Drug addiction is diagnosed based on the same diagnostic criteria and symptoms as alcoholism. Drug addiction is a much rarer condition in terms of numbers. The lifetime prevalence rate of illicit drug use for any drug is 26.7%, the 12-months prevalence rate is 5.1%. The lifetime prevalence rate of cannabis use (“soft drug”) among 18- to 64-year-olds is 25.6%; for amphetamines it is 3.7%, for cocaine 3.3%, for ecstasy 2.4%, for LSD 2.4%, and for heroin 0.5%.
We provide qualified withdrawal for dependence from the following drugs:
- etc. like Crack, LSD, Crystal Meth
These are psychotropic substances that are usually obtained and used illegally. It is a highly heterogeneous group of drugs with very different chemical compositions and effects. However, all of them have a high addiction potential and can cause severe, partly irreversible or even deadly damage in a very short time.
A growing problem is also the development and distribution of new psychoactive substances (e.g. Spice and synthetic cannabinoids). The term “legal highs“ is misleading because these designer drugs fall under the German Medicinal Products Act; their putting into circulation without prescription is a punishable act.
The effects of drugs are subject to numerous modulating influences; one and the same substance can have very different effects depending on dosage, type of application, existing tolerance, genetically determined metabolism, age, gender, clinical status, comorbidities, etc. In addition, (partially toxic) additives and substitute substances must be expected. Hence, drug, drug user and situational factors play a role (set and setting).
Polyvalent misuse, multiple dependence as well as polytoxicomania often lead to diagnostic insecurity and require increased caution. From a differential diagnostic point of view, the presence of overlapping, not substance-related disorders and illnesses must also be considered at all times.
TREATMENT OF MARIJUANA DEPENDENCY
Cannabis is the leading substance among the illegal drugs. The term refers to a sum of bioactive substances from the female flowers of cannabis sativa, a hemp plant of Asian origin. The most active of these substances is delta-9-tetrahydrocannbinol (THC), which is contained in marijuana with approx. 1- 5% and in hashish with up to 10%. Preferred applications are smoking, eating and snuffing. In addition to its euphoric effect, it can lead to vegetative symptoms, anxiety, impairment of the power of judgment, social withdrawal and sometimes also perception disorders with illusions, hallucinations and psychoses of various lengths.
Sometimes, a psychic dependence evolves, physical dependence is less common. We carry out inpatient treatment in cases of severe withdrawal syndrome, risk of relapse or therapy-refractory outpatient treatment, severe comorbid disorder (personality disorders, including adult ADHS, schizophrenia, affective and anxiety disorders as well as consumption of other substances) and marked consequential damages (various psychoses, flash-back tendency, amotivational syndrome and cognitive disorders).
In the context of our supportive and protective treatment setting, we usually take recourse to benzodiazepines (Rivotril) or (low-potency) neuroleptic drugs or also natural medicines and homeopathic drugs in the case of a severe intoxication or marked withdrawal syndrome. (Induced) psychoses are treated in accordance with the applicable AWMF guidelines, e.g. with (atypical) neuroleptic drugs. Our psychotherapeutic approach is characterized by motivation-supporting interventions, cognitive behavioral therapy and individual case management.
TREATMENT OF OPIATE DEPENDENCY
The most important opiates are morphine and its derivate, heroin and dihydrocodeine. They impact the µ-opioid receptors, inhibiting spontaneous neural activity in the locus coeruleus, the origin of the noradrenergic system (sympathetic trunk). This explains a large number of symptoms of opioid intoxication, e.g. bradycardia and respiratory depression, and of the opioid withdrawal syndrome. This leads to severe psychological and physical dependence which—especially in the case of heroin, the substance with the highest addictive potential—can develop after 2-3 injections already. In the case of opiate addicts it must be taken into account in particular, that approx. 70% of them suffer from concomitant disorders and most of them have serious intrapsychic and interpersonal problems. They may also interact unfavorably with their environment, with an escalating effect, and even get in trouble with the law.
We prefer to use an opioid-based approach for opiate addicts in the context of our qualified withdrawal treatment and use Methadone, Polamidone, Subutex or Suboxone. Withdrawal is supported by high-intensity, complex psychotherapy as well as physical therapy, balneotherapy and relaxation procedures. We use sedating anti-depressants, atypical neuroleptic drugs, Clonidine as well as natural and homeopathic medicines in our pharmacological approach. While opioid withdrawal is considerably less dangerous than alcohol withdrawal, it goes along with a lot of suffering. A full withdrawal treatment from opioids usually takes longer than for other addictive substances. But it is also an option to start with partial withdrawal and continue after a stabilization stage. It must be assessed as a first success of the therapy, if the patient perseveres in the withdrawal process.
TREATMENT OF COCAINE DEPENDENCY
Another focus of our center is the treatment of disorders caused by cocaine and other stimulants. Cocaine is produced from the leaves of the coca bush. It is mostly snuffed, in Peru it is also chewed. Crack, a derivate, is smoked; it has a faster and stronger effect and is also more dangerous in terms of complications and the potential of becoming addicted. Cocaine is often mixed with heroine and injected (speed ball).
Cocaine and stimulants have a high addiction potential and a tolerance develops relatively quickly. They activate mesolimbic and mesocortical dopaminergic neurons. Cocaine inhibits the return of synaptically released dopamine (and of serotonin and noradrenalin) into the nerve cell.
TREATMENT OF AMPHETAMINE DEPENDENCY
Amphetamines include amphetamine, metamphetamine (Speed; Ice, Crystal) and 3.4-methylendioxy-N-ethyl-amphetamine (MDEA; Ecstasy, E, X, XTC, Adam, love drug). Amphetamines also inhibit the re-uptake of the neurotransmitters dopamine and noradrenaline, but in addition they also release them into the synaptic cleft.
The combination of cocaine and amphetamines with anti-depressants can trigger an exponentiating interaction. Among the most dangerous complications are vascular complications such as myocardial infarction and ischemic as well as hemorrhagic stroke.
We usually treat cocaine or amphetamine intoxication with benzodiazepines (Lorazepam) and, in the case of a psychotic syndrome, atypical neuroleptic drugs are given in addition.
The withdrawal of these substances can lead to the following symptoms: Dysphoria, fatigue, vivid, unpleasant dreams, sleeplessness or hypersomnia, increased appetite, psychomotor retardation or restlessness.
The withdrawal symptoms for cocaine occur much sooner due to its relatively short half-life of 45- 60 minutes than in the case of metamphetamine with a half-life of 10- 30 hours.
TREATMENT OF ACCOMPANYING ILLNESSES OF DRUG ADDICTS
Drug-related diseases often go along with other mental disorders. More than half of the addicts suffer from at least one additional mental disorder in their lifetime, mostly from affective andanxiety disorder, schizophrenia and other psychoses, behavioral disorders starting during childhood and adolescence (including ADHS) as well as personality disorders. In most cases, the comorbid mental health problem already exists before.