[4 years' methadone substitution therapy in Austria].

On September 25th 1987 methadone was legalized for therapeutic use in Austria. During the past four years altogether 1828 opiate addicts were admitted to methadone maintenance treatment. 439 females and 926 males were currently being treated in December 1991; their age ranged from 16-59 years, the daily oral d,l methadone dose levels varied between 10 mg and 250 mg per day. Only 406 doctors and 123 pharmacies participate in methadone maintenance treatment, which does not provide complete cover for the area in spite of increased finding. Moreover, the doctors' skills in this treatment have to be improved by requisite training. As Austrian experience shows, methadone treatment offers a first step towards social rehabilitation for drug addicts who have been living as criminals on the fringe of society. Socioeconomic data, as well as criminal behaviour changed dramatically for the better due to this treatment in Austria. Physicians have a clear responsibility to lead the effort on all fronts in the implementation of this treatment modality. Therapeutic drug monitoring should become routine in methadone treatment to ensure compliance and to achieve optimum results, especially in patients who complain of withdrawal symptoms and continue high-risk behaviour and to increase acceptance of substitution therapy. The Austrian treatment model for methadone maintenance treatment is a positive example for other countries who wish to introduce this treatment modality for drug addiction.