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

Plans for new guidelines and standards, or guidelines and standards underpreparation, primarily focus on describing services in the form of catalogues on theone hand and the related quality and continuity standards on the other, in particularregarding links between inpatient and outpatient services and across different serviceproviders (see Chapter 5.2).11.3 Implementation processImplementation of the aforementioned standards by the attending doctors andaddiction treatment and support services is voluntary because, with the exception ofdecrees and organisational guidelines, they are mere recommendations. Therefore theauthorities in charge (i.e., public health officers, Ministry of Health, Vienna Addictionand Drug Coordination Office) only supervise adherence to the provisions of theobligatory organisational guidelines and decrees. In Carinthia, a guide has beenpublished to assist public health officers, which lists competences regarding individualprovisions of the Narcotic Drugs Decree as well as ways of ensuring whether doctorsdelivering OST meet the corresponding regulations (Amt der Kärntner Landesregierung2007b). The activities undertaken to safeguard consistency in the execution of theDecree primarily focus on information and communication of knowhow by means offurther 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 orill, who turns to them for medical advice or treatment. In addition, doctors shallregularly take part in recognised further training programmes organised by theProvincial or Austrian Medical Associations or in recognised further trainingprogrammes of other countries and, according to the state of the art of medicine andpractical experience, while meeting any applicable regulations and professional qualitystandards, 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 bythe Decree of 2007 issued on the basis of Section 10, Para. 1 No. 5 of the NarcoticSubstances Act, were regarded as too restrictive by the doctors, arguing that thislimited their competences defined by the Act on Doctors. The modifications laid downin the amendment to the Decree on Narcotic Drugs adopted late in 2009 as a result ofexperience with the existing Decree (see GÖG/ÖBIG 2008c and 2009b as well asChapter 5.1) have increased the doctors' acceptance. What continues to becontroversial is the fact that treatment-related decisions which are not in line with theDecree may still have legal consequences for the attending doctor in question. Theissue of criminal law aspects of substitution treatment thus was a focal theme at thisyear's Substitution Forum at Mondsee organised by the Austrian Society of106 © GÖG/ÖBIG, <strong>Report</strong> on the Drug Situation 2010