Turkey Country Drug Report 2019

Treatment

The treatment system

The current national strategy outlines treatment-related objectives that focus on facilitating drug users’ access to treatment and care services that meet the established standards and protocols. The implementation of drug-related treatment in Turkey is the responsibility of the Ministry of Health, and the Science Committee for Substance Addiction is responsible for its national coordination. Since the end of 2013, Provincial Healthcare Directorates have been authorised to license and supervise substance use treatment centres.

Drug treatment is provided by the Alcohol-Substance Addiction Research, Therapy and Education Centres, psychiatric clinics in public hospitals under the Ministry of Health, university-based treatment units and some private hospitals. The majority of these institutions provide inpatient and outpatient treatment. Funding for drug treatment services is mainly provided by the state through social or health insurance funds. Most drug treatment services treat dependency in general, providing treatment for both alcohol and illicit drug use.

Drug treatment programmes in Turkey aim to help clients achieve a drug-free state. An essential part of the treatment is detoxification, which is complemented by other interventions consisting of motivational interviewing techniques and cognitive therapies that aim to prevent relapse. Pharmacological treatment with opioid agonists or an antagonist is also available. Some treatment centres provide short-term residential treatment, and some non-governmental organisations provide treatment communities.

Opioid substitution treatment (OST) using buprenorphine-based medication has been available in Turkey since 2010. All treatment centres that are licensed by the Ministry of Health can provide OST. Up to 80 % of OST medication costs are covered by general health insurance; clients contribute the remaining 20 %.

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Treatment provision

In 2017, the majority of drug-related treatment in Turkey took place in outpatient settings.

Treatment demand data in Turkey are reported by 45 inpatient treatment centres. Outpatient centres in the country do not report data on their clients.

The majority of clients entering inpatient drug treatment services in 2017 required treatment for primary opioid use, mainly use of heroin, followed by cannabis and stimulants other than cocaine. Since 2014, increases in the number of new clients entering inpatient treatment for problems related to primary use of amphetamines and cocaine have been reported; however, trend data present methodological limitations.

The proportion of cannabis-related inpatient treatment entries has decreased in the last decade, while, in recent years, the proportion of clients who have entered treatment for the use of other illicit substances, mostly synthetic cannabinoids, has increased.

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Methodological note: Analysis of trends is based only on those countries providing sufficient data to describe changes over the period specified. The reader should also be aware that monitoring patterns and trends in a hidden and stigmatised behaviour like drug use is both practically and methodologically challenging. For this reason, multiple sources of data are used for the purposes of analysis in this report. Caution is therefore required in interpretation, in particular when countries are compared on any single measure. Detailed information on methodology and caveats and comments on the limitations in the information set available can be found in the EMCDDA Statistical Bulletin.