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

Country	Methadone treatment initiation			Buprenorphine treatment initiation
Country	Any medical doctor	Specialised medical doctors	Treatment centres	Any medical doctor	Specialised medical doctors	Treatment centres	Law/guidelines	Sources

Belgium		a, p	a, p		a	a	Royal Decree on Substitution Treatments of 19 March 2004	1, 2
Bulgaria			a, p				Decree No 24 of 31 October 2000	3, 4
Czech Republic	a	a	a, p	a, p	a, p	a, p	Act No 379/2005	1, 2
Denmark		a	a, p		a	a	Practice of Medicine Act, Section 5f	1, 2
Germany		a, p	a, p		a	a	Narcotic Drugs Prescription Ordinance, Section 5 (2)	1, 2
Ireland		a, p	a, p		a	a	Misuse of Drugs (Supervision of Prescription and Supply of Methadone Regulations) 1998	1, 2
Greece			a, p			a, p	Law 2955/2002; Ministerial Decree 19546/2003	1, 2
Spain		a, p	a, p		a	a	Royal Decree 75/1990, amended by Royal Decree 5/1996	1, 2
France			a, p	a, p	a, p	a, p		1, 2
Italy	a	a	a, p	a	a	a, p	Presidential Decree 309/90, Article 43	2
Cyprus		a	a		a	a, p	Regulation 160/79	1, 2
Latvia		a	a, p			a, p		2
Lithuania			a, p			a	Order No 702 of Ministry of Health (Žin., 1998, 13-326)	1, 2
Luxembourg		a	a, p		a	a	Grand-Ducal Decree on substitution treatment programmes 30 January 2002	1, 2
Hungary			a, p				Methodological Guidelines of the Professional College of Psychiatry on Methadone Treatment (2002)	1, 2
Malta			a, p		a	a, p		2, 4
Netherlands	a	a	a, p	a	a	a		1
Austria		a, p	a		a	a, p		2
Poland			a, p					1, 2
Portugal			a, p	a	a	a, p	Decree-Law 183/2001, Article 44.1; Decree-Law 15/93, Article 15, 1-3	1
Romania			a, p					4
Slovenia			a, p			a, p		2, 3
Slovakia		a	a, p	a	a	a		1
Finland		a	a, p		a	a, p	Decree 33/2008	2
Sweden			a, p			a, p	Medical Products Agency's Code of Statutes LVFS 2004:15	1, 2
United Kingdom	a, p	a, p	a, p	a, p	a, p	a, p	Misuse of Drugs Act 1971, Section 7.3(a)	1, 2
Norway			a, p			a, p	Regulation 24 April 1998 No 455, Article 2-1 (3)d	1, 2
Croatia	a, p	a, p	a, p	a, p	a, p	a, p
Turkey

Notes:

‘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.

Sources:

(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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