Present situation: the extensiveness of problematic drug use

According to national report given to EMCDDA by Finnish authorities, during the late 1990ies the drug use situation seemed to be worsening in all reported areas including drug related health problems, criminality, mortality etc.
Recent data covering years 2001-2004 show that this unfavourable development has become slower with the exception of the estimated prevalence of drug abuse.
According to recent data 3% of the adult population have taken drugs during the year while 0.5% are considered to have drug abuse problem. The estimated number of persons with addiction problem is between 16000-21000, a majority of them (70-75%) are using amphetamine.
Another particular Finnish feature is the status of buprenorphine as the main opioid drug abused. Heroin has been practically out of market during the last years and there were no heroin related deaths in Finland in 2004.
Buprenorhine, however, has considerable potential for illicit diversion. Most persons with drug addiction problems are residing in Southern Finland and 30-40% of them (5300-7800) live in the capital area.

National drug strategy

The Action Plan for more Efficient Drugs Policies was adopted in 2000. The main goal of the Finnish drug policy is to prevent drug use and the proliferation of drugs.
The plan consists of measures for prevention and early detection, treatment and support for drug abusers, reduction of drug related harms etc..

The service system in Helsinki

1. Out-patient and institutional services
- In primary care setting health centers and social service centers provide advice, treatment of somatic problems and professional help in social issues
- 7 “A-clinics” and 3 Youth units are city funded treatment centers with trained staff - a 24 h open walk-in unit run by a non-profit organization and funded by Helsinki City
- rehabilitation center for persons needing practical support in activities of daily living after longer treatment periods
- 3 local and one mobile health counselling units providing needle exchange; the program is argued to have been successful in limiting the spreading of infectious diseases
- opiate detoxification opportunities available both in out-patient and institutional settings
- patients with drug related psychoses are treated at Helsinki City psychiatric hospital
- Psychiatric Unit for Drug Dependence and Psychiatric Ward of Psychiatric Unit for Drug Dependence at Hospital District of Helsinki and Uusimaa (HUS) provide assessment and treatment for patients with comorbid diseases (psychoses, mood disorders, personality disorders and neuropsychiatric disorders).

2. Opioid substitution and maintenance assessment and treatment
- provided in co-operation with Social Services Department, Health Center and Hospital District of Helsinki and Uusimaa (HUS)
- a comprehensive assessment program for all patients seeking for short- and long-term substitution/maintenance carried on at the Outpatient Clinic of Psychiatric Unit for Drug Dependence at HUS.
- induction onto methadone or buprenorphine when assessed to be an appropriate treatment. Psychosocial activities included in the treatment program.
- maintenance program for persons with severe asocial personality disorder
- substitution program for pregnant women with opioid addiction at the Women’s hospital at HUS.
- maintenance program for somatic severely ill persons
- other opioid substitution and maintenance programs; limited number of specialized centers; available for ab. 300 persons at present.

Actual challenges

- In the age-group 15-24 years 12% have been taking drugs and 0.9-1.3% are considered to have problematic drug use. The recognition of young people in danger of becoming societal drop-outs forms an impelling challenge.

- The availability of the present opioid substitution and maintenance programs in Helsinki is inadequate. City Of Helsinki has remarkably increased the funds for the substitution and maintenance to include about 100 more patients in the treatment programs.

- The vast majority, 70%, of persons utilizing services for intoxicant abusers are alcohol abusers. In addition, it is estimated that nearly one third of population is consuming alcohol in amounts forming a health risk. The increasing consumption of alcohol is a national concern. A program aiming at improving citizen’s own awareness of alcohol induced harm (“mini-intervention”) has been started in 2004. Finnish clinicians now have access to a “ National Evidence Based Current Care Guideline on Treatment of Persons with Alcohol Problems” published in 2005.

Preventive measures and treatment development plans

- City of Helsinki arranges activities jointly responsible for preventing young people’s substance use. Program “Klaari “ (“Clear”) Helsinki enables the adolescents and adults and co-workers of different fields to operate voluntarily and to assist in order to implement new ideas.
The main goal is to create for young people a safe network that helps them to improve their well-being and to decrease their substance abuse. Attempts are made to decrease regional risk factors and to increase protective factors in co-operation with the children, adolescents, families, municipal officers/authorities and other co-workers.

- Helsinki is participating in the oncoming ECAD study surveying young people aged 15-26 in order to examine the possible influence of family life, hobbies etc on the risk (increased or diminished) of drug abuse.

- In order to develop new treatment opportunities the Psychiatric Unit for Drug Dependence (HUS) is participating in a research program studying possibilities for pharmacological substitution treatment suitable for persons with amphetamine addiction.

 
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