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Treatment services for drug users

Published 20 December 2005.

The basic structure of the treatment system of drug dependency is similar to that of other intoxicant dependency treatments. According to the Act on Welfare for Substance Abusers, the main responsibility for organising treatment lies with the social and health care authorities within municipalities.

The first level consists of general social and health care services, in other words, places that provide general treatment, not only intoxicant-related services. The next level consists of special welfare services provided for intoxicant users, specialising in treating all intoxicant-related problems. The last level consists of a few intoxicant treatment units that provide services especially for drug addicts or patients needing a particular method of drug treatment. Transferring patients from one unit to another and the coverage of fees sometimes causes problems, even though the goal of the system is to provide a flexible, individually tailored treatment programme for each patient.

Basic health care information, counselling and treatment for somatic and mental symptoms is provided in social service offices and various special health care units. Referrals for special treatment units can also be provided through these centres. It is in the interest of the patient and the treatment system alike that the problems are diagnosed at an early stage.

A core network of special services consists of A-Clinics, youth centres and their detoxification and rehabilitation units that provide 24-hour-care. Most municipalities have their own A-Clinic or a contract to buy services from an A-Clinic in the neighbouring municipalities. Most A-Clinics have experience treating also drug and mixed users, even though the name originally referred to alcohol. In Helsinki, for example, the Kettutie A-polyclinic has vast experience treating drug users. Most other special service units for intoxicant users also treat drug users, even if customers are predominantly alcoholics or pharmaceutical abusers. These include the A-Clinic Foundation’s Addiction Hospital and the Kalliola clinics that offer their services nationwide. Certain national or municipal units have specialised in the treatment of drug users. Some towns have drug treatment polyclinics that are open 24 hours a day (for example Kurvi drug polyclinic in Helsinki). In many towns there are health advice centres for users of intravenous drugs where the users receive information about the prevention of contagious diseases, vaccinations, clean needles and syringes. Some treatment units follow the principles of a therapeutic community and support their patients on their way to sobriety without the help of medicines (the A-Clinic Foundation’s Hietalinna community and the Kisko unit of Kalliola clinics are examples).

For the treatment of opiate addiction and/or pharmaceutical detoxification, substitution or a maintenance treatment can sometimes be used to complement one’s treatment process. The need for this type of treatment is assessed at university or central hospitals or at the Järvenpää Addiction Hospital and then carried out at other in or outpatient units.

Drug treatments are almost always based on the patient’s own will to receive treatment. Involuntary treatment can sometimes be used on the basis of the Act on Child Welfare, the Law on Mental Health services or the Act on Welfare for Substance Abusers.

Peer group activities play an important part in the service system for drug users; one of the best known forms of them are NA-groups (narcotics anonymous).

Most outpatient services of the health service system for intoxicant users are free for the patient. Utilising inpatient care, the patient is responsible for the excess fees not covered under agreement with one’s municipality. A written financial obligation can be obtained from the social services office of one’s home municipality. Every municipality has a plan on services that should be used. You can get more information on these services from your local social services office, health centre or A-clinic.

Rauno Mäkelä
Medical superintendent,
A-Clinic Foundation (retired)

 

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