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Berlin – Patients with severe opioid addiction should be able to receive replacement therapy with diamorphine more quickly in the future. The guidelines authority of the German Medical Association (BÄK) is being expanded to include substitution treatment with diamorphine. This is provided for in a draft regulation from the Federal Ministry of Health (BMG). German medical journal is present.

The core is the lowering of the age limit for diamorphine therapy from at least 23 years to 18 years. However, for everyone under the age of 23, a second opinion from another addiction doctor who is not part of the same facility is required.

Among other things, patients must have been addicted to opioids for at least two years. They must have significant medical, psychological or social deficits, each of which can be traced back to the consumption of illegally obtained opioids. A treatment attempt with alternatives must have taken place for at least six months and not been successful.

In the future, it will also be stipulated that diamorphine may only be prescribed if the doctor is qualified in addiction medicine, his addiction medicine qualification extends to treatment with diamorphine or he has been a doctor for at least six months as part of the model project “Heroin-assisted treatment of opiate addicts”.

The aim is to adapt the narcotics law requirements to the experiences and findings of treatment practice, writes the ministry. The aim is to be able to offer this treatment option to severely addicted patients in a more needs-based manner in order to ensure their survival and achieve health and social stabilization earlier.

During the first six months of treatment, “psychosocial care measures must be started promptly,” it continues.

In the future, the German Medical Association should in particular be able to make determinations regarding the requirements for initiating treatment with diamorphine.

According to the ministry, the measures also serve to create more legal certainty for the treating doctors in this special form of substitution therapy. In this way, more doctors could be attracted to offer this treatment and contribute to improving the care of substitution patients overall. © may/aerzteblatt.de