Internationally substitution is the most common treatment of drug addi
cts. Studies show that there are positive effects compared to control
groups without treatment, that only few patients are discharged from s
ubstitution treatment regularly and that dropout from treatment is mos
tly the cause for relapse. Furthermore the results depend on the varyi
ng quality of treatment implementation. Since introduction of the NUB
guidelines (drawn up by the medical organisation of federal physicians
and the insurance companies) in Germany the amount of substitution ha
s risen considerably up to 15.000 patients. Standardized regulations a
re missing, the implementation does not currently meet the necessary q
uality requirements.