A critical view on legal barriers and the need for trust – the ATOME Slovakia National Symposium on Access to Opioid Medication

Posted on April 28, 2014 by pallcare

Eugenia Larjow, sociologist at the University Hospital of Bonn, Germany, and member of the ATOME (Access to Opioid Medication in Europe) Project Management Team.

Dr Ľubomír Okruhlica Director, Centre for Drug Dependence Treatment Bratislava, presented some epidemiological results based on the EU- funded project, Improvement of Access to Treatment for People with Alcohol- and Drug-Related Problems.
(Photograph: Katherine Pettus)

Nearly 60 people participated in the ATOME conference held in Bratislava on Tuesday, 25^th March 2014, including representatives of the Ministry of Health, physicians and experts from palliative care, pain management and harm reduction.

“At the beginning I was sceptical, but then I noted people look at me differently, not as a ‘drug addict’. My family accepted me back. I look and feel better. Two years ago I was on the street and on my own. Methadone saved me.”

This is one example of how patients in Slovakia assess their methadone maintenance treatment. Nevertheless, regulatory barriers such as formal documents increase the threshold for access to treatment. Absence of Opioid Agonist Therapy (OAT) in prison, no willingness to prescribe and no access to programmes outside Bratislava are some of the parameters that challenge substitution therapy in Slovakia. However, general epidemiological parameters show a good situation compared to other countries. The insurance system with OAT being free of charge was highlighted as a positive aspect of harm reduction in Slovakia.

Mortality Slide from Dr Okruhlica’s presentation

With regards to opioid therapy in palliative care, a lack of trust towards the expertise of palliative care professionals was demonstrated. Education and sustainability in palliative care services are necessary to handle ‘palliaphobia’. Establishment of networks would be very important. Changes related to prescription restrictions for palliative specialists and reimbursement of mobility costs would also improve the situation of palliative care in Slovakia.

The discussion about the review of the legislation related to opioid prescription, dispensing and use was an important part of the conference. A representative of the Ministry of Health emphasised the influence of European guidelines on Slovakian opioid regulations.

Professor Sheila Payne, President of the European Association for Palliative Care, concluded the conference by highlighting the main messages such as transfer of knowledge to relevant faculties at the universities and increases in the number of palliative care beds, but also revision of the legislation at least in some points.

To find out more…
Click here for more information about the ATOME project. You can also read several other posts on the EAPC blog about previous ATOME meetings.