Austria

"In Austria, experience of illicit drug use primarily concerns cannabis, with prevalence rates of approximately 30% to 40% among young adults. According to the majority of representative studies, approximately 2% to 4% of the population have had experience of ecstasy, cocaine and amphetamines, and approximately 1% and a maximum of 2% have had some experience of opioids (see Table A1 and Table A2). In recent years, the range of substances taken in the context of experimental use has widened. Within certain scenes and groups of young people, high prevalence rates are found for a variety of substances, including biogenic drugs, solvents and inhalants. However, in most cases, use of illicit substances is limited to a short period in life. Very few data are available regarding the use of research chemicals and legal highs in the general population, which, however, indicate insignificant prevalence levels, in contrast to the great interest in this theme reflected by media coverage."

"The prevalence rates covering the past year (12-month prevalence) have gone down considerably. They are above one percent only in the case of cannabis (2.8 %; 2004: 7.5 %) and under one percent regarding all other substances (see Figure 2.1). This confirms the assumption that use of illicit drugs tends to be limited to a certain period in life or to experimental use. However, the strong decrease in 12-month prevalence rates for illicit substances compared to 2004 should be assessed critically.
"Recent data are again available from the Vienna drug survey4, which permits an analysis of long-term trends since 1993 (IFES 2009; see also Table A1 in Annex A and ST1).
"Compared to previous surveys, indications of drug use went down or remained at levels similar to the past, with the exception of opioids (see Figure 2.2). Regarding cannabis, after a continuous rise, rates of use went down again. Although the decline is considerably smaller here, this result shows an interesting parallel to the development of prevalence rates in the aforementioned nationwide population surveys, and should be discussed.
"In the age groups under 30 and between 30 and 40, a share of 20% reported experience of cannabis, compared to 22% in the group aged 40 to 50 and 25% in the group between 50 and 60. In the group older than 60, only 3% indicated experience of cannabis. As a rule, life-time prevalence rates are higher among men than among women (e.g., cannabis: 22% v. 11%). To obtain a more comprehensive picture, also use in the past three years and in the past 30 days was studied: here the resulting prevalence rates are considerably lower compared to lifetime use (e.g., cannabis: 5% v. 3%)."

"The data available have limitations in respect to quality and coverage, however, the information available suggests that heroin was only present in the majority of overdose deaths in a relatively small number of EU countries. A significant share of overdose deaths was reported by Austria (67%), Italy (56%), Ireland (46% in 2017), Poland (44% in 2016) and Romania (43%). In 7 other European countries, heroin was found in approximately a quarter to a third of reported overdose deaths: Portugal (37%), Slovenia (33%), Denmark (36%), France (33% in 2020), Türkiye (32%), Spain (28% in 2020) and Norway (23%). In 2021, in the north of Europe, less than 1 in 6 overdose deaths in Finland, Sweden and in the Baltic countries was reported to involve heroin."

"In 2021, the proportion of overdose deaths involving benzodiazepines increased in several countries and was present in more than half of the cases in Denmark, Austria, Portugal and Finland (see figure Proportion of drug-induced deaths with benzodiazepines involved in selected countries, 2019–2021 in Drug-induced deaths in Europe)."

"In the early 1990s the HIV prevalence rate was still as high as around 20% in the group of injecting drug users, but has gone down to low levels since then (2013: 0% to 11%; see Table 6.1), with the largest numbers recorded among drug-related deaths. Here, slightly elevated figures have repeatedly been registered in recent years (e.g. 2012: 5% to 12%; see GÖG/ÖBIG 2013c). Figure 6.1 shows that the percentage of persons with HIV infections due to IDU who have been included in Austria's HIV cohort study36 has gone down in recent years. However, in 2011 we see an increase for the first time since 2007, especially in the group aged under 25. As of 2012, the figures have not continued to rise, and in 2013 a marked decline has been re-corded.
"In the available sources of data, the hepatitis B prevalence rates range from 5% to 25% in the reporting period. In the majority of cases one can rule out the possibility that any positive test results may be due to previous vaccination (see also footnotes to Table 6.1).
"The hepatitis C antibody (HCV-Ab) prevalence rate remained stable at a level over 50% for several years in the past. It lay between 20% and 69% in 2012, and between 13% and 70% in 2013. However, on grounds of data quality and data collection settings, it cannot be verified whether or not this is a general trend. In order to obtain reliable figures on the prevalence of infectious diseases in persons with drug problems, it would be very important to improve the national monitoring routines (e.g. conducting a representative seroprevalence study).

"In 2013, a total of 122 fatal overdoses were verified in the context of autopsies. An additional 16 deaths – for which no autopsies were performed – are very likely to result from drug overdoses (narcotic drug poisoning given as the cause of death in the confirmation-of-death certificate after external post-mortem examination)39. A total number of 138 deaths directly related to overdoses is therefore assumed for 2013. A decline in drug-related deaths has become apparent in recent years (see Figure 6 3). Figures for individual provinces and age groups are given in Tables A3 to A7.
"In 13% of drug-related deaths for which conclusive toxicological analyses were available, only illicit drugs (one drug or a combination of several drugs) were found. In 61% of cases, psycho-pharmaceuticals were detected as well, in 6% alcohol was found in addition to illicit drugs, and in 20%, both substances, i.e. alcohol as well as psychopharmaceuticals. As in previous years, fatal polydrug overdoses involving opioids clearly predominate (see Figure 6.4). Patterns of polydrug use involving opioids, where the effects of different substances may be potentiating and are thus difficult to control, continue to be widespread and to constitute serious health risks."

"The client year 2011 is the sixth year for which data of the DOKLI [Austrian Treatment Demand Indicator System] nationwide documentation system of clients of Austrian drug services have been available 36 (see also Tables A23–A28).
"The drug support and treatment centres in Austria that are covered by the DOKLI system communicated data on a total of 3,037 people who had started long-term outpatient treatment in 2011. For 1,589 of them this was the first drug treatment they had ever had in their lives. 1,526 clients started long-term inpatient/residential treatment, and for 272 of them this was their first long-term drug-related treatment. Apart from people undergoing conventional drug-related medical treatment, DOKLI also registered 379 people turning to low-threshold services, and 6 511 people requiring drug-related services in the form of short-term contacts. Generally speaking, the data gathered for 2011 correspond to those of previous years.
"Approximately one in six clients treated is younger than 20 – except in inpatient settings, where they account for 8% of patients A proportion of between 45% (low-threshold services) and 61% (long-term inpatient treatment) is between 20 and 29 years old (see Figure 5.1 and Table A23).
"In all settings studied, the percentage of women clients was between 20% and 25%."

"Although the capacities of addiction support and treatment services in Austria have been continually expanded, many centres have waiting lists, and clients have to accept waiting times, which, however, depend on many factors, and may vary greatly. For instance, in 2011 the OIKOS support and treatment centre (see also Chapter 11) usually had more applicants for residential treatment than available places (Oikos 2012), whereas in summer 2012, waiting times were virtually nil (Witting, personal communication). In January 2012, the clients of the b.a.s. outpatient service in Graz faced waiting times of between six and eight weeks before they could enter treatment, (b.a.s 2012a), whereas in July 2012, the waiting times were only two to four weeks (b.a.s 2012b).
"While the centres of the Maria Ebene Foundation report slightly smaller caseloads in 2011 (Stiftung Maria Ebene 2012b), the new Oikos support and cannabis outpatient services in Klagenfurt, which opened in autumn 2009, registered a considerable rise in clients in that year (Oikos 2012). This increase is primarily accounted for by young first consumers, but relatives of drug users have also been increasingly turning to the centre for information and advice. In order to meet the demand, three additional general practitioners have been appointed. Following the expansion of addiction support centres in Lower Austria in recent years, a significantly greater number of clients have received services, and advice with regard to non-substance-related forms of addiction has also been offered more often (Hörhan, personal communication)."

"The prevention of infections continues to play an important role in low-threshold centres and outreach work: in this context, the exchange and sale of syringes is of great relevance. In the majority of centres, the return rates for used syringes are very high (97%) (see Caritas Diözese Graz-Seckau 2014b). In addition to syringe exchange, it is possible to buy syringe sets at vending machines in five provinces. The sets also include accessories such as alcohol pads, as well as information on safer use (see Figure 7.1 and Figure 7.2, as well as Table A31).
"In addition to the established programmes for the exchange and sale of syringes that are run at the provincial level, in Austria it is also possible to buy syringes and needles at pharmacies.
"The number of syringes that have been returned or sold in the individual provinces has further risen. In 2013 a total of 4 762 999 syringes or needles were issued to drug users throughout Austria (2012: 4 625 121). Assuming that there are between 11 000 and 15 000 injecting drug users in Austria, an average of approximately 360 sterile syringes per year have been issued per injecting drug user in the context of syringe exchange. Austria thus continues to rank top in Europe and also meets the goal defined by the WHO to a great extent45 (see GÖG/ÖBIG 2013a). The number of permanent locations where syringes can be exchanged or bought has not changed. In Carinthia, one streetwork service is no longer available, whereas in Upper Austria an additional syringe vending machine was installed in the reporting period (see Table A31 and ST10).
"In 2013, Vienna recorded 210 021 contacts with clients in the context of syringe exchange. Even though this represents an increase as against the previous two years, it is lower than the figures for the period from 2007 to 2009 (245 000 to 279 000 contacts). The number of syringes that were exchanged in the reporting period has also gone up slightly (2012: 2 924 487; 2013: 2 940 457) (see SHW 2014a; Table A31). The streetwork service at Karlsplatz in Vienna only dispenses emergency syringe sets. In 2013, a daily average of 24 emergency sets were provided (2012: 54), and 13 sets were issued on an average day in the context of street social work (2012: 10) (SHW 2014a, SHW 2014c)."