Misuse of Substitution Drugs in the Substitution-Based Therapy.

Background: The reasons for, and the extent of, misuse of prescribed substitution medication as well as parallel consumption of other drugs during substitution-based therapy have still not been adequately researched in Germany.

Methods: This study examines the use of substitution medication in German substitution clinics utilizing a nationwide survey with anonymised questionnaires.

Results: The analysis of the 605 questionnaires showed a 30-day consumption prevalence of 8.8% with regard to misuse of substitution substances. The lack of available heroin (38%) and the lack of open spots in treatment programs (21%) were quoted as being the main reasons for the misuse of substitution medication.

Conclusion: Although the misuse of substitution medications is considered an important problem, our study showed that the current misuse was prevalent only among a minority of the patients. German regulations focused on the avoidance of misuse might be partially contributing to the problem.