Evidenzgrade in der Suchttherapie von alkoholbezogenen Störungen und illegalen Drogen

 

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Zusammenfassung

Substanzbezogene Störungen sind klinisch und gesellschaftlich von hoher Bedeutung. In Deutschland sind über eine Million Menschen unterschiedlichsten Alters betroffen. Je nach Substanz und Stadium der Behandlung werden Medikamente und verschiedene Therapieverfahren eingesetzt. Durch eine Literaturrecherche wurde untersucht, zu welchen Pharmaka und Therapieverfahren aktuell randomisierte Studien zum Nachweis einer Wirksamkeit in der Suchttherapie vorliegen. Ziel war es, für jeden pharmakologischen Wirkstoff oder jedes Therapieverfahren Evidenzgrade festzulegen. Für die pharmakologische Therapie des Alkohol-, Kokain- und Opiatentzugssyndroms, sowie deren Rückfallprophylaxe bzw. Substitutionstherapie liegen Medikamente mit hohem Evidenzgrad vor. Eine Wirksamkeit ist auch für Verfahren wie die Verhaltenstherapie, das Kontingenzmanagement oder die motivierende Gesprächsführung wissenschaftlich nachgewiesen.

Abstract

Substance-related disorders are clinically and socially very important. In Germany over a million people of varying ages are affected. Depending on the substance and stage of treatment, drugs and different treatment methods are used. Through a literature search we examined the current knowledge of what drugs and therapies are used to date, and what randomised trials have been carried out to prove the efficacy of drug therapy. The aim was to define for each drug or pharmacological therapy a specific level of evidence. For the pharmacological treatment of alcohol, cocaine and opiate withdrawal syndromes and their relapses, prophylaxis or replacement therapy drugs are found to have a high level of evidence. Efficacy has been proven scientifically for processes such as behaviour therapy, contingency management or motivational interviewing.

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