All nine Austrian provinces have drawn up drug strategies and nominated drug coordinators, who are responsible for coordinating drug treatment at the regional level. A drug coordinator has been appointed to accredit and monitor treatment at the national level under the Federal Ministry of Labour, Social Affairs, Health and Consumer Protection. The Provincial Conference of Drug Coordinators ensures inter-regional coordination of drug treatment policies. The provincial governments, the social insurance funds and the federal government fund most drug treatment.
Drug treatment services are provided both by specialised centres and as part of general healthcare services, such as psychiatric hospitals, psychosocial services and office-based medical doctors. Primary healthcare services are also involved in the provision of opioid substitution treatment (OST). Drug treatment services provide a range of options and can be flexibly applied to respond to a client’s treatment and social needs. Treatment programmes are offered in modular form, providing both short-term and long-term options. Treatment is mostly provided on an outpatient basis, and most outpatient facilities are also counselling centres. Whereas counselling centres treat users of both licit and illicit substances, several specialised treatment and reintegration facilities are available almost exclusively for illicit drug users. Outpatient psychosocial interventions cover a range of services, such as counselling, outreach work, psychotherapy, aftercare and reintegration programmes.
Inpatient psychosocial interventions are provided in both specific and generic facilities, offering long-term and short-term treatment, often combined with inpatient detoxification. Detoxification treatment is primarily carried out in inpatient facilities, but it is becoming increasingly available in outpatient settings. Many providers of inpatient or residential treatment are organised as non-profit limited companies or associations and provide mainly residential treatment programmes including pre- and aftercare. New target groups for treatment service providers are migrants, pregnant women, young people, older drug users and people with psychiatric comorbidity. Special treatment programmes are also available for cocaine or cannabis users. The areas of advice, support and treatment have been increasingly oriented towards integrated services, and regional networking has been a key feature of recent developments.
OST is widely available and is the treatment of choice for opioid dependence in Austria. It is mostly provided by general practitioners, but psychiatrists can also prescribe OST medications. OST is also provided by public health authorities, hospitals, residential treatment providers and prisons. In recent years, actions have been taken at the provincial level to improve the quality of OST services and integrate them with complementary psychosocial support services. Austria is one of the few countries in Europe where slow-release morphine is prescribed as an opioid substitution medication.
In 2017, over 24 000 people were treated in Austria, mostly in outpatient settings. Only a small proportion received treatment in inpatient settings and prisons. Data on those who entered treatment in 2017 indicate that opioids are the primary substance for which drug users seek treatment, followed by cannabis. In total, 18 632 patients were prescribed OST in 2017, mainly in the form of slow-release opioid treatment.