Although it is widely acknowledged that substitution treatment should be accompanied by psychosocial support, this is far from being a routine component of treatment. In the Czech Republic, Germany and the Netherlands, a shortage of resources limits the delivery of adequate psychosocial support. And in Norway, although, in theory, every client of substitution treatment should be allocated a social consultant, in practice there is not always sufficient capacity to achieve this. One Danish study found that methadone clients who do not receive any psychosocial support use a secondary drug significantly more often than those who do receive such support. Further research is currently investigating whether expanded psychosocial support can improve treatment outcomes (Pedersen, 2001). The Irish College of General Practitioners has endorsed evidence-based substitution treatment guidelines (2003) stressing the need for a psychosocial component.
The usefulness of psychosocial support depends also, however, on clients’ perceived value of this kind of therapeutic option. In Greece, it is reported that patients in methadone treatment programmes make frequent use of psychosocial counselling, whereas in Latvia only a few patients are willing to receive this kind of intervention.