Drug substitution treatment patients to be treated at Helsinki public health clinics
Doctors and nurses worried about ability to cope with new responsibilities
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Public health clinics in Helsinki are concerned about their ability to cope with an influx of patients needing replacement therapy drug dependence.
The enactment of a new statute on replacement therapy this month is moving treatment of some opiate addicts from special facilities to ordinary public health clinics.
"They are patients just like any other. We have nothing against them as such", says Kati Kobler, head physician at the Vallila clinic.
However, many doctors are unhappy that yet another area of specialised medicine is being imposed on basic health care services. "Again a new area of expertise that we have to become acquainted with."
Clinics are not being offered any new material resources for dealing with the situation.
The aim is that those who get replacement drug treatment at health clinics would be working people, students, and those who are otherwise living as normal a life as possible.
However, it has been noted that 86 per cent of patients undergoing drug replacement therapy suffer from some kind of a personality disorder. "They have many kinds of problems", says ward nurse Anna Tynell.
She notes that training for dealing with such patients has clearly focused on specialised care and care in the "third sector" - involving treatment offered by foundations, and by non-profit and voluntary organisations.
"It is completely new for us." In the first inquiry, nurses were not found at every city health clinic who would have been willing to work with drug replacement programmes.
The greatest fear at public health clinics involves the prospect of a sudden influx of addicts, who might try to get treatment past the normal channels.
"We have already had several break-ins. When word about replacement drugs spreads, break-ins might also increase", Kobler warns.
One recent poll indicated that 82 per cent of respondents did not feel that it was a good idea for drug addicts to share the same waiting room with other patients.
The director of Helsinki's health clinics, Outi Kupiainen, says that she understands the qualms that health clinic personnel might have in treating the new class of patients.
The idea is that the patients that would be shifted from the A-Clinics to their local health centres would be the ones who are very motivated in their treatment. Kupiainen says that there are about 50 such patients now. The total number of patients receiving replacement drugs to cope with their dependency is just under 400.
Only about 10 public health clinics in Helsinki will take part in treating the new patients.
The new venture will also cost money. Kupiainen says that the replacement drugs will cost Helsinki between EUR 270,000 and EUR 300,000 a year.
Helsingin Sanomat
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| 6.2.2008 - TODAY |
 Drug substitution treatment patients to be treated at Helsinki public health clinics |
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