Seek addiction as a disease seriously

Addicts still struggle with great prejudices in Germany. Many sufferers try to hide their addiction and thereby forego early help. In addition to the social stigma, they also encounter barriers in the healthcare sector. For this reason, at the DGPPN congress in Berlin, search experts are calling for open treatment of addiction disorders and tailor-made care services for those affected.
Addiction is a serious disease. Biological, genetic, psychological and social factors play an important role in their formation. "An addiction disorder is based on a malfunction of the reward system in the brain. Addictive substances activate various messenger substances that, for example, trigger well-being or euphoria. As a result, the brain learns relatively quickly to perceive a particular addictive substance as a positive stimulus. If this stimulus is lacking, it feels a kind of reward deficit - with the result that the uncontrolled desire for the addictive substance arises. Addiction is therefore not a weakness of character, but a disease that can be detected in the brain, "explains Prof. Falk Kiefer, medical director of the Department of Dependent Behavior and Addiction Medicine at the Central Institute of Mental Health in Mannheim.

Image: Luis Echeverri Urrea - fotolia

Although the causes and mechanisms of addictions can be scientifically explained today, addicts are still socially stigmatized. They experience discrimination again and again - for example, in the search for work and home. Around 36 percent of the population consider addiction to be a self-inflicted disease. The result: addictions are hushed up by those affected and their social environment. Therapeutic interventions often occur only at a very late stage of dependence.

"But even the health sector is not sufficiently sensitized to addiction disorders. Especially in primary care, the degree of awareness can be improved, but at the same time too little time is devoted to diagnostics and treatment planning. The curative therapy, the withdrawal treatment, which takes place mainly in specialized departments of the clinics for psychiatry and psychotherapy, is not yet fully exploited by intervention of the cost bearer - for example, in terms of treatment duration and treatment goals. The legally regulated responsibilities do not promote efficient networking with the addiction help system. Assistance is offered to those affected too little differentiated. For example, only about 10 percent of alcoholics receive rehabilitative treatment each year. The standard screening of addiction disorders is still not a reality in outpatient and inpatient care. While good results are achieved in therapy, public opinion equates treatment success with abstinence as the criterion for success, and overlooks the fact that this therapeutic goal is not suitable for all addicts for a variety of reasons, "notes Dr. med. Heribert Fleischmann firmly, stv. Head of the DGPPN Department of Dependence Diseases and Chairman of the German Center for Addiction Issues (DHS).

Exclusion of patients and deficits in care are causing much suffering for those affected and their families. There are also high follow-up costs for the company. "We need to integrate addictions into the healthcare system in a qualified manner and ensure a smooth transition to aftercare, as well as improved access to treatment. So-called stepped care models could be forward-looking here. At the same time, we need to focus even more on addictions. All occupational groups that come in contact with addicts are called upon - and this at a very early stage. Targeted questions - for example, with the family doctor - can be used to identify risky consumption or addiction at an early stage and initiate countermeasures or referral to a specialist in psychiatry and psychotherapy. Attempting to deal with the disease in the long term also contributes to their de-stigmatization, "says DGPPN President Dr. Ing. Iris Hauth. (Pm)