engleski

The organization, policy and concept of contemporary approach to treatment of drug addicts in the Republic of Croatia

By accepting the National strategy on drug abuse prevention (1996), the Republic of Croatia has accepted the basic principles of good state policy for treatment as well. In accordance to the evidence-based approach, drug addiction is accepted in the medical practice as chronic, recidivistic disease that should be treated within the public health model. There is continuous effort to protect addicts and their families from disastrous consequences of stigmatization and marginalization, which cause the hiding of problems and not taking adequate protective measures. The society suffers numerous secondary harmful consequences if these patients become social outcasts. To avoid this, as well as to protect the health of these very young people, the profession suggests measures aimed at early detection of as many of these patients as possible, as well as at their inclusion in treatment programs that should be specialized, easily accessible outside of hospital, acceptable and adapted to very individualized needs of these, in many respects, special patients. The treatment is planed as a long-lasting and persistent process, completely opened with respect to goals that should eventually be accomplished. In the beginning, the expectations are focused on reducing harmful consequences. Later in the course of complex procedure more demanding goals are set, in the unpredictable dynamics and constant monitoring of patients. In accordance with the agreed goals and needs of patients, depending on their condition, single or all the elements of the procedure are used: pharmacotherapy, social interventions, psychotherapy, family procedures, psycho education, urine testing, behavioral management and comorbidity therapy. The basic state system for medical treatment consists of a net of Centers for outpatient treatment of addictions (today they are integrated as special services in the net of the Institute of public health). Centers’ professional interdisciplinary teams closely cooperate with general practitioners who, through completely decentralized model, provide necessary medications (opiate agonists such as buprenorphine and methadone) to the most numerous and heaviest category of heroine addicts. The yearly number of first time treated heroine addicts is around 900, and they first come for treatment at the age of 26. Health of addicts is completely taken care for, they are all tested for HBV (15%), HCV (40%) (treatment with pegylated interferon is ensured), HIV (0.5%). The basic element of initial treatment of opiate addicts is buprenorphine pharmacotherapy, which is today easily accessible, while methadone (accessible on the national level since 1991.), is slowly pushed in the other plan. Treatment of addicts is ensured in the prison system as well, and some addicts use social rehabilitation programs in some of the therapeutic communities.

addiction; treatment; therapy; prevention; state policy

nije evidentirano