EN
In Germany addiction is treated as an illness, not as weakness of character. That is not a softening phrase but a working principle: it follows that treatment is not by “willpower” but to protocol — first the physical dependence is dealt with under medical supervision, then months of work on what led to it. In Germany the second part is regarded as the main one, and it is the part most often skipped.
What counts as addiction here
The diagnosis is made by the international classification of diseases: loss of control over how much and when, craving, growing tolerance, withdrawal, a narrowing of interests around the substance, and continued use despite obvious harm. It covers alcohol, opioids, stimulants, cannabis, sedatives and sleeping pills, nicotine, and also addictions without a substance — gambling and internet-related.
Accompanying mental disorders are assessed separately. Depression, anxiety disorder, post-traumatic stress disorder and adult ADHD are common in addiction, and treating only the use while leaving them unattended makes a relapse all but certain. German clinics manage such cases as a dual diagnosis — in parallel, not one after the other.
Two stages that do not substitute for each other
Detoxification (Entzug). An inpatient stage of roughly one to three weeks. The task is to get through withdrawal safely. This is not a formality: withdrawal from alcohol and from high doses of sedatives can involve seizures and delirium and is life-threatening without medical supervision. So the patient’s condition is monitored around the clock and medication to ease withdrawal is given where needed.
The German standard is not “plain” detoxification but qualified detoxification — qualifizierter Entzug: from the first days, as soon as the patient’s condition allows, conversations with a psychotherapist, review of the situation and work on motivation begin. The point is that someone whose body has simply been cleared of the substance and who is then sent home returns to exactly the circumstances that brought him to the clinic.
Rehabilitation (Entwöhnung). The main stage, and a long one: as a rule from eight weeks to six months, as an inpatient or in a day programme. Here the work is no longer with the substance but with the person — individual and group psychotherapy, family sessions, daily structure, physical activity, occupational therapy, and learning to recognise situations of risk and to have a plan for them in advance. Outpatient follow-up comes after: review appointments, support groups.
What German clinics do not do
This is worth stating plainly, because patients often arrive with different expectations.
- No “coding” or implanted deterrents. Methods built on intimidation and suggestion are not part of German evidence-based practice. Supportive medication exists, but that is a different thing: drugs that reduce craving are prescribed alongside psychotherapy, not instead of it.
- No “ultra-rapid detoxification under anaesthesia”. German guidelines do not support the procedure in which opioid withdrawal is put through in a few hours under general anaesthetic: it offers no proven advantage and carries real risk.
- No treatment against a person’s will. An adult cannot be admitted at the request of relatives. Compulsory admission is possible only by a court decision and only where there is immediate danger to the person or to others. If the patient does not agree to treatment, the trip cannot be arranged — that is where the conversation begins.
- No promises of a result. No doctor will guarantee a cure, and a clinic that does is breaking German law on advertising in healthcare. Relapse is a common feature of this illness, and it is treated as a reason to adjust the treatment rather than as a failure.
Substitution therapy: an important limitation
For opioid dependence Germany uses substitution therapy — methadone, levomethadone, buprenorphine. But a patient from abroad needs to understand how it works: these are strictly controlled narcotic medicines, their prescription is governed by the narcotics law, they are dispensed by a doctor with a separate qualification, and at the start of the course they are taken under supervision. A months-long supply is not issued, and it cannot be taken out of the country — that is a criminal offence both in Germany and at the border.
The practical conclusion: substitution therapy works as a long-term programme where you live, not as a course you travel for. We do not send medicines and do not undertake to arrange the continuation of such therapy after departure — instead, doctors agree on continuity of treatment in advance, before discharge.
How long it takes and what has to be arranged
Detoxification fits within an ordinary Schengen visa; a full course with rehabilitation almost never does. If the planned treatment lasts longer than 90 days, a national category D visa is needed; a Schengen visa is not enough and cannot be extended on the spot. Processing takes time, so the decision about length is made before the application is submitted, not after arrival.
Patients from abroad pay directly, against the clinic’s invoice. German health and pension insurance covers rehabilitation only for those insured in Germany; it does not extend to foreign patients. The clinic issues an estimate for detoxification and for the rehabilitation course in advance, as separate items.
Medical confidentiality is protected by law: information about treatment is not passed to an employer or to relatives without the patient’s written consent, nor to any register outside the clinic.
Where to start
Send us the discharge letters and reports if the person has already been under care — in your own language; we will do the translation. It is important to describe honestly what is being used and for how long, in what doses, whether there have been attempts at treatment and how they ended, and whether there are other illnesses. On that depends whether admission with supervision is needed or a day programme will do, and which clinic it makes sense to look for.
After that we find a suitable clinic, agree the dates and the estimate, arrange the invitation for the visa, and meet and accompany you with an interpreter. Write to us — we will go through your situation and say plainly what can realistically be done in it.