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Heroin Addiction and Related Clinical Problems: 2007, 09, 4 (pages: 9 - 20)

Maintenance: How Long ? Experiences from a German Practice

Ulmer A., Muller M., Frietsch B.

Summary: Objective: Classical addiction treatments comprise detoxification therapies and in, some cases, inpatient therapies in special clinics. This kind of treatment is so firmly established that society, many professionals and even many addicts think it should be possible to cure addiction diseases within a few months. This is why, maintenance therapies are believed to be disease-prolonging. The prescribers are often asked how long they plan to treat their patients. Methods: For 17 years now, we have been observing the evolution of > 350 addicted patients in our practice with the help of diagrams, leading to an overview of what we have seen, rather than to statistical analyses. Results: The impression is absolutely clear: addiction diseases are chronic, life-accompanying diseases. Patients who are able to overcome the symptomatic phase of this kind of disease forever, within months or only a few years, are rare and, in most cases, are among those less seriously affected. Even our 'best', and most presentable patients need ten and more years of treatment for a lasting stabilization even when they are already stable. Other patients who have not been stable over a long period of time, usually need much longer. Conclusions: When treating addicted patients, we must have plenty of patience. The overwhelming majority need therapy for many years, often for the rest of their lives. We should always look forward, and never give up. The prognosis for most of the patients is hopeful. Lasting improvement has been seen in at least a majority of our patients.