"The German National Strategy on Drug and Addiction Policy focuses on treatment and counselling alongside prevention and early intervention. In Germany, the responsibility for the implementation of drug treatment lies with the federal Länder and the municipalities. Available treatments range from low-threshold contacts and counselling services to intensive treatment and therapy in specialised inpatient facilities. Long-term treatment options exist in the form of opioid substitution treatment (OST), long-term rehabilitative treatment and social reintegration options.
"First, we confirmed that the rate of diagnosed OUD has increased steadily among commercially insured adults, and we documented how the age distribution of OUD has changed. In 2008 diagnosed OUD among the youngest age group (ages 18–24) was more than double that among the oldest group (ages 55–64). However, in 2017 diagnosis rates exhibited a hump-shaped pattern in age, with the highest rate (4.75 per 1,000 enrollees) among the middle-aged (people ages 35–44) and the greatest increase among the near-elderly (ages 55–64).
"Analysis of court statistics demonstrates that the 2013–2014 amendments have not led to the expected outcome of “motivating” PWUD to undergo drug treatment or rehabilitation. Only about 2% of people convicted for drug administrative offenses chose to undergo treatment rather than punishment (about 1500 out of more than 70,000)  and only about 1% of 48,557 people who were involuntarily ordered to undergo drug dependence treatment remained drug-free within a year or more after treatment.
"This large multicentre, randomised, controlled, comparative effectiveness trial had five major findings. First, it was more difficult to start XR-NTX [Extended-release naltrexone] treatment than BUP-NX [sublingual buprenorphine-naloxone] treatment: 28% dropped out of treatment before XR-NTX induction versus only 6% before BUP-NX induction. Second, nearly all induction failures had early relapse. Third, in the intention-to-treat population of all patients who were randomly assigned, XR-NTX had lower relapse-free survival than BUP-NX, directly related to early induction failure.
"NSDUH includes questions that are used to identify people who needed substance use treatment (i.e., treatment for problems related to the use of alcohol or illicit drugs) in the past year. For NSDUH, people are defined as needing substance use treatment if they had an SUD in the past year or if they received substance use treatment at a specialty facility32 in the past year.33,34
"Drug dependence treatment—within an acute care, symptoms-focused paradigm—has fallen short of properly addressing the complex, multifactorial nature of drug dependence that often follows the course of a relapsing and remitting chronic disease. There is disillusionment with the 'admit, treat, and discharge', revolving door cycles of high dropout rates, post-treatment relapse, and readmission rates.
"Medication-assisted opioid therapy includes the use of methadone or buprenorphine for the treatment of opioid addiction or dependence and the use of extended-release injectable naltrex-one (Vivitrol®) for relapse prevention in opioid addiction.
" Marijuana/hashish was reported as the primary substance of abuse by 14 percent of TEDS admissions aged 12 and older in 2015 [Table 1.1b].
" The average age at admission for primary marijuana/hashish admissions was 26 years [Table 2.1b]. Thirty-one percent of marijuana/hashish admissions were under age 20 (vs. 7 percent of all admissions combined), and primary marijuana/hashish abuse accounted for 78 percent of admissions aged 12 to 14 and 75 percent of admissions aged 15 to 17 years [Table 2.1c].
"The inaccessibility and poor quality of services pertaining to the treatment of drug dependence in Russia have been extensively documented. Treatment methods reported include flogging, beatings, punishment by starvation, long-term handcuffing to bed frames, 'coding' (hypnotherapy aimed at persuading the patient that drug use leads to death), electric shock, burying patients in the ground and xenoimplantation of guinea pig brains62.
"During the course of treatment, many treatment seekers stopped using the drugs that they reported using at entry to the study. Lower rates of drug use were recorded at each follow-up. Furthermore, those that continued to use tended to use less. Most of the changes observed occurred by first follow-up. For most forms of drug use, no particular treatment modality was more associated with cessation than any other and the route into treatment (CJS or non-CJS) did not influence drug-use outcomes.