Objective: A newly opened out-patient clinic with an opiate-substitution facility was frequently visited by German opiate dependent patients with a migration background from the former Soviet Union (late repatriates). The fact that this highly stigmatised clientele had higher hepatitis C and mortality rates have to be taken into account in order to improve treatment. Methods: Basic psychiatric and psychosocial data gathered on admission and during a treatment course of 122 patients was compared with those of German born drug addicts on methadone treatment. Results: A high percentage of the significantly younger, less disintegrated patients, in whom substitution was started after the shortest duration of dependence, had not undergone any in-patient or abstinence orientated therapy. Most were not adequately informed about the drug help system despite being on methadone for an average of three years. Language problems were not the main barrier. The adherence to the treatment regime was poor. Conclusion: Psychosocial therapy, as specified in the German BUB-guidelines, has to target the specific needs of this distinct patient sub-group. Substitution services have to emphasise harm reduction methods to reduce transmission of Hepatitis C among this clientele. © Georg Thieme Verlag KG Stuttgart.

Migration Substitution Opiate addiction Psychosocial treatment Hepatitis C

controlled study major clinical study Germany immigrant virus transmission USSR outpatient care methadone language Conference Paper treatment planning opiate addiction psychotherapy patient compliance human treatment duration hepatitis C Treatment Outcome