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Methods and definitions

Health and social responses

Information is provided on availability of substitution treatment and of different types of needle and syringe programmes (NSPs), including pharmacy-based programmes.

Methods and definitions: health service responses

Programmes for needle and syringe provision

Since 2004, the 27 EU Member States and Norway report data on needle and syringe availability through specialised needle and syringe programmes (NSPs) using a standardised format (standard table on syringe availability). Data are now available for the years 2002 to 2005, allowing a better insight into the recent evolution of this type of service in the reporting countries.

The data reporting tool comprises information on the availability of different types of needle and syringe programmes (NSPs) in the country, including pharmacy and non pharmacy-based programmes, and on the number of syringes provided at these programmes, as well as on syringe provision via vending machines. It includes data on the number of syringe provision points, defined as individual locations or physically distinct outlets where syringes are available for free or against payment.

While data on quantity and types of syringe provision points that are offered provide important background information, it is essential to interpret the number of specialized syringe programme points and of the syringes provided in the national context, in particular with regard to estimated prevalence level of drug injecting, as well as density of the national pharmacy network, availability of syringes in pharmacies and pharmacists attitudes with regard to syringe sales to drug users.

Information on the number of pharmacy sales and of client contacts and the number of individual clients that make use of needle and syringe programmes are also collected with Standard Table 10 and have previously been reported for those countries where they were available. But as this information was even more patchy or unavailable in 2006, it is no longer presented here.

Substitution treatment provision and availability

Data on substitution treatment provision and availability in the EU was mainly collected through a standard table on treatment availability (ST 24) filled out by National Focal Points in 2004 and 2006 and by a structured questionnaire on treatment programmes (SQ 27) which was implemented in 2005. Complementary sources of information used to compile a number of tables on the availability of treatment, initiation, and client numbers have been the National Reports.

Statistical data from INCB technical reports on methadone consumption have also been compiled.

Information about the legal framework of substitution treatment was collected through a survey among the legal correspondents of the EMCDDA in 2006. The results are described in more detail in a topic overview in the legal database.

When reporting on numbers of clients in substitution treatment, cases of detoxification treatment as well as substitution treatment in prison have as far as possible been excluded to avoid double-counting.

The current lack of harmonisation in case-reporting doesn’t allow any comparisons between countries and the EMCDDA is working on achieving better reporting standards to improve its information on treatment coverage.

The establishment of a national monitoring system and /or a national register of individuals receiving opioid substitution treatment is a means to prevent double-prescription and diversion of the prescribed substances in many countries. While specialised treatment agencies are more likely to be covered by such registries as well as clients receiving methadone, underreporting in such registries of clients treated by private medical doctors and with other substitution medicines is rather likely.

However, the establishment of registration systems over the last few years in further countries is likely to have led to improvements in the quality of data on substitution treatment and as a result, a clearer European picture of this type of service provision can be drawn.

Page last updated: Tuesday, 20 March 2012