[Recognizing and treating drug addicts. Part 2. Differential diagnosis, therapy].

Persons addicted to opiates often have fresh injection scars on the skin directly above the veins in the arms and legs. These appear as well as scars from abscesses and burns, tattoos, advanced tooth decay and signs of chronic hepatitis. An intensive consumption of hallucinogens is often connected to an inclination toward apathy and a loss of contact to reality (amotivational syndrome). It is necessary to have a sufficiently wide spectrum of therapeutic and rehabilitation measures being offered, due to the wide range of variants one can expect in the personality structure and the primary disturbance. The slogan of "therapy instead of punishment" leads nowhere. Long-term in-patient programmes, still presently favoured in our country, are not sufficient and are being increasingly more frequently rejected by the addicts themselves. Out-patient therapy trends, which are both extremely necessary and promising, are to be found in the close co-operation between physicians and specialists in social therapy while utilizing community resources. Two examples for such a programme are discussed (Hesse, Marx). A more concentrated improvement of out-patient therapy and rehabilitation of drug addicts is only possible when the chemical-toxicological diagnosis of addicting substances in urine becomes a routine process in the medical laboratory, e.g. by enzyme immunological methods.