Search

Alcohol-related disorders are widespread and often underdiagnosed. They are associated with substantial costs, not only for the individual drinking alcohol but to the society as a whole. Questionnaires and biomarkers are useful to facilitate screening, diagnosis, and treatment of alcohol-related disorders and thus prevent later complications. The analytical spectrum offers a wide portfolio of direct and indirect alcohol markers which can be investigated. Indirect state markers such as gamma-glutamyl transpeptidase (GGT), carbohydrate deficiency transferrin (CDT), and the mean corpuscular volume (MCV) are influenced by age and sex, various substances, and non-alcohol-related diseases. Furthermore, they do not cover the entire timeline for alcohol consumption. Direct state markers such as ethyl glucuronide (EtG), phosphatidylethanol (PEth), and fatty acid ethyl esters (FAEE) have gained enormous interest in the last decades as they embed the consumed ethanol within their chemical structure. As biomarkers with high sensitivity and specificity covering different windows of detection, they are recommended in guidelines, should be routinely applied, and contribute to new perspectives in the prevention, interdisciplinary cooperation, diagnosis, and treatment of alcohol-related disorders.

Introduction: In addition to the prevention of tobacco consumption, the establishment and assurance of high-quality treatment for harmful use and dependence on tobacco products remains an important health-related task in Germany. Regular updating of the Association of the Scientific Medical Societies (AWMF) S3 guideline Smoking and Tobacco Dependence: Screening, Diagnosis, and Treatment (Tobacco Guideline) offers a sustainable and reputable source of knowledge on smoking cessation. Methods: Under the auspices of the German Society for Psychiatry, Psychotherapy, Psychosomatics, and Neurology (DGPPN) and the German Society for Addiction Research and Addiction Therapy (DG-Sucht), the Tobacco Guideline was revised in 2019-2020 by 63 experts, who were involved in the development process of the text, in 11 working groups. Undue influence of conflicts of interest on the guideline could be minimized through careful conflict of interest management. Delegates from 50 professional societies discussed the 80 guideline recommendations and voted online. Results: In addition to recommendations for screening and diagnostics, the Tobacco Guideline takes a positive stance towards the use of low-threshold counseling and support services. If, due to the severity of the tobacco-related disorder, brief counseling, telephone counseling, or internet- or smartphone-based methods are not sufficiently effective, individual or group behavioral therapy, possibly in combination with medication, is indicated. If nicotine replacement therapy is not effective, varenicline or bupropion should be offered. Alternative strategies with a lower level of recommendation are hypnotherapy, mindfulness-based treatments, or medication with cytisine. In adolescents and pregnant women, the use of medication should be limited to well-specified exceptions and nicotine replacement. The mean agreement with the recommendations reached a value of 98%. A general overview of the treatment recommendations of the Tobacco

Introduction: In addition to the prevention of tobacco consumption, the establishment and assurance of high-quality treatment for harmful use and dependance on tobacco products remains an important health-related task in Germany. Regular updating of the AWMF-S3Guideline,Smoking and Tobacco Dependence: Screening, Diagnosis and Treatment (Tobacco Guideline) offers a sustainable and reputable source of knowledge on smoking cessation. Methods: Under the auspices of the German Society for Psychiatry, Psychotherapy, Psychosomatics and Neurology (DGPPN) and the German Society for Addiction Research and Addiction Therapy (DG-Sucht), the Tobacco Guideline was revised in 2019-2020 by 63 people, who were involved in the development process of the text, in 11 working groups. Through careful COI management, the influence of conflicts of interest could be minimised. Delegates from 50 professional societies discussed the 80 guideline recommendations and voted online. Results: In addition to recommendations for screening and diagnostics, the Tobacco Guideline takes a positive stance towards the use of low-threshold counselling and support services. If, due to the severity of the tobacco-related disorder, brief counselling, telephone counselling or internet- or smartphone-based methods are not sufficiently effective, individual or group behavioural therapy, possibly in combination with medication, is indicated. If nicotine replacement therapy is not effective, varenicline or bupropion should be offered. Alternative strategies with a lower level of recommendation are hypnotherapy, mindfulness-based treatments or cytisine. In adolescents and pregnant women, the use of medication should be limited to well-specified exceptions and nicotine replacement. The mean agreement with the recommendations reaches a value of 98 %. A general overview of the treatment recommendations of the Tobacco Guideline is provided by three clinical algorithms.

Background: In response to the COVID-19-pandemic, a lockdown was established in the middle of March 2020 by the German Federal Government resulting in drastic reduction of private and professional traveling in and out of Germany with a reduction of social contacts in public areas. Research Questions: We seek evidence on whether the lockdown has led to a reduced availability of illegal drugs and whether subjects with substance-related problems tried to cope with possible drug availability issues by increasingly obtaining drugs via the internet, replacing their preferred illegal drug with novel psychoactive substances, including new synthetic opioids (NSO), and/or by seeking drug treatment. Methods: A questionnaire was anonymously filled in by subjects with substance-related disorders, typically attending low-threshold settings, drug consumption facilities, and inpatient detoxification wards from a range of locations in the Western part of Germany. Participants had to both identify their main drug of abuse and to answer questions regarding its availability, price, quality, and routes of acquisition. Results: Data were obtained from 362 participants. The most frequent main substances of abuse were cannabis (n = 109), heroin (n = 103), and cocaine (n = 75). A minority of participants reported decreased availability (8.4%), increased price (14.4%), or decreased quality (28.3%) of their main drug. About 81% reported no change in their drug consumption due to the COVID-19 pandemic and the lockdown. A shift to the use of novel psychoactive substances including NSO were reported only by single subjects. Only 1-2% of the participants obtained their main drug via the web. Discussion: Present findings may suggest that recent pandemic-related imposed restrictions may have not been able to substantially influence either acquisition or consumption of drugs within the context of polydrug users (including opiates) attending a range of addiction services in Germany.