Institutions for persons with disabilities Psychiatric comorbidities Dependence on addictive substances, in particular, illegal substances, is stigmatised in society. This isolates persons from their surroundings, and relatives are also often marginalised. And yet the reasons for addiction are manifold. In addition to genetic, neurobiological and neurochemical factors, social, psychological and neuropsychological influencing factors also often play a significant role. Concomitant comorbid psychiatric disorders are more the rule than the exception with alcohol and drug abuse. It is important to recognise that these illnesses are not healed once the “drugs” are no longer inside the body or withdrawal symptoms (abstinence syndrome) have eased off. On the contrary, the substance-related dependencies continue and relapses can be perceived as an integral part of the illnesses. At this point, it is worth drawing a comparison with other chronic somatic and psychiatric diseases (diabetes mellitus, high blood pressure, asthma, schizophrenia, depression), as these also require long-term or lifelong treatment and multi-professional interventions. Structural deficits Commissions 3 and 6 visited outpatient and inpatient facilities that offer opioid substitution therapies in Carinthia, Lower Austria and Styria for the first time at the end of 2016 and during the year under review 2017. This brought several structural deficits to light that worthy of detailed discussion. Experts criticised that the existing treatment concepts restricted personal rights but that there were no individual declarations of consent. In some cases, the focus of the treatment is only on the substance use disorder but not on the underlying psychiatric or somatic illnesses. The treatment of these is thus inadequate. A massive undersupply of outpatient and inpatient treatment options and the resultant inacceptable waiting times for persons who wish to undergo opioid substitution therapy was observed in Carinthia. The regional government of Carinthia has since promised to take remedial action. Instructions were also issued to further develop the outdated Addiction Aid Plan with new concepts for the “Carinthian Addiction Strategy 2018 to 2028”. This is urgently necessary in the view of the NPM because contrary to most of the other Laender, the health care of those suffering from addiction in Carinthia is provided mainly in the Clinic Klagenfurt (Klinikum Klagenfurt am Wörthersee), and only to a minor extent in facilities which are recognised by the Federal Ministry of Labour, Social Affairs, Health and Consumer Protection according to Section 15 of the Narcotic Substances Act (Suchtmittelgesetz). To date, the regional government of Carinthia has not managed to convince office-based doctors to become involved, which would make it possible to offer more outpatient treatment. In one facility, Commission 3 viewed the lack of individual therapy plans drawn up with the consent of the patients as well as the insufficiently established cooperation with adult psychiatry in emergencies or crises as highly critical. Also the lack of verifiable evidence that patients are informed 98