[Prevalence of HIV-1 infection in intravenous drug dependent patients 1986 to 1989 in Vienna]. / Prävalenz von HIV-1-Infektion bei intravenös Drogenabhängigen 1986 bis 1989 in Wien.

We report the results of a survey of a total of 553 intravenous drug users (IVDUs) investigated at the drug addiction out-patient unit of the Psychiatric Department of Vienna University for antibodies to human immunodeficiency virus (HIV-1) using both enzyme-linked immuno sorbent and Western blot assays. HIV-1 antibodies were found 1985/86 in 8.5%, 1986/87 in 14.5%, 1988 in 27.7% and 1989 in 29.7% of IVDUs. The introduction of methadone maintenance in 1987 attracted many IVDUs and increased the number of patients at the out-patient clinic. In 1989 more than 50% of the IVDUs are on methadone maintenance and already 84.5% of the HIV-1 infected drug users are treated with methadone.

[Fractionated opiate withdrawal with tiapride and naloxone, a new treatment approach]. / Fraktionierter Opiatentzug mit Tiaprid und Naloxon, ein neuer Therapieansatz.

To date, no satisfying solution has been found to the problem of how to avoid the distressing withdrawal symptoms accompanying opiate detoxification. By administering staggered doses of naloxone to the patient while under tiapride (Delpral-R), the various discomforts were satisfactorily reduced and the detoxification syndrome could be limited to 50 hours. This study covers 15 patients who had an average addiction history of more than 7 1/e years, and who underwent inpatient rapid opiate withdrawal treatment lasting an average of five days.

["Induced detoxification treatment" of opiate dependent patients--a new therapy concept]. / Die "induzierte Entzugsbehandlung" bei Opiatabhängigen--ein neues Therapiekonzept.

Induced detoxification treatment of opiate addicts by means of naloxone was developed at the intensive care unit of the Department of Psychiatry at the University of Vienna. Two methods were tested 1. Rapid opiate withdrawal by means of a staggered naloxone regimen. 2. Ultrashort opiate detoxification during general anaesthesia using high doses of naloxone. In an open trial 15 patients were treated with staggered doses of naloxone while under tiapride. The various discomforts were satisfactorily reduced, and the detoxification syndrome was limited to 50 hours. In a second open trial 6 patients were administered 10 mg naloxone under general anaesthesia. All naloxone induced withdrawal syndromes can be suppressed by barbiturate anaesthesia. They do not appear even after the effect of the anaesthesia wears off if the patient is kept on a naloxone regimen as long as opiates remain present in the circulatory system. Both methods shorten detoxification treatment and provide smooth transition to a naltrexone maintenance programme.