- Care practices are heterogeneous with relevant deviations from evidence-based recommendations, notably regarding pharmacological strategies and inconsistent patient-centred implementation.
- Evidence-based pharmacotherapy for alcohol disorders is often not initiated or continued, and rehabilitation settings limit access for patients on opioid substitution.
- Relapse management is individualised and motivation-based, yet repeated unreported relapse often leads to treatment termination; temporal aspects and regional practices vary.
Nervenarzt. 2026 Sep 22. doi: 10.1007/s00115-026-02014-w. Online ahead of print.
ABSTRACT
BACKGROUND: Systematic data on the implementation of key elements of inpatient treatment for substance use disorders in Germany are still limited.
OBJECTIVE: To systematically assess inpatient care practices with a focus on pharmacological strategies, relapse management, temporal aspects of (qualified) withdrawal treatment, and the management of psychiatric comorbidities, as well as differences between acute care and rehabilitation settings and regional variations.
MATERIALS AND METHODS: Nationwide, anonymized online survey of 500 inpatient facilities (acute care and rehabilitation clinics). Structural characteristics, treatment strategies, and organizational aspects were assessed. Data were analyzed descriptively and inferentially (χ2 test/Fisher’s exact test).
RESULTS: A total of 112 facilities participated (68 acute care and 44 rehabilitation clinics). Treatment services covered a broad range of substances. Evidence-based pharmacotherapy for alcohol-related disorders was often not initiated or continued, particularly in rehabilitation settings. Access for patients receiving opioid substitution treatment was limited in these settings. Relapses were frequently managed on an individualized and motivation-based basis; however, in cases of repeated unreported relapse, treatment was often terminated. Temporal aspects of qualified withdrawal treatment varied considerably, with regional differences. Psychiatric comorbidities were widely addressed.
CONCLUSION: Care practices are heterogeneous, with relevant deviations from evidence-based recommendations, particularly regarding pharmacological strategies and access for specific patient groups. There is a need for more consistently evidence-based and patient-centered inpatient treatment approaches.
PMID:42771037 | DOI:10.1007/s00115-026-02014-w
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