40 ára afmælisráðstefna SÁÁ: Opioid addiction in Iceland SÁÁ
Valgerður Rúnarsdóttir, MD, Medical Director at SÁÁ

Abstract
In Iceland, the opioid addiction problem is because of prescription opioid almost solely. Heroin is not generally found on the black market but prescription tablets are.

Prescription drugs are part of the addiction problem in general, like in other countries. In Iceland, it is especially stimulants (methylphenidate), sedatives and opioids.

People who inject drugs in Iceland are primarily using stimulants and to a lesser degree opioids.

At SÁÁ´s treatment centers, especially Vogur Hospital, there is good data on those admitted for treatment, which is readily available and accessible to all for all substances. Information from these admissions reflect the trends of the addiction problem in Iceland. Vogur Hospital has treated 7,5% of all living Icelanders >14 years old, about 24000 individuals for 76000 admissions. Thorough collection of data prospectively for the last 40 years at SÁÁ, puts Iceland in a unique position with vast information on this group of patients, that reflects the nation´s problem and use.

At the end of last century there was an increase in opioid use among patients coming for treatment, and those injecting raised an alarming concern. At that time, 1999, SÁÁ initiated it´s opioid maintenance treatment with medically assisted treatment, primarily with buprenorphine. Since then, the OMT has grown year by year, and is now counting steadily 120-130 individuals, mostly for people who have injected. The opioid addiction in Iceland was on the rise 1999-2004 but then decreased/stabilized, as to interventions, the OMT, actions by the Directorate of Health and access to physician´s prescription database.

The OMT is given in a controlled, flexible, individualized manner, with psychosocial treatment along with it, frequent interventions and different services. It is provided by healthcare professionals at Vogur Hospital and Clinic, by contract with the ministry of Welfare. There is good collaboration with other healthcare facilities and social services but many obstacles and pitfalls still exist, that need attention and dedicated work from officials soon.

Valgerður Rúnarsdóttir MD, Medical Director of SÁÁ, graduated from medical school, University of Iceland 1992, internship in Iceland til 1995.

Residency in Internal Medicine at Brown University program Rhode Island and to follow Addiction Medicine fellowship, 1995-2000. Board certified in Internal Medicine 1999 and Addiction Medicine 2000 in the US and licensed specialist in both in Iceland.

Diplomate study in public governance from University of Iceland 2014.

Participated in diverse activities for the Icelandic Medical Society in the last 17 years, on the Board and vice president, in Ethical Committee, in Election committee.

Participated in diverse clinical research and some publications

Worked full time in addiction medicine at SÁÁ´s hospital and clinics since 2000, for the total of over 17 years, and recently became the medical director of SÁÁ´s addiction treatments.