Department of Social Sciences and Philosophy, University of Jyväskylä, P.O. Box 35, FI-40014 Jyväskylä, Finland.
National Institute for Health and Welfare, P.O. Box 30, FI-00271 Helsinki, Finland.
Int J Drug Policy. 2013 Nov;24(6):e66-72. doi: 10.1016/j.drugpo.2013.08.007. Epub 2013 Sep 8.
The aim of the article is to analyze changes in opioid substitution treatments (OST) in Finland. OST spread in Finland in the late 1990s and early 2000s (Phase 1). Since then, OST has become an integrated part of Finnish drug policy and is provided in various substance abuse treatment units as well as in municipal health centers (Phase 2).
The paper analyses the policy around the implementation of opioid substitution treatment in Finland, focusing on identifying the key factors and the relations between them that have contributed to the implementation of OST in Finland.
OST has become accepted in Finland during the past ten years as a crucial element of a harm reduction strategy. Present incentives behind this development are not as clearly related to drug-specific policies as in the late 1990s; rather, they stem from both the restructuring of health care services (e.g. cost-effectiveness) and the strengthening of the medical or technico-administrative approach to the development of OST.
Since the early 2000s, the development of substitution treatment in Finland has not taken place under explicit drug-political guidance, but largely as a result of many differing intended and unintended effects. One of the unintended effects is the fact that buprenorphine has replaced heroin as the most commonly misused opioid in Finland.
本文旨在分析芬兰阿片类物质替代疗法（OST）的变化。OST 在 20 世纪 90 年代末和 21 世纪初在芬兰传播（第 1 阶段）。从那时起，OST 已成为芬兰毒品政策的一个组成部分，在各种药物滥用治疗单位以及市立保健中心提供（第 2 阶段）。
本文分析了在芬兰实施阿片类物质替代治疗的政策，重点是确定促成芬兰 OST 实施的关键因素及其相互关系。
在过去的十年中，OST 在芬兰已被接受，成为减少伤害策略的关键要素。目前推动这一发展的动力与其说是与特定药物的政策明显相关，不如说是来自医疗保健服务的重构（例如成本效益），以及对 OST 发展的医疗或技术行政方法的加强。
自 21 世纪初以来，芬兰替代疗法的发展并没有在明确的毒品政策指导下进行，而是在很大程度上是由于许多不同的预期和非预期的效果。非预期的效果之一是丁丙诺啡已取代海洛因，成为芬兰最常被滥用的阿片类药物。
