The results suggest gender differences in the context of drinking. The context of drinking needs to be considered in the development and implementation of target group-specific prevention and intervention measures. What is known: • The context of drinking, e.g. when, where, why and with whom is associated with episodic heavy drinking among adolescents. What is new: • Male and female inpatients with acute alcohol intoxication differ with regards to the context of drinking, i.e. in admission time, drinking situation, drinking occasion and admission context. • Being admitted to hospital from public places is associated with higher blood alcohol concentration.

Background: Methamphetamine abuse is expanding in Europe, leading to a shortfall in medical care for related disorders in many regions. Research focusing on the effectiveness and feasibility of methamphetamine-specific treatment programs is scarce, especially in short-term settings. Methods: To this end, we treated 31 patients with methamphetamine dependence using a new group psychotherapy manual added to standard psychiatric care. Trained research assistants recorded demographic, illness and treatment variables using a standardized interview at baseline and a follow-up visit 3 months later. Outcome and process variables for this intervention encompassing 15 modules for qualified detoxification and motivation of patients with methamphetamine dependence are reported. Results: Retention and abstinence rates as well as acceptance and feasibility in daily routine were assessed positively. Patients with an unsuccessful outcome were characterized by longer regular methamphetamine use (t = −2.513, df = 29, p = 0.018) and a shorter abstinence period at baseline (U = 74.500, z = −1.808, p = 0.072). Among the demographic and clinical variables, the only predictor significantly increasing the odds of a successful outcome was a shorter period of regular methamphetamine use (OR = 1.318, CI 95% for OR = 1.021-1.700, b = 0.276, SE = 0.130, p = 0.034). Conclusions: This freely available therapy manual can help counter the shortfall in available psychotherapeutic interventions for patients with methamphetamine dependence in German-speaking countries. The routinely assessed parameters duration of regular methamphetamine use and abstinence before treatment were associated with outcome and may be used to personalize therapeutic strategies.

Aim: Methamphetamine (MA) abuse and dependence are increasing worldwide and are commonly associated with cognitive deficits. Some studies indicate that such impairments can improve if users become abstinent, but overall results remain inconclusive. Hence, we have performed a longitudinal case-control study investigating key surrogates for attention and impulsive decision-making before and after treatment. Methods: Thirty patients with MA dependence and 24 non-substance-abusing control participants were recruited. Groups were matched on age, sex and education. All subjects performed a baseline assessment to obtain neurocognitive measures of sustained attention and delay discounting. Patients subsequently participated in an MA-specific relapse prevention program including repeated monitoring of relapse status. After 3 months, participants of both groups were reevaluated for neurocognitive performance. Results: At baseline, MA patients showed a significantly higher number of omissions compared to controls, indicative of lower sustained attention. Interestingly, we observed a steep decrease of omissions in MA patients to control-group level post treatment. On the other hand, MA patients discounted delayed rewards significantly stronger than controls, indicating a more impulsive choice behavior both before and after treatment. Limitation: The results should be interpreted with care because of the small sample and short follow-up period. Conclusion: Our data support earlier findings on partial recovery of cognitive deficits in MA patients. They also strengthen the indication for recently recommended psychotherapeutic interventions and may provide a behavioral monitoring tool to inform treatment progress.

This naturalistic study confirms that known risk factors for the development of AUD also apply to AIA. This finding facilitates targeted prevention efforts for those cases of AIA who need more than the standard brief intervention for aftercare.

Zusammenfassung. Zielsetzung: Suchtkranke Personen und insbesondere Methamphetamin (MA) -abhängige schwangere Frauen, Mütter und Väter brauchen spezifische Hilfsangebote für sich und ihre Kinder. Am Universitätsklinikum Dresden wurde 2016 dazu das interdisziplinäre Programm „Mama denk‘ an mich“ (MAMADAM) ins Leben gerufen, dessen suchttherapeutischer Teil hier vorgestellt wird. Methode: Die Therapieaufgaben der Ärzte, Psychologen und Sozialarbeiter werden dargestellt. Spezifisch gehören dazu die MA-spezifische Gruppenpsychotherapie für schwangere Frauen und Mütter, Vorgehen beim Abstinenznachweis und bei positivem Drogentest sowie die Zusammenarbeit mit den Jugendämtern. Ergebnisse: Bislang wurden insgesamt 13 Schwangere, 49 Mütter und19 Väter vorstellig. Die Hauptsuchtmittel waren MA (65 %), Alkohol (18 %) und Cannabis (15 %). Komorbide psychiatrische Störungen lagen bei 78 % der Fälle vor, bei 56 % beinhaltete dies auch nicht suchtbezogene Störungen. 71 % waren zu Therapiebeginn überwiegend fremdmotiviert, 71 % bezogen Arbeitslosengeld II und 38 % waren vorbestraft. Die Haltequote für Patienten, die ins Therapieprogramm eingeschlossen wurden, lag bei 77 % bei einer Therapiedauer von 22 Wochen (Median). 20 Patienten wurden in stationäre Entgiftungs-/Reha-Behandlung vermittelt. Diskussion: Die behandelte Stichprobe stellt eine hoch risikobehaftete Klientel dar. Dennoch gelang es im ambulanten Setting, den überwiegenden Anteil abstinent in Therapie zu halten. Die ambulante psychiatrische Suchttherapie kann somit für Eltern eine sinnvolle Alternative zur stationären Langzeittherapie darstellen.

Background/Aims: Adolescent alcohol binge-induced hospital admissions (BIHAs) are an increasing problem in Europe. We investigated whether psychosocial factors (e.g., drinking situations, drinking occasions and neighborhood unemployment) are associated with particularly risky patterns of alcohol or substance use. Method: We performed a systematic retrospective chart review of all the respective cases in 2003-2008 (n = 586; age range: 12-17 years) from both pediatric hospitals in the city of Dresden, Germany. Results: The vast majority of adolescent BIHAs were associated with drinking together with peers at weekend parties. Compared to this ‘typical' drinking pattern, adolescents drinking ‘atypically' (i.e., drinking either alone, to cope or despite the fact that the next day was a school/work day) more often had already used alcohol and illegal substances before and were more often diagnosed with substance use disorders and other mental disorders prior to BIHA. The unemployment rate in the patients' neighborhood was positively related to the incidence proportion of adolescent BIHAs in the respective subdistricts (r_s = 0.61). Conclusion: Adolescent atypical drinking may indicate an increased risk for the development of alcohol and substance use disorders. This information is quickly accessible and can alert clinicians to initiate psychosocial aftercare; their infrastructure should address the strong relation between BIHA probability and neighborhood unemployment rates.

Zusammenfassung Einleitung Methamphetaminkonsum hat sich im Südosten Deutschlands zu einer flächendeckenden Problematik ausgeweitet. Gleichzeitig fehlen deutschsprachige, standardisierte Therapiemanuale in der Versorgungslandschaft. Methodik Evaluation von Prozessvariablen eines neuen Manuals für die qualifizierte Entgiftungs- und Motivationsbehandlung der Methamphetaminabhängigkeit. Hierzu wurden 31 Patienten1 (Durchschnittsalter 29 Jahre, 11 weiblich) über 3 Monate regelmäßig untersucht. Ergebnisse Akzeptanz sowie Durchführbarkeit im stationären Alltag wurden positiv bewertet. Häufung von Abbrüchen bei Übergang in ambulantes Setting. Schlussfolgerung Das Manual wirkt der Versorgungslücke entgegen. Durchführbarkeit im klinischen Setting ließe sich durch Straffung der Module und höhere Therapiefrequenz verbessern.

Background and Objectives: Although the number of adolescents admitted to in-patient treatment with alcohol intoxication (AIA) has strongly risen in many countries, knowledge about this patient population with respect to risk and resilience factors is lacking. The objectives of this study were (1) to explore whether the prevalence of substance use and use-related problems in a sample of AIA is elevated compared to adolescents from the general population and (2) to investigate which biopsychosocial factors are associated with prior problematic alcohol use in AIA.