Drug Abuse in the Global Village

Drug Abuse in Eastern Europe

                                        TREATMENT AND REHABILITATION

BELARUS
Treatment and rehabilitation policy emphasizes early identification of drug abusers by legal and narcological services. When in need, hospitalization and detoxification as well as outpatient care are provided. There are no programmes for social reintegration of drug addicts (U.N. 1992).

BULGARIA
Treatment, selected to suit individual needs, is provided in an out-patient centre, in emergency units and psychiatric clinics in Sofia and Suhodol. New treatment approaches are now sought to supplement moralizing used during by previous regimes. "Electric sleep" and acupuncture are used. Attempts on rehabilitation and reintegration into society are made. Therapeutic communities based on principles of self and mutual support are being planned (Bulgaria 1991).

            One hundred and seventy nine persons were provided treatment in 1990 (78 for opiate type drugs and 101 for psychotropic substance dependence). Of these, 61 were treated for the first time. Relapse rate is estimated at approximately 50% (U.N. 1990).

CROATIA
Priority is placed on out-patient programmes and drug free treatment (U.N. 1992).

            The following treatment facilities were available in 1992: 1 therapeutic community, 8 psychiatric hospitals, 7 general hospitals, 50 primary care facilities, 1 specialized detoxification facility and 2 treatment facilities in prisons (U.N. 1992).

            In 1992, a total of 402 drug abusers were undergoing treatment in Zagreb. About half were opiate addicts, 19% were sedative type drug addicts and 9% were multiple drug dependent. The success in treatment of heroin addicts is estimated at 80% (U.N. 1992).

            Methadone substitution programmes are being used increasingly (U.N. 1992).

CZECHOSLOVAKIA
Treatment is carried out in state psychiatric institutions as well as in out patient mobile treatment centres. A new system of in-patient treatment (MONAR) is in planning (U.N. 1990).

HUNGARY
The elaboration of a nation wide drug treatment and rehabilitation plan was being formulated in 1991.

            In 1991, there were 7 out-patient clinic in Hungary. Treatment is provided to 50 to 130 clients every year. Children and young drug abusers are referred to out-patient clinics (104 patients in 1990, 55 for organic solvent abuse (10 girls, 45 boys; 56 were treated for the first time). Adult drug abusers are usually referred to psychiatric hospitals. A special drug abuse ward has been opened in the National Institute of Neurology and Mental Hygiene (20 beds). In 1990, 1 179 patients were treated in psychiatric out-patient clinics for psychotropic substances dependence and 164 for psychosis caused by medicines (790 of the total were female, 553 males) (Hungary 1991).

LATVIA
The Latvian State Drug Abuse Treatment and Health Care Centre was established in January 1993. The Centre's main tasks is to collect drug abuse data, develop preventive programmes and fund and coordinate treatment programmes (Nordic-Baltic Meeting 1993). Treatment is available in therapeutic communities (38 patients), psychiatric hospitals (27 patients), self-help facilities (15 patients), private clinics, primary care facilities (all 635 registered patients) and detoxification (186 patients). Of the total 635 patients registered in 1992, 248 were seeking treatment for the first time (U.N. 1992).

POLAND
The treatment system is composed of out-patient clinics where patients are diagnosed and referred to detoxification services and to rehabilitation centres. Treatment is free of charge and based on voluntary participation (minors excepted). Treatment facilities in 1991 include 38 non-hospital residential units (run by independent health services or non-governmental organizations, or attached to psychiatric hospitals) and 15 specialized detoxification facilities (CMO 1991).

            In 1991, a total of 3857 drug addicts were undergoing treatment (2919 males, 938 females). Detoxification programmes treat about 3000 opiate dependent addicts annually. Experimental Maintenance Programmes for intravenous drug abusers who have failed traditional abstinence programmes were treating approximately 60 persons in 1991 (CMO 1991).

            In view of the growing AIDS problem, treatment approaches have been modified. Criteria for readmission are more liberal, more efforts are being placed in seeking addicts in their environment and substitution therapy programmes have started operating (CMO 1991).

            The State encourages, supports and supervises activities of NGOs, which run more than half of the rehabilitation services (CMO 1991).

ROMANIA
There are no specialized treatment facilities. Treatment is carried out in psychiatric hospitals (U.N. 1992).

RUSSIA
Drug addicts are required to undergo minimum mandatory in-patient treatment. First-time registered addicts are placed in hospitals for examination and detoxification as well as psychotherapy. Out-patient anti-recidivist programmes include psychotherapy (primarily rational psychotherapy but also hypnotherapy and autogenic training), electrically induced sleep, medicine based therapy designed to provide general physical strengthening and acupuncture (U.N. 1992).

SLOVENIA
No information reported by 31st December 1993.

UKRAINE
Treatment programmes are under the direction of the Ukrainian Ministry of Health. Since 1990, treatment is voluntary, free, individually tailored, and of unlimited duration. All patients are registered when they apply for treatment and are subsequently monitored through consultations at clinics and health centres over a five year period (U.N. 1992).

            In 1992, 26,589 drug abusers were registered in the Statistical Department of the Ministry of Health (31,080 in 1991). Of these, 4921 were registered in 1992 (3551 in 1991). This represents 0.09 % of the total population who abuse drugs (0.06% in 1991) (U.N. 1991,1992).

            Treatment is based on medicines and includes psychotherapy and hypnosis. In 1992, there were 26 specialized detoxification facilities treating 15,530 opiate addicts, 5100 seeking treatment for the first time. The average rate of relapse is estimated at 76%. One self-help service is operating in Kiev (U.N. 1992).

            The increase in the number of registered addicts has been accompanied by a decline in the effectiveness of treatment (measured in terms of the abstention from drugs over a five year period). This is attributed to the absence of rehabilitation programmes (U.N. 1992).

            Difficulties in recruiting ex-drug addicts for social work has been reported (U.N. 1992).