According to the WHO, dependence on opiates such as heroin is a serious psychiatric disorder. This dependence is accompanied by particularly serious health risks; overdose can even be fatal. Because opiates are often administered intravenously, there is a risk of additional diseases such as hepatitis, HIV, or tuberculosis.
Opioid use currently accounts for the majority of problem drug use in Austria. Approximately 90 percent of individuals in drug-related care are primarily being treated for opioids. There are currently 30,000 to 34,000 individuals who are abusing opioids. About half of them live in Vienna. Substance abuse occurs more frequently in urban areas than in rural areas (ÖBIG (Austrian Health Institute), 2013 Report on the Drug Situation).
Individuals who are dependent on opiates often suffer from severe mental disorders such as anxiety, depression, or psychosis. They often suffer from other physical illnesses such as hepatitis C or HIV. Their life expectancy is thus significantly reduced compared with that of a healthy individual. Opioid dependence is one of the most difficult psychiatric disorders to treat.
Heroin dependence can be effectively countered with substitution therapy. The craving for the addictive substance will be curbed or substituted by administering a medically prescribed, sustained-release opioid. The physical and psychological symptoms of sufferers can thereby be stabilised. Abstinence used to be the primary objective of the therapy. Although abstinence still remains the long-term goal, long-term maintenance therapy now utilises medically prescribed synthetic opioids. These medications are given daily to affected individuals under strictly regulated conditions. Under certain circumstances, these may be given for a short period of time. Restoring the physical and mental health of affected individuals should facilitate their re-integration into ordered social structures.
The acceptance of substitution treatment has led to an increasing number of opioid-dependent individuals in substitution treatment (16,892 individuals in 2012). This means that currently more than half of all individuals with problematic opioid consumption are undergoing substitution treatment (ÖBIG, 2013 Report on the Drug Situation).
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Despite the far-reaching consequences of dependence, it is still possible for affected individuals to regain control of their lives. Affected individuals who accept the consequences of the disease, who seek help, and who are motivated to change are able to lead productive lives that are not dominated by dependence. It is important that affected individuals accept help and are motivated to change. The earlier the affected individuals seek help, the better the chances they have of regaining an orderly life.
In Austria, those affected by dependence are fortunate to have a well-structured support system. This includes low threshold, anonymous dependence counselling, inpatient psychiatric wards in hospitals, and inpatient/outpatient and day-care withdrawal programmes. Individuals in acute situations can best find help by contacting dependence counselling centres that provide a confidential atmosphere in which to discuss further dependence support measures.
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