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

CountryNotes MMTSources HDBTSources Heroin assisted treatment Sources Slow-release morphineSourcesbuprenorphine/ naloxone combinationSources
Belgium(1)199432003620073N/Ap.N/Ap.
Bulgaria19968N/Ap.N/Ap.20061320084
Czech Republic(2)1998320006N/Ap.N/Ap.20084
Denmark197051999620084N/Ap.:
Germany(3)19925, 122000620033N/Ap.:
Estonia2001720036N/Ap.N/Ap.:
Ireland1992520023N/Ap.N/Ap.20074
Greece1993520029N/Ap.N/Ap.20063
Spain(4), (5), (6)1990519961020033N/Ap.:
France1995519966N/Ap.:N/Ap.
Italy1975519996N/Ap.:200714
CyprusN/Ap.20073N/Ap.N/Ap.:
Latvia1996720033N/Ap.N/Ap.:
Lithuania1996820026N/Ap.N/Ap.:
Luxembourg(7)1989520026N/Ap.20063N/Ap.
Hungary19957N/Ap.N/Ap.N/Ap.20073
Malta19871120063N/Ap.::
Netherlands(8)196851999619983::
Austria1987519996N/Ap.1998120083
Poland19937N/Ap.N/Ap.N/Ap.200815
Portugal1977519996N/Ap.N/Ap.:
Romania1998720073N/Ap.N/Ap.:
Slovenia1990720056, 3N/Ap.2005120074
Slovakia1997819993N/Ap.20052:
Finland1974519976N/Ap.N/Ap.20041
Sweden(9)1967519996N/Ap.N/Ap.N/Ap.
United Kingdom(10)19685199961920s1:1620063
Croatia1990320063N/Ap.::
TurkeyN/Ap.N/Ap.N/Ap.N/Ap.N/Ap.
Norway1998320016N/Ap.N/Ap.:

Notes:

 N/Ap. indicates that the treatment is not available in the country.   

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

 Substitution treatment programmes are currently under preparation in Turkey.         

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

 (1) Heroin pilot project for 200 drug users, Autumn 2007 - 2010, Liège (Belgium). See also: Heroin Delivery under Control: feasibility and follow-up study (DHCo)

 (2) A first unofficial 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 first large-scale pilot project in North Rhine Westphalia began. Official introduction of MMT through change in narcotics law in 1992 (Michels et al., 2007, see reference link in Sources).  

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

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

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

 (7) In Luxembourg a pilot heroin assisted treatment scheme is under consultation. 

 (8) 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. 

 (9) 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. 

 (10) 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. However, it may be prescribed ‘offlicense’ for this purpose by clinicians with appropriate specialist competencies. 

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

Sources:

 Structured Questionnaire 27 Part 1(SQ27P1) 'treatment programmes', submitted by NFPs in 2008.         

 Standard Tables 24 (ST24) on 'treatment availability' submitted by NFPs in 2008.         

 (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. 

 (6) EMCDDA (2005) Annual Report 2005: selected issues. No 3: Buprenorphine — treatment, misuse 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) Arpa S, Muscat R (P-PG/Epid 2003 37E, p. 30).         

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

 (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. 

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