Pharmacopsychiatry 2020; 53(01): 37-39
DOI: 10.1055/a-0896-2757
Letter to the Editor
© Georg Thieme Verlag KG Stuttgart · New York

Very Low Frequency of Drug Therapy of Alcohol Dependence in Germany – Analysis of Data of A Statutory Health Insurance

Norbert Scherbaum
1  LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
Rüdiger Holzbach
2  St. Johannis-Hospital, Klinik für Psychiatrie, Klinikum Hochsauerland, Arnsberg, Germany, and Centre of Interdisciplinary Addiction Research (ZIS) of the University of Hamburg
Gunnar Stammen
3  Krankenhaus Maria Hilf, Warstein, Germany
Ute Kirchof
4  AOK Nordwest, Dortmund, Germany
Udo Bonnet
5  Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Germany
› Author Affiliations
Further Information

Publication History

received 23 October 2018
revised 08 April 2019

accepted 15 April 2019

Publication Date:
27 May 2019 (online)


Acamprosate and naltrexone are medications of proven efficacy in the treatment of alcohol dependence. In order to investigate the prescription of these drugs in outpatient routine treatment in Germany (frequency of prescription, duration, medical specialty of prescribing physician), data of a large statutory health insurance were analyzed. Persons were included who were discharged from inpatient treatment with an alcohol-related disorder among their diagnoses during a one year observation period and with no diagnosed additional substance-related disorder (apart from nicotine- and cannabis-related disorders). Thus 12.958 patients were identified (mainly male, 77.9%; at average 51.4 years [+/−12.7] of age). 44.3% of these patients were treated in a psychiatric hospital, the remaining patients in hospitals of other specialties (e. g. 9.2% in departments of surgery). During an observation period of 6 months after discharge, acamprosate or naltrexone were prescribed at least once to 98 persons (0.76% of 12.958 patients; acamprosate n=80, 0.62%; naltrexone n=18, 0.14%). 16 (0.12%) patients were prescribed acamprosate or naltrexone for more than 3 months. Half of the prescriptions were issued by general practitioners. Possible reasons for this under-prescription are lack of knowledge about the drug treatment of alcohol dependence outside of addiction psychiatry, neglect of biological aspects (including medication) regarding etiology and treatment of substance-related disorders, and stigma of patients with substance-related disorders.