Substitution-based therapy of opioid addicts: clarified clarifications on the GKV range of services
The Federal Joint Committee (G-BA) amended the regulations according to which opioid addicts can receive substitution-based therapy at the expense of statutory health insurance (SHI). The current range of services was adapted to the new requirements of the Narcotic Prescription Ordinance (BtMVV) and the findings of the German Medical Association (BÄK). The necessary clarifications on the substitution-supported treatment of opioid addicts as GKV services are now available.
Necessary adaptations of the guideline Methods of contract medical care (MVV-RL) to the changed legal conditions concerned in particular the treatment goals of a substitution, the indication and the therapy concept.
A primarily abstinence-oriented treatment approach was replaced by a therapeutic approach with broader goals. For example, ensuring survival and abstinence from illicitly acquired and acquired opioids are now anchored as treatment goals.
The treatment concept takes into account more clearly than before, that opioid dependence is a severe chronic disease that usually requires lifelong treatment in which physical, mental and social aspects must be considered equally.
The G-BA also changed the documentation requirements for the substituting physicians. The bureaucratic effort in the care of opioid dependent is thus significantly reduced.
In Germany there are estimated between 150,000 and 200,000 opioid-dependent. According to the Federal Opium Agency, 78,800 use substitution-based treatment. The number of physicians offering substitution treatment is around 2600.
The decision of the G-BA is submitted to the Federal Ministry of Health (BMG) for review and comes into force in the Federal Gazette after the non-objection and announcement.