Table HSR-1. Year of introduction of methadone maintenance treatment (MMT), high-dosage buprenorphine treatment (HDBT), heroin-assisted treatment, slow-release morphine and Suboxone®

Country	Notes	MMT	Sources	HDBT	Sources	Heroin assisted treatment	Sources	Slow-release morphine	Sources	buprenorphine/ naloxone combination	Sources
Belgium	(1)	1994	3	2003	6	2007	3	N/Ap.		N/Ap.
Bulgaria		1996	8	N/Ap.		N/Ap.		2006	13	2008	4
Czech Republic	(2)	1998	3	2000	6	N/Ap.		N/Ap.		2008	4
Denmark		1970	5	1999	6	2008	4	N/Ap.		:
Germany	(3)	1992	5, 12	2000	6	2003	3	N/Ap.		:
Estonia		2001	7	2003	6	N/Ap.		N/Ap.		:
Ireland		1992	5	2002	3	N/Ap.		N/Ap.		2007	4
Greece		1993	5	2002	9	N/Ap.		N/Ap.		2006	3
Spain	(4), (5), (6)	1990	5	1996	10	2003	3	N/Ap.		:
France		1995	5	1996	6	N/Ap.		:		N/Ap.
Italy		1975	5	1999	6	N/Ap.		:		2007	14
Cyprus		N/Ap.		2007	3	N/Ap.		N/Ap.		:
Latvia		1996	7	2003	3	N/Ap.		N/Ap.		:
Lithuania		1996	8	2002	6	N/Ap.		N/Ap.		:
Luxembourg	(7)	1989	5	2002	6	N/Ap.		2006	3	N/Ap.
Hungary		1995	7	N/Ap.		N/Ap.		N/Ap.		2007	3
Malta		1987	11	2006	3	N/Ap.		:		:
Netherlands	(8)	1968	5	1999	6	1998	3	:		:
Austria		1987	5	1999	6	N/Ap.		1998	1	2008	3
Poland		1993	7	N/Ap.		N/Ap.		N/Ap.		2008	15
Portugal		1977	5	1999	6	N/Ap.		N/Ap.		:
Romania		1998	7	2007	3	N/Ap.		N/Ap.		:
Slovenia		1990	7	2005	6, 3	N/Ap.		2005	1	2007	4
Slovakia		1997	8	1999	3	N/Ap.		2005	2	:
Finland		1974	5	1997	6	N/Ap.		N/Ap.		2004	1
Sweden	(9)	1967	5	1999	6	N/Ap.		N/Ap.		N/Ap.
United Kingdom	(10)	1968	5	1999	6	1920s	1	:	16	2006	3
Croatia		1990	3	2006	3	N/Ap.		:		:
Turkey		N/Ap.		N/Ap.		N/Ap.		N/Ap.		N/Ap.
Norway		1998	3	2001	6	N/Ap.		N/Ap.		:

Notes:

 N/Ap. indicates that the treatment is not available in the country.   

 Where data are not available for a country, the table entry is left empty.         

 Substitution treatment programmes are currently under preparation in Turkey.         

 Buprenorphine/naloxone date of issue of marketing authorisation valid throughout the European Union: 26 September 2006 (EMEA).         

 (1) Heroin pilot project for 200 drug users, Autumn 2007 - 2010, Liège (Belgium). See also: Heroin Delivery under Control: feasibility and follow-up study (DHCo). 

 (2) A first unofficial programme was already implemented in 1992, see Czech Republic National Report 2000. 

 (3) First methadone maintenance trial in Germany took place in the mid 1970s in Hannover, but only in 1987 first large-scale pilot project in North Rhine Westphalia began. Official introduction of MMT through change in narcotics law in 1992 (Michels et al., 2007, see reference link in Sources).  

 (4) HDB is a legally recognised drug for opioid substitution treatment in Spain, yet it is not commercially available.   

 (5) Buprenorphine-Naloxone is commercially available in Spain although it is not financed by the national drug funding system.   

 (6) After introduction in 1983, methadone substitution was prohibited again between 1985 and 1990. Heroin-assisted clinical trials are ongoing in Catalonia and Andalucia. . 

 (7) In Luxembourg a pilot heroin assisted treatment scheme is under consultation. 

 (8) The Central Committee on the Treatment of Heroin Addicts was already established in December 1996 and preparations for the heroin pilot in the NL started in 1997. Clients were admitted from July 1998 onwards. Heroin prescription became a regular scheme in the Netherlands in 2006. 

 (9) Methadone maintenance treatment began on trial basis in 1967 and was introduced on a permanent basis in 1981 in Sweden, see Skretting (2006) Treatment and harm reduction measures, in: Kouvonen P, Skretting A & Rosenqvist P (2006), Drugs in the Nordic Countries, NAD publication 48, pp.73-104. 

 (10) In the UK, slow release morphine has been used for a long time for the management of pain but is not licensed for the treatment of opiate dependence. However, it may be prescribed ‘offlicense’ for this purpose by clinicians with appropriate specialist competencies. 

 See also 'General notes for interpreting data' on theExplanatory notes and help page.   

Sources:

 Structured Questionnaire 27 Part 1(SQ27P1) 'treatment programmes', submitted by NFPs in 2008.         

 Standard Tables 24 (ST24) on 'treatment availability' submitted by NFPs in 2008.         

 (1) Reitox National Reports 2005.   

 (2) Reitox National Reports 2006.   

 (3) Reitox National Reports 2007. 

 (4) Reitox National Reports 2008. 

 (5) Farrell, F., Verster, A., Davoli, M., Nilson, M. and Merino, P. P. (2000) Reviewing current practice in drug-substitution treatment in the European Union, EMCDDA Insights series, No. 3, EMCDDA, Lisbon. 

 (6) EMCDDA (2005) Annual Report 2005: selected issues. No 3: Buprenorphine — treatment, misuse and prescription practices, Luxembourg: Office for Official Publications of the European Communities. 

 (7) EMCDDA (2003) The state of the drugs problem in the acceding and candidate countries to the European Union, Luxembourg, Office for Official Publications of the European Communities. 

 (8) According to data on methadone consumption published by the INCB, Technical reports 'Estimated world requirements for 2001 — Statistics for 1999', ‘Part four, Statistical information on narcotic drugs’, INCB, 2000. Tables of reported statistics 1995–99. Table IX. 

  (9) Personal communication, Greek NFP, 30 May 2006.         

 (10) Decreto 89/1996, of 4 June.         

 (11) Arpa S, Muscat R (P-PG/Epid 2003 37E, p. 30).         

 (12) Michels II, Stöver H and Gerlach R (2007) Substitution treatment for opioid addicts in Germany Harm Reduction Journal 2007, 4:5. 

 (13) Georgi N. Vasilev, Daniela Z. Alexieva, Rositsa Z. Pavlova (2006), " Safety and Efficacy of Oral Slow Release Morphine for Maintenance Treatment in Heroin Addicts: A 6-Month Open Noncomparative Study", Eur Addict Res,12:53-60. 

 (14) Gazzetta Ufficiale, 271, 21/11/2007. 

 (15) Personal Communication, Polish NFP, May 2009. 

 (16) Personal communication, UK NFP, May 2009. 

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