Drug detoxification treatment increasingly difficult to find in Helsinki

Improved access to replacement treatment

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By Merituuli Saikkonen
     
     Those seeking to shake off a drug dependency in Helsinki are finding it increasingly difficult to get into detoxification treatment. At the beginning of the year, the City of Helsinki closed down a detoxification unit operating in Munkkisaari in the south of the city, and now, the Hietalinna Community, maintained by the A-Clinic Foundation, is also threatened with closure.
     “Helsinki has said that it is no longer buying our services, and will move us to the Järvenpää Social Hospital”, says Katriina Pajupuro, director of Hietalinna.
     
The Hietalinna Community is the only place in the area that offers detoxification treatment, which does not use any medications. Located in Töölö, the centre has space for 15 residential patients.
     “Our clients are young people who are at serious risk of becoming marginalised. They are local kids who hang around here without education or a place to live”, Pajupuro explains.
     “Most of them are users of five or more different substances. The basic cocktail includes amphetamine, cannabis, buprenorphine, diazepam, and alcohol.”
     According to Pajupuro, the advantage of the Hietalinna community is its location in the centre of the city. The customers come of their own free will, and do not need a referral from a doctor. Motivation to stop using drugs usually lasts only a short time.
     “It won’t last all the way to Järvenpää”, Pajupuro says.
      The lack of detox treatment has also been noticed at the outpatient clinic for intoxicant psychiatry of the Helsinki and Uusimaa Hospital District.
     “There are fewer detoxification places than before, and there are pressures to put patients like that on psychiatric wards, who would not belong there”, says Saija Turtiainen, deputy head physician at the clinic.
     
The psychiatric ward for abusers of intoxicants generally treats patients with serious mental health problems and who are addicted to an illegal drug.
     Turtiainen says that the city has also started to cut costs by cutting the duration of detoxification treatment from three weeks to two. She feels that the trend is a bad one.
     “Finnish drug users take benzodiazepines and buprenorphine in large doses. They are drugs of such long effect that two weeks si not quite enough for withdrawal”, she Turtiainen says.
     
Helsinki has made efforts recently to shorten the treatment queues for drug replacement treatment. As a result, it is now possible to get into replacement treatment for opioid dependency in less than six months.
     Opioids are opium derivatives such as heroin, codeine, and morphine. In addition, synthetic substances with an effect similar to that of morphine are also classified as opioids. Drugs used in replacement and maintenance treatment are methadone and Suboxone, a form of buprenorphine.
      Mika Mikkonen feels that Helsinki has invested too much in replacement treatment, at the expense of other therapies. Mikkonen works for the A Clinic Foundation, and is a regional director of the Vinkki centres, which offer health advice and clean needles and syringes to intravenous drug users.
     Mikkonen feels that units such as Hietalinna, which offer individualised drug rehabilitation treatment, have suffered.
     “Now the focus is on replacement treatment, and there are cutbacks at the other end. Community treatment will be missed, when it no longer exists”, Mikkonen says.
     
Helsingin Sanomat / First published in print 14..4.2009


Links:
  A Clinic Foundation
  Hietalinna Community

MERITUULI SAIKKONEN / Helsingin Sanomat
merituuli.saikkonen@hs.fi