Access to opioid substitution treatment in Europe

• Author: European Monitoring Centre for Drugs and Drug Addiction (EU body or agency)
• Pages: 9-19

TECHNICAL REPORT | Balancing access to opioid substitution treatment with preventing diversion of medications

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including the impact of past drug epidemics, drug policies, geographical availability, health

service funding, health insurance reimbursement schemes and legal prescribing frameworks

(Vranken et al., 2014; Hedrich and Pirona, 2017).

1.3. Methods

For this report, a non-systematic review of the international literature was carried out. Primary

analyses, including not previously published analyses, used national epidemiological data

submitted by the Reitox national focal points to the EMCDDA. The main national datasets used

in this report were the treatment demand, health and social responses, overdose deaths,

seizures of drugs and problem drug use datasets published annually in the EMCDDA’s

Statistical Bulletin. Previously published data were also used, namely from the EMCDDA’s

European Drug Report, EMCDDA-Europol EU Drug Markets Report and Statistical Bulletin.

Data sources are referenced in the report where necessary. Further national information on the

history, availability, accessibility and affordability of OST, as well as on the misuse and diversion

of OST medications at the national level, was collected through a dedicated survey among

national focal points from Czechia, Germany, Ireland, France, Austria, Poland and Finland.

2. Access to opioid substitution treatment in Europe

Access to OST can be understood as a general concept that includes a set of more s pecific

dimensions describing the fit between the patient and the system providing OST. These

dimensions include availability and accessibility, but also the affordability and acceptability of

OST (see the Glossary). In a country, these dimensions are affected by moderating factors,

each of which can have an impact on one or more of the dimensions. For example, legal

frameworks or national regulations will determine which OST medications can be prescribed for

the treatment of opioid dependence and which medical professionals are allowed to prescribe

them. Limitations in one or more of these dimensions will have an impact on the overall level of

access to OST in a country (or region or city) (Figure 1).

Figure 1. System dimensions and their moderating factors affecting access to opioid substitution

treatment