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We understand the worries expressed by our colleagues, that the term of take home maintenance medication may imply that the substances come from practices’ own dispensaries. We welcome the opportunity to explain potentially misleading phrases. Our study relates to the only legal form of take home substitution treatment—namely, that of taking home maintenance medication from the pharmacy after presenting a doctor’s prescription. For this reason we did not mention any “take home maintenance medication from a practice’s dispensary. If we reported the fact that a proportion of patients were “recruited” from a hospital, the “take home maintenance medication” relates to the outpatient treatment these patients received before entering hospital (1).
The legal situation that our correspondents thankfully clarified in their contributions was previously the topic of a comprehensive article by Rainer Ullmann, also reported in Deutsches Ärzteblatt (2), which we cited in our article, pointing out “current German law.” Like ourselves, Ullman used the German term “Mitgabe [giving someone something to take with them]” rather than the English term “take home” prescription. These terms are used as equivalents in the literature (2, 3), and for this reason, we wrote that this approach is known as “take home” dispensing (1). We explicitly agree with Ms Piekoschowski, that the English term “take home” is misleading when combined with the terms “prescription/daily dispensing”, because it creates the impression that they relate to two different approaches. For this reason too, the term ‘take home maintenance medication' is consistently used in our article consistently , in order to outline its legal status.
You pointed out the registration of substitute medication with the BfArM. The number of 5032 patients receiving substitute medication, as reported in our article, refers to the response from Berlin’s Association of Statutory Health Insurance Physicians (Kassenärztliche Vereinigung Berlin, KV-Berlin), which communicated to us on 23 September 2011 that at that moment, “5032 patients” were registered as receiving substitute medication. We assume that the data from BfArM and KV-Berlin are identical. We regret having written erroneously in our article that these patients were registered with a medical association, instead of with the “KV-Berlin.”
Dr. med. Stefan Gutwinski
Universitätspsychiatrie der Charité im St. Hedwig-Krankenhaus
Lena Karoline Bald
Prof. Dr. med. Andreas Heinz
Dr. med. Christian A. Müller
Ane Katrin Schmidt
Prof. Dr. med. Felix Bermpohl
Prof. Dr. med. Jürgen Gallinat
Conflict of interest statement
The authors of all contributions declare that no conflict of interest exists.
|1.||Gutwinski S, Bald LK, Heinz A, Müller CA, Schmidt AK, Wiers C, Bermpohl F, Gallinat J: Take home maintenance medication in opiate dependence. Dtsch Arztebl Int 2013; 110(23–24): 405–12 VOLLTEXT|
|2.||Ullmann R. Substitutionsbehandlung Heroinabhängiger: Behandlung wird wieder kriminalisiert. Dtsch Arztebl 2009; 106(18): 874–6 VOLLTEXT|
|3.||Scherbaum N. Die Substitutionsbehandlung Opiatabhängiger. Nervenarzt 2007; 78(1): 103–9 CrossRef MEDLINE|