The treatment-related objectives of the current Hungarian National Anti-Drug Strategy are built on a recovery-oriented approach and place emphasis on enhancing the availability and quality of treatment services, with a particular focus on young people. In Hungary, treatment of drug users is a task shared by the healthcare system and social services, with the participation of non-governmental institutions. The State Secretariat for Healthcare is responsible for all aspects of drug users’ healthcare, while the State Secretariat for Social Affairs and Social Inclusion is in charge of issues related to social care. Both secretariats are located in the Ministry of Human Capacities. Treatment services are mainly provided by public bodies and by non-governmental drug service providers.
A clear separation exists between the financing, definition, regulation and inspection of social and health services. Health services for people who use drugs are mainly financed by the National Health Insurance Fund, while the majority of social services are financed using a fixed financing model through the social budget, which may be supplemented with additional resources allocated through tendering.
In Hungary, drug treatment is not substance based and covers licit and illicit substances, other dependencies and psychiatric problems. Treatment is offered to drug users at various outpatient and inpatient facilities throughout the country. Some treatment units provide only health or social services, while others provide mixed services. The Hungarian treatment system includes specialised inpatient and outpatient drug treatment units (including low-threshold services), inpatient and outpatient units for addiction or mental health, therapeutic communities and crisis intervention departments.
Long-term rehabilitation is also provided mostly by non-governmental organisations; though it has a healthcare component, it is predominantly focused on social support and integration. Other available services include a publicly funded housing service and an online self-help programme for problem cannabis use offered by some outpatient centres in Budapest. Treatment is also offered as an alternative to criminal procedure for some minor drug offences.
Opioid substitution treatment (OST) has been available since 1994 (with methadone), while buprenorphine-based treatment was introduced in 2007. Both methadone- and buprenorphine-based treatments are publicly funded. Methadone is provided only at specialised outpatient treatment centres, whereas buprenorphine can be prescribed by any psychiatrist. OST is provided within the remit of outpatient treatment services, but it is also provided by some inpatient treatment providers, mostly for detoxification purposes.
Over 4 800 clients entered drug treatment services in 2017, most of whom did so as an alternative to criminal proceedings. Most clients were treated in outpatient units. Cannabis remained the primary substance among treatment clients overall, followed by new psychoactive substances (NPS), amphetamines and opioids. Cannabis is also the most frequently reported primary substance for those who enter treatment through the criminal justice system. The long-term analysis up to 2014-15 indicates a decrease in heroin-related treatment demands and an increase in the number of clients entering treatment for NPS use. However, more recently, there has been an increase in treatment demands for heroin use and a decrease for NPS use. Synthetic cannabinoids and synthetic cathinones are the most common groups of NPS for which treatment is sought.
The number of OST clients in Hungary has remained stable in recent years, with changes in trends explained primarily by changes in data collection methods in 2010 and 2011. The majority of OST clients are treated with methadone.