Report on the Drug Situation 2010 - Bundesministerium für ...

Plans for new guidelines and standards, or guidelines and standards under
preparation, primarily focus on describing services in the form of catalogues on the
one hand and the related quality and continuity standards on the other, in particular
regarding links between inpatient and outpatient services and across different service
providers (see Chapter 5.2).
11.3 Implementation process
Implementation of the aforementioned standards by the attending doctors and
addiction treatment and support services is voluntary because, with the exception of
decrees and organisational guidelines, they are mere recommendations. Therefore the
authorities in charge (i.e., public health officers, Ministry of Health, Vienna Addiction
and Drug Coordination Office) only supervise adherence to the provisions of the
obligatory organisational guidelines and decrees. In Carinthia, a guide has been
published to assist public health officers, which lists competences regarding individual
provisions of the Narcotic Drugs Decree as well as ways of ensuring whether doctors
delivering OST meet the corresponding regulations (Amt der Kärntner Landesregierung
2007b). The activities undertaken to safeguard consistency in the execution of the
Decree primarily focus on information and communication of knowhow by means of
further training schemes. For this purpose, quality circles have been established,
among other further training events.
The Act on Doctors (BGBl I 1998/169, latest amendment published in BGBl I 2009/144)
obliges doctors to treat diligently and without distinction any person, either healthy or
ill, who turns to them for medical advice or treatment. In addition, doctors shall
regularly take part in recognised further training programmes organised by the
Provincial or Austrian Medical Associations or in recognised further training
programmes of other countries and, according to the state of the art of medicine and
practical experience, while meeting any applicable regulations and professional quality
standards, restore the wellbeing of the sick and protect the healthy (Act on Doctors,
Section 49, Para. 1). The detailed regulations for substitution treatment, as provided by
the Decree of 2007 issued on the basis of Section 10, Para. 1 No. 5 of the Narcotic
Substances Act, were regarded as too restrictive by the doctors, arguing that this
limited their competences defined by the Act on Doctors. The modifications laid down
in the amendment to the Decree on Narcotic Drugs adopted late in 2009 as a result of
experience with the existing Decree (see GÖG/ÖBIG 2008c and 2009b as well as
Chapter 5.1) have increased the doctors' acceptance. What continues to be
controversial is the fact that treatment-related decisions which are not in line with the
Decree may still have legal consequences for the attending doctor in question. The
issue of criminal law aspects of substitution treatment thus was a focal theme at this
year's Substitution Forum at Mondsee organised by the Austrian Society of
106 © GÖG/ÖBIG, <strong>Report</strong> on the Drug Situation 2010