Foreigner info

Published: 04.07.2007

In Treatment

Outpatient Services in Finland

Outpatient treatment in Finland consists mainly of therapy or counselling for individuals, couples, families or groups. The theory base for the intervention can be cognitive-behavioural, motivational, systemic, solution-focussed, neuro-linguistic programming or other, depending on the therapist's training and on the needs of the client. Art therapy and other creative therapies are also used. Harm reduction is an important objective and incorporated into various treatment processes. Services are mainly provided by municipal or A-Clinic Foundation's A-Clinics but also private services are available.

The Aim
The overall aim is to enhance the quality of life for the client and for his/her important others, and to help the client stop substance use, reduce substance use (for instance non-dependent heavy drinkers) or reduce the level of risk or harm associated with substance use.

Outpatient detoxification
This is connected in most cases with binge drinking, but also possible with less severe abuse of prescription drugs or illegal drugs, or poly-drug use.

The detoxification process includes

individual assessment
monitoring one’s health status
short-term medication
acupuncture to counteract withdrawal
individual development plan for rehabilitation and follow-up

Types of Medication Used
Long-term medication of alcohol dependence include disulfiram and naltrexone. Nalmefene is used only in clinical trials. Antidepressants and other psychotropic medications are used especially for dual-diagnosed clients. Benzodiazepine dependence can be treated by gradually decreasing the dosage over several months. Some outpatient units provide opiate addicts with substitution treatment using methadone or buprenorphine. A precondition is that eligibility for such treatment has been determined by Järvenpää Addiction Hospital or by one of the university hospitals.

Free of charge
Outpatient services in public A-Clinics are free of charge, with the costs covered by one’s municipality of residence. Most outpatient units are over-crowded, so there may be a 2-6 week waiting list for long-term therapy and detoxification. Crisis counselling can usually be provided immediately or at least within a few days. Here you can find a list of outpatient units in Finland (register maintained by Stakes).

Inpatient Services in Finland

The most commonly provided inpatient programme is detoxification or managed withdrawal from alcohol or poly-drug abuse. Detoxification lasts 4-7 days. Benzodiazepine or other medication, acupuncture and supportive counselling are used to assist with withdrawal. Some units offer rehabilitation programmes lasting 4-8 weeks, possibly longer. In therapeutic communities, most of which cater to young people, no medications are used. Here is information of Detoxification Centres and here you can find a list of Therapeutic Communities in Finland (register maintained by Stakes). Detoxification units and rehabilitation centres are usually maintained by co-operating municipalities or owned by organizations.

Järvenpää Addiction Hospital
Järvenpää Addiction Hospital is the only specialised hospital for the treatment of addictions in Finland. The hospital offers short-term alcohol detoxification, short-term and long-term managed withdrawal from various substances, a therapeutic community programme, a women’s programme, a family treatment programme, and work ability assessment including a rehabilitation plan.

A referral is necessary to access treatment and one should check with their local municipality to see if agreement exists that community members can utilise services though they may not be living within its municipality.

Costs of care
The total cost for inpatient treatment varies between 100 and 500 € per day, depending on the number and types of staff required for one’s treatment programme. The client pays about 22 € of this sum. Clients with no means of their own can seek financial assistance from the social welfare services.

The largest part of the inpatient expenses are normally paid by the client's municipality of residence. In these cases a written commitment from the social welfare services is required for admission into treatment. In many municipalities, access to inpatient treatment is limited due to lack of fiscal resources.