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Table HSR-2. Legal framework and practice of substitution treatment initiation

CountryMethadone treatment initiationBuprenorphine treatment initiation
Any medical doctorSpecialised medical doctorsTreatment centresAny medical doctorSpecialised medical doctorsTreatment centresLaw/guidelinesSources
Belgiuma, pa, paaRoyal Decree on Substitution Treatments of 19 March 20041, 2
Bulgariaa, pDecree No 24 of 31 October 20003, 4
Czech Republicaaa, pa, pa, pa, pAct No 379/20051, 2
Denmarkaa, paaPractice of Medicine Act, Section 5f 1, 2
Germanya, pa, paaNarcotic Drugs Prescription Ordinance, Section 5 (2)1, 2
Irelanda, pa, paaMisuse of Drugs (Supervision of Prescription and Supply of Methadone Regulations) 1998 1, 2
Greecea, pa, pLaw 2955/2002; Ministerial Decree 19546/20031, 2
Spaina, pa, paaRoyal Decree 75/1990, amended by Royal Decree 5/1996 1, 2
Francea, pa, pa, pa, p1, 2
Italyaaa, paaa, pPresidential Decree 309/90, Article 432
Cyprusa aaa, pRegulation 160/791, 2
Latviaaa, pa, p2
Lithuaniaa, paOrder No 702 of Ministry of Health (Žin., 1998, 13-326)1, 2
Luxembourgaa, paaGrand-Ducal Decree on substitution treatment programmes 30 January 2002 1, 2
Hungarya, pMethodological Guidelines of the Professional College of Psychiatry on Methadone Treatment (2002)1, 2
Maltaa, paa, p2, 4
Netherlandsaaa, paaa1
Austriaa, paaa, p2
Polanda, p1, 2
Portugala, paaa, pDecree-Law 183/2001, Article 44.1; Decree-Law 15/93, Article 15, 1-3 1
Romaniaa, p4
Sloveniaa, pa, p2, 3
Slovakiaaa, paaa1
Finlandaa, paa, pDecree 33/20082
Swedena, pa, pMedical Products Agency's Code of Statutes LVFS 2004:15 1, 2
United Kingdoma, pa, pa, pa, pa, pa, pMisuse of Drugs Act 1971, Section 7.3(a)1, 2
Norwaya, pa, pRegulation 24 April 1998 No 455, Article 2-1 (3)d1, 2
Croatiaa, pa, pa, pa, pa, pa, p


 ‘a’ indicates who is allowed to initiate substitution treatment. 

 ‘p’ indicates who is predominantly involved in initiating substitution treatment. 

 ‘Specialised medical doctors’ refers to specifically trained or accredited office-based medical doctors. 

 In Turkey, opioid substitution treatment is currently not allowed. However, studies on the applicability of such treatments in the Turkish treatment system are under discussion. 

 See also 'General notes for interpreting data' on the Explanatory notes and help page


 (1) 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). For further results see http://eldd.emcdda.europa.eu/?nnodeid=5036.  

 (2) Structured questionnaire on 'Treatment programmes' (SQ 27), submitted by NFPs in 2005. 

 (3) Standard tables on 'Treatment availability' (ST 24), submitted by NFPs in 2004 and 2006. 

 (4) Reitox national reports 2007

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Page last updated: Tuesday, 24 February 2009