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Table HSR-2. Legal framework of opioid substitution treatment initiation, continuation and dispensing (by substitution medication) in EU, Croatia, Turkey and Norway
Part (i) Legal framework regarding the initiation of OST by substitution medication
| Country | METHADONE | HIGH DOSAGE BUPRENORPHINE | BUPRENORPHINE-NALOXONE COMBINATION | SLOW-RELEASE MORPHINE | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| medical doctors at specialised drug treatment centres | specialised medical doctors | any medical doctor | other provider | medical doctors at specialised drug treatment centres | specialised medical doctors | any medical doctor | other provider | medical doctors at specialised drug treatment centres | specialised medical doctors | any medical doctor | other provider | medical doctors at specialised drug treatment centres | specialised medical doctors | any medical doctor | other provider | |||||||||
| Belgium (Flemish community) | Y | Y | Y | Y | Y | |||||||||||||||||||
| Belgium (French community) | Y | Y | Y | Y | ||||||||||||||||||||
| Bulgaria | Y | Y | (iii) | Y | Y | (iii) | ||||||||||||||||||
| Czech Republic | (1) | Y | Y | Y | Y | Y | ||||||||||||||||||
| Denmark | Y | Y | Y | (i) | Y | Y | Y | (i) | Y | Y | Y | (i) | ||||||||||||
| Germany | Y | Y | Y | Y | Y | Y | Y | Y | Y | |||||||||||||||
| Estonia | Y | Y | Y | |||||||||||||||||||||
| Ireland | (2) | Y | Y | Y | Y | |||||||||||||||||||
| Greece | Y | Y | Y | |||||||||||||||||||||
| Spain | (3) | Y | Y | |||||||||||||||||||||
| France | Y | Y | (ii) | Y | Y | Y | Y | |||||||||||||||||
| Italy | Y | Y | Y | Y | Y | Y | Y | Y | ||||||||||||||||
| Cyprus | Y | (ii) | Y | Y | (ii) | Y | (ii) | Y | (ii) | |||||||||||||||
| Latvia | Y | Y | Y | Y | Y | |||||||||||||||||||
| Lithuania | Y | Y | (iii) | Y | Y | (iii) | Y | Y | (iii) | |||||||||||||||
| Luxembourg | Y | Y | Y | Y | Y | Y | Y | Y | ||||||||||||||||
| Hungary | Y | Y | Y | |||||||||||||||||||||
| Malta | ||||||||||||||||||||||||
| Netherlands | Y | Y | Y | Y | (iv) | Y | Y | Y | Y | Y | Y | Y | Y | Y | ||||||||||
| Austria | Y | Y | Y | Y | Y | Y | ||||||||||||||||||
| Poland | Y | |||||||||||||||||||||||
| Portugal | Y | Y | Y | Y | Y | Y | Y | Y | ||||||||||||||||
| Romania | Y | Y | Y | Y | ||||||||||||||||||||
| Slovenia | y | Y | Y | Y | (i) | Y | Y | |||||||||||||||||
| Slovakia | Y | Y | Y | |||||||||||||||||||||
| Finland | Y | Y | Y | |||||||||||||||||||||
| Sweden | ||||||||||||||||||||||||
| United Kingdom | Y | Y | Y | Y | (i) | Y | Y | Y | Y | (i) | Y | Y | Y | Y | (i) | Y | Y | Y | Y | (i) | ||||
| Croatia | Y | Y | Y | Y | ||||||||||||||||||||
| Turkey | (4) | |||||||||||||||||||||||
| Norway | Y | Y | Y | |||||||||||||||||||||
Notes:
'Y' indicates whether a specific provider is involved in initiating opioid substitution treatment.
Where a specific provider is not allowed to initiate a specific treatment, the table entry is left empty. Exception for Malta, Sweden and Croatia for which data were not available .
'Specialized medical doctors' refers to specifically trained or accredited office-based medical doctors or general practitioners practicing outside specialised drug treatment centres.
'Any medical doctor' refers to office-based medical doctors practicing outside specialised drug treatment centres.
(1) In Czech Republic any medical doctor can prescribe methadone, however it has not been marketed yet as proprietary (commercial) medicine, thus currently methadone is only available in specialised centres.
(2) In Ireland, buprenorphine is provided for substitution in a pilot programme. It does not come under the same legal framework as methadone but does come under the controlled drug legislation.
(3) In Spain, high dosage buprenorphine is not commercially available.
(4) In Turkey Buprenorphine-Naloxone combination treatment is available since 2009.
Other providers:
(i) Prison and probation services
(ii) Doctors based in public hospitals
(iii) Psychiatrists
(iv) Medical nurses
See also 'General notes for interpreting data' on the Explanatory notes and help page.
Sources:
Structured Questionnaire on 'treatment programmes' (SQ27P1), submitted by NFPs.
Answers from the legal correspondents of the European Legal Database on Drugs (ELDD) to a EMCDDA survey on the legal framework of substitution treatment (2006). See also ELDD topic overview.