Guidelines for Substitution Treatment (Slovakia)

1. Guidelines for Substitution Treatment(Slovakia) Main Suggestions L. Okruhlica

2. Slovak ST Guidelines • Substitution treatment is medically assisted treatment, use agonist or antagonist medicinal drugs, maintain drug addicts in long-term medical treatment in order to reduce the consumption of illegal drugs and the risk of infectious diseases, to improve the mental an physical health, to reduce drug-related crime, with the end goal of achieving abstinence.

3. Slovak ST Guidelines • Inclusion criteria (minimum limit of age, lenght of the drug dependency) • Exclusion criteria (contra indications of medical products) should be defined before supplying any kind treatment to drug users. • Other selection criteria could be considered (pregnancy, high risk for HIV infection, life-threatening diseases).

4. Slovak ST Guidelines Use of : • counseling • psychoeducational group counseling • psychotherapy • a social aid should be systematically associated when needed

5. Use of Standards • Qualifications of care providers are needed. Care providers should exhibit special certificates or a minimum long/lasting experience in the field. • Consensus on adequate dosages and pharmaceutical forms of medical preparations. • Use of medical preparations (market authorization for that therapeutic use) • Consensus to avoid risk associations (e.g. BDZ)

6. Use of Standards • Compliance testing methods: • physical examination • urine toxicology • dosage level • administration under the supervision of care providers

7. Use of Standards • Standardized data collection on the treatment process (on patient and medicinal drug) within respect of confidentiality. • Differentiate: • starting phase – induction period • and stabilisation phase – rehabilitation phase

8. Assessment of Substitution Treatments Indicators • Illicit drug use • Polydrug abuse • Psychiatric morbidity • Somatic morbidity (HIV, HCV) • Mortality • Criminality ratio • Social integration