Referral to treatment and length of stay

Drug treatment is the primary intervention utilised for individuals who experience problems with their drug use, including dependence, and ensuring good access to appropriate treatment services is a key policy aim. Monitoring treatment outcomes is important for improving the treatment journeys that clients take and adjusting services to better fit observed needs.

Self-referral continues to be the most common route into treatment. This form of referral, which also includes referral by family members or friends, accounted for around half of those entering specialised drug treatment in Europe in 2015. An additional 25 % of clients were referred by health and social services, while 15 % were referred by the criminal justice system. In a number of countries, schemes are in place to divert drug offenders away from the criminal justice system and into drug treatment programmes. This may involve a court order to attend treatment or a suspended sentence conditional on treatment; in some countries diversion is also possible at earlier stages of the criminal justice process. In 2015, cannabis clients were the most likely to be referred by the criminal justice system; in Hungary, around 80 % of cannabis treatment referrals came from this source.

Client pathways through drug treatment are often characterised by the use of different services, multiple entries and varying lengths of stay. An insight into treatment journeys is provided by results from an analysis of specialised treatment data from 7 European countries in 2015. Of the 400 000 clients reported in treatment in these countries during that year, just under 20 % had entered treatment for the first time in their life; around 30 % had re-entered treatment, having received treatment in an earlier year; and around half had been in continuous treatment for more than 1 year. Most of the clients in continuous treatment were males, in their late 30s, had been in treatment for more than 3 years and had problems related to opioid use, especially heroin.