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Germany's Battle Against Drug Addiction

Monika Hoegen (sac)May 10, 2006

In Europe, at least 150,000 people die each year as a result of drug abuse. Germany is no exception. But it is leading the way in researching and treating addictions.

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Smoking kills more people in Germany than any other drugImage: AP

Experts in Germany are calling for more funding for drug prevention and education, so that more can be done than just reacting with hindsight. Victims of illegal drugs in particular, such as heroin, cocaine or hashish, face an alarming situation.

"We're mainly talking about young people," said spokesman Rolf Hüllinghorst from the German Central Office for Dependency Matters (DHS). "They start to smoke fairly early and move relatively quickly on to other drugs. That's why it's somewhat of a seismographic development among young people, which has a stronger impact on our society than the consumption of legal substances." DHS represents all 24 substance addiction organizations in Germany.

Hüllinghorst added that German treatment and rehabilitation programs even surpassed those in neighboring liberal Holland, which is very experienced in dealing with drugs.

"When it comes to the treatment of addiction in general, we are clearly in the fore in Europe," Hüllinghorst said. "The treatment of dependency illnesses is a standard treatment. Health and pension fund insurers feel responsible and offer certain programs."

Public health insurers and pension funds in Germany finance more than 100,000 inpatient and outpatient withdrawal treatments annually.

Therapy instead of jail

The model "Therapy instead of Penalty" has also been developed. A drug addict convicted to a prison sentence of less than two years for a criminal offense can go into withdrawal treatment instead of going to jail. The therapy's duration is then deducted from the sentence.

Symbolbild, Kokainkonsum
Many drug addicts turn to crime to finance their habitImage: dpa

This therapy usually lasts nine months. According to Hüllinghorst, the patient has the opportunity during this time to not only be physically healed, but also to develop new perspectives for his life and to reintegrate himself into society -- which wouldn't be possible in prison.

Substitution therapy is another treatment used in Germany. The patient gets an addictive-like substance, which at least temporarily simulates the drug. This facilitates the withdrawal and gradually enables the patient to get clean. Hüllinghorst said it's a successful concept.

"We have thereby nullified the pressure to obtain drugs, can tackle health problems and expect then that these people who get substitution products at some point work together with therapists and can be influenced to leave drugs," he said.

Heroin as medicine?

Heroinambulanz in Bonn
There is a sharp debate on the controlled distribution of heroinImage: dpa

Some 60,000 patients in Germany undergo substitution treatment in Germany. But this therapy has not been successful with a small group of about 1,500 drug addicts. For these people, experts are calling for increasing use of heroin as a means to get clean. This means the patients are provided with the drug in a protected space, so that they don't have to acquire it by criminal means. At the same time, they are offered psychological and group therapy. Perspectives for the future can then be developed together.

Some attempts in the controlled distribution of heroin on the way to getting clean have already been made. The result: the concept was successful among approximately half of the addicts. Still, it remains disputed in Germany.

Legal drugs are also a problem

But drug abuse isn't just limited to illegal substances, such as heroin or cocaine. Alcohol and tobacco misuse lead to serious health problems and even death.

Alcohol continues to play the dominant role in addiction in Germany. Besides excessive nicotine use, alcohol abuse is the main cause of drug-related deaths in Germany.

According to DHS, there were in 2005 some 40,000 alcohol-related deaths, 111,000 deaths from smoking and "only" 1,385 deaths as a result of the consumption of illegal drugs.

But this phenomenon is to a large extent still taboo and no one wants to talk about it, Hüllinghorst said.

"The normal citizen would, of course, rather deal with the consequences of drugs, because it's not something that is close to him," Hüllinghorst said. "He prefers to talk less about his own alcohol and cigarette consumption."

But DHS wants to change this. It is calling on German politicians to provide significantly more financing for education campaigns, which show the dangers of drug consumption. This should include the alleged harmless legal drugs such as alcohol and tobacco.

Giving young people the wrong picture

Jugendliche Mädchen rauchen Zigarette Krebs Krebsrisiko Zigarettenkonsum Anti-Raucher-Kampagne
Teenagers are increasingly taking up smoking at an early ageImage: AP

According to Hüllinghorst, DHS hopes that the federal government will implement the European Union's tobacco advertising guideline, which would mean that tobacco ads would be prohibited in Europe.

"The question of alcohol advertising continues to play a major role," he said.

According to Hüllinghorst, 500 million euros ($639.4 million) is spent on alcohol advertising compared to some 10 million euros for prevention.

"These are proportions, which just can't be right," he said. "And they immediately give children and young people the wrong picture."