment is not available in the country.

(...) indicates that the treatment substance is legally available in the country but there are no reported clients.

Where data are not available for a country, the table entry is left empty.

Buprenorphine/naloxone combination date of issue of marketing authorisation valid throughout the European Union: 26 September 2006 (EMEA).

(1) An heroin-assisted treatment pilot project have started in 2011 in the city of Liège (Belgium).

(2) A first unofficial substitution programme was already implemented in 1992, see Czech Republic National Report 2000.

(3) First methadone maintenance trial in Germany took place in the mid 1970s in Hannover, but only in 1987 did the first large-scale pilot project in North Rhine Westphalia begin. Official introduction of MMT through change in narcotics law in 1992 (Michels et al., 2007, see reference link in Sources).

(4) After introduction in 1983, methadone substitution was prohibited again between 1985 and 1990. Heroin-assisted clinical trials are ongoing in Catalonia and Andalucia.

(5) HDB is a legally recognised medication for opioid substitution treatment in Spain, yet it is not commercially available. .

(6) Buprenorphine-Naloxone is commercially available in Spain although it is not financed by the national drug funding system.

(7) The Central Committee on the Treatment of Heroin Addicts was already established in December 1996 and preparations for the heroin pilot in the NL started in 1997. Clients were admitted from July 1998 onwards. Heroin prescription became a regular scheme in the Netherlands in 2006.

(8) Methadone maintenance treatment began on trial basis in 1967 and was introduced on a permanent basis in 1981 in Sweden, see Skretting (2006) Treatment and harm reduction measures, in: Kouvonen P, Skretting A & Rosenqvist P (2006), Drugs in the Nordic Countries, NAD publication 48, pp.73-104.

(9) In the UK, slow release morphine has been used for a long time for the management of pain but is not licensed for the treatment of opiate dependence.

(10) Buprenorphine substitution therapy was introduced in 2004 while the financing of treatment costs has been legally regulated in 2006. In 2009 buprenorphine was replaced by the buprenorphine/naloxone pharmacotherapy.

See also 'General notes for interpreting data' on the Explanatory notes and help page.

Sources:

Structured Questionnaire 27 Part 1(SQ27P1) 'treatment programmes', submitted by NFPs.

Standard Tables 24 (ST24) on 'treatment availability' submitted by NFPs.

(1) Reitox National Reports 2005.

(2) Reitox National Reports 2006.

(3) Reitox National Reports 2007.

(4) Reitox National Reports 2008.

(5) Farrell, F., Verster, A., Davoli, M., Nilson, M. and Merino, P. P. (2000) Reviewing current practice in drug-substitution treatment in the European Union, EMCDDA Insights series, No. 3, EMCDDA, Lisbon. (last accessed 07/04/2010)

(6) EMCDDA (2005) Annual Report 2005: selected issues. No 3: Buprenorphine — treatment, misuse (last accessed 07/04/2010) and prescription practices, Luxembourg: Office for Official Publications of the European Communities.

(7) EMCDDA (2003) The state of the drugs problem in the acceding and candidate countries to the European Union, Luxembourg, Office for Official Publications of the European Communities.

(8) According to data on methadone consumption published by the INCB, Technical reports 'Estimated world requirements for 2001 — Statistics for 1999', ‘Part four, Statistical information on narcotic drugs’, INCB, 2000. Tables of reported statistics 1995–99. Table IX.

(9) Personal communication, Greek NFP, 30 May 2006.

(10) Decreto 89/1996, of 4 June.

(11) Reitox National Report 2004.

(12) Michels II, Stöver H and Gerlach R (2007) Substitution treatment for opioid addicts in Germany Harm Reduction Journal 2007, 4:5. (last accessed 07/04/2010)

(13) Georgi N. Vasilev, Daniela Z. Alexieva, Rositsa Z. Pavlova (2006), ' Safety and Efficacy of Oral Slow Release Morphine for Maintenance Treatment in Heroin Addicts: A 6-Month Open Noncomparative Study', Eur Addict Res,12:53-60.

(14) Gazzetta Ufficiale, 271, 21/11/2007.

(15) Personal Communication, Polish NFP, May 2009.

(16) Personal communication, UK NFP, May 2009.

(17) Reitox National Reports 2009.

(18) Personal communication, HR NFP, May 2010 and May 2012.

(19) Personal communication, NFP, April 2011.

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