ÖBIG Austrian Health Institute Gender Analysis and Women in Substitution Treatment in Austria Meeting on Treatment Demand Indicator EMCDDA 23 rd September 2004 Martin Busch

ÖBIG Substitution Treatment in Austria Substitution Treatment was introduced in Austria in 1987 as ultima ratio 1998 Substitution Treatment is defined as equal form of therapy among other approaches with the indications: at least one year opiate dependence and failed efforts of abstinence oriented treatment, HIV-Infection, pregnancy or partner in substitution treatment Diversification of substitution medicaments: 1987 only Methadone, 1998 Substitol (slow release morphine), 1999 Buprenorphine

ÖBIG Substitution Treatment Database Data since 1987 There is oblilgation to report each begin and end of treatment to Ministry for Health and Women Data comes from treatment centers as well as from general practicioners Variables included: Date of beginning of substitution treatment, date of end of substitution treatment, sex, region, substitution medicament

ÖBIG Clients in Substitution Treatment 1987 to 2003

ÖBIG Clients in Substitution Treatment 1987 to 2003 and Gender – First Treatments

ÖBIG Women and Opiates Substitution Treatment 2003: First Treatments 20 % All Treatments 29 % BADO Vienna (not only opiates!) % Prevalence Estimation 1999: 26 % Direct Drug Related Deaths 2003: 18 % Opiate related notifications of the police 1999: 19 %

ÖBIG Clients in Substitution Treatment 1987 to 2003 Gender and Mean-Age – First Treatments

ÖBIG Gender and Age other Sources of Data BADO Vienna 2002 Age < 20: men 20 % women 31 % Direct Drug Related Deaths 2001–2003 Age < 20: men 11 % women 25 % Opiate related notifications of the police Age < 25: men 45 % women 53 %

ÖBIG Conclusions and Hypotheses, Questions Availlability of substitution treatment for women seems to be equal than other kinds of drug related treatment Female opiate users start problem drug use at an earlier age Latency period of female opiate users is shorter – possible reasons: e.g. pregnancy, women are more realistic in assessing their health status Do the existing system of drug treatment meet the needs of women? There is strong need for further research!