Substance Use Disorder Treatment Quality Standards in Lithuania 1992–2022: From Grassroots Initiatives to Nationwide Strategies

BACKGROUND: The implementation of quality standards in the treatment of substance use disorders in Lithuania is not well documented in the literature. AIMS: To describe the process of the development of quality standards from grassroots initiatives to their integration into mainstream healthcare under the leadership of the Ministry of Health.

METHODS: Narrative review of retrieved documents, including related legal acts, followed by a subsequent content analysis.

RESULTS: The implementation was divided into three stages characterised by specific activities, leading stakeholders, and the degree of integration into the national healthcare system. The driving element in the initial stage turned out to be grassroots initiatives from professional associations and healthcare providers. Because of the availability of private, EU, and UN agencies’ funding to curb the HIV epidemic, Lithuanian professionals had an opportunity to provide assistance in establishing quality standards in Eastern European and Central Asian countries and to learn from Western good practices. During later stages the Lithuanian national system of quality assurance was fully developed and SUD treatment was gradually integrated into the mainstream healthcare system, with the Ministry of Health assuming a leading role.

CONCLUSIONS: In the period of deep transition since 1990, when the national quality assurance system was weak, professional associations have played a major role. Exposure to best practices in other countries was valuable in empowering professionals to initiate and implement quality standards which were later integrated into the national quality assurance system.