ABSTRACT
INTRODUCTION: Alcohol consumption in Germany is associated with considerable health and economic consequences. In addition to prevention, the early detection and differential treatment of those affected play an important role. The guideline "Screening, Diagnosis, and Treatment of Alcohol Use Disorders" forms the basis of this care for people suffering from alcohol use disorders. Regular updates integrate the current state of research evidence and clinical expertise. METHODS: Under the auspices of the German Society for Psychiatry, Psychotherapy, Psychosomatics, and Neurology and the German Society for Addiction Research and Addiction Therapy e.V. (DG-Sucht), the 2019-2020 S3 guideline on alcohol was revised by eight working groups. Thirty-five professional societies participated in a structured consensus process to deliberate the recommendations. Potential conflicts of interest were examined in advance, documented, and taken into account during the voting on the recommendations. RESULTS: The guideline provides recommendations on screening and brief interventions for different groups of people, as well as on treatment of individuals in the acute and post-acute phases of withdrawal. Special emphasis was placed on the treatment of comorbid somatic and psychological disorders. In addition, recommendations for specific groups of people (e.g., children and adolescents, pregnant women) have been made and adapted to the German care landscape.
Subject(s)
Alcoholism , Psychiatry , Adolescent , Alcohol Drinking , Alcoholism/diagnosis , Alcoholism/epidemiology , Alcoholism/therapy , Child , Female , Germany/epidemiology , Humans , Mass Screening , Pregnancy , PsychotherapyABSTRACT
Reducing alcohol consumption is one of the central health goals in Germany because the negative health consequences of excessive alcohol consumption are among the country's most serious and avoidable health risks. The care system for people with alcohol-related disorders comprises a large number of services, but due to the historically developed structures and respective responsibilities, it also includes many interfaces. Alcohol addicts often seek professional help only after many years of dependence. Especially in the areas of early detection and early intervention, there is a significant undersupply for people with alcohol-related disorders (see S3 guideline on alcohol-related disorders). Therefore, efforts should be made to promote the competence of the various actors (e.â¯g. general practitioners, hospital and nursing staff, psychotherapists, case managers in job centers/employment agencies) to recognize alcohol-related disorders in their respective field of activity, to deal with them in a target-oriented manner, to identify risk groups, and to convey them according to their respective needs (e.â¯g. in offers for qualified withdrawal, medical rehabilitation facilities (alcohol addiction treatment)). Accordingly, development potentials for promoting early and seamless access are presented using selected fields of action as an example. It is also emphasized that the implementation of case management is necessary to build bridges between the utility sectors. Finally, central aspects for the future development of the care system for people with alcohol-related problems are described.
Subject(s)
Alcohol-Related Disorders/therapy , Alcoholism , General Practitioners , Germany , Humans , Risk FactorsABSTRACT
BACKGROUND: Alcohol dependence is one of the most serious diseases of addiction in Germany. The new S3-guideline "Screening, Diagnostics and Treatment of Alcohol-Related Disorders" has been presented in 2015 and summarizes the present state of knowledge pertaining to the diagnosis and treatment of alcohol abuse and alcohol dependence. METHODS: This guideline was developed over four years within the framework of the Association of the Scientific Medical Societies in Germany (AWMF). The German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) and the German Society for Research and Therapy in Addiction (DG-Sucht) took the lead in the organization. More than 50 professional societies and associations and health organizations as well as more than 60 acknowledged experts were involved, including networks of self-help groups and relatives. The working group on "health care organization", whose results are presented here, was one out of thirteen working groups, focusing on the task how to implement the guideline under the basic conditions of the German health care system with its sectors and interfaces. RESULTS: For the chapter on "health care organization" 27 recommendations have been consented. Many of these have been prepared by the respective working groups. These recommendations cover areas such as screening, diagnostics and short interventions, detoxification and withdrawal as well as pharmacotherapy, physical complications and psychic comorbidity, medical rehabilitation and other forms of post-acute treatment, primary care by general practitioners, as well as specific target groups such as children and adolescents, (pregnant) women and the elderly, and, in addition, self-help approaches. CONCLUSION: For needs-based diagnostics and treatment of alcohol-related disorders, guideline-based recommendations for health care organization offer a framework for the cooperation and coordination of all health sectors and occupational groups, especially with respect to their interfaces. This includes the cooperation between the medical and the psychosocial system and stretches from harm reduction to social inclusion of people concerned. Particularly the field of rehabilitation with its explicit aims for participation relies heavily on such a cooperation.
