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Aims: Our study aimed to a) describe the distribution of hospital discharges with primary and secondary alcohol‐specific diagnoses by sex and age group, and b) describe how the number of hospital discharges with primary and secondary alcohol‐specific diagnoses have changed across different diagnostic groups (categorized by primary International Classification of Diseases, 10th Revision [ICD‐10] diagnosis) over time. Design: Retrospective cross‐sectional analysis. Setting: German hospital settings between 2012 and 2021. Participants: All persons aged 15–69 admitted to hospitals as registered in a nationwide data set. Measurements We counted a) the number of all hospital discharges and b) the number of hospital discharges with at least one alcohol‐specific secondary diagnosis (secondary alcohol‐specific diagnosis) by year, sex, age group, and diagnostic group. One diagnostic group included all primary alcohol‐specific diagnoses, while 13 additional groups aligned with ICD‐10 chapters (e.g., neoplasms). Alcohol‐involvement was defined as either a primary or secondary alcohol‐specific diagnosis. Findings Of 95 417 204 recorded hospital discharges between 2012 and 2021, 3 828 917 discharges (4.0%; 2 913 903 men (6.4%); 915 014 women (1.8%)) involved either a primary or at least one secondary diagnosis related to alcohol. Of all alcohol‐involved hospital discharges, 56.8% (1 654 736 discharges) had no primary but only a secondary alcohol‐specific diagnosis. Secondary alcohol‐specific diagnoses were particularly prevalent in hospital discharges due to injuries. With rising age, alcohol‐involvement in hospital discharges due to digestive or cardiovascular diseases increased. Between 2012 and 2021, the rate of alcohol‐involved hospital discharges has decreased more in younger as compared with older adults (average change between 2012 and 2021: 15–24: −55%; 25–34: −41%; 35–44: −23%; 45–54: −31%; 55–64: −21%; 65–69: −8%). Conclusions: The number of alcohol‐involved hospital discharges in Germany from 2012 to 2021 more than doubles (from 1 654 736 to 3 828 917) when including secondary alcohol‐specific diagnoses. More pronounced declines among younger adults may be attributed to unequal changes in alcohol consumption patterns across the population and to the hazardous effects of long‐term alcohol use. [ABSTRACT FROM AUTHOR]

Introduction: Since April 2015, slow-release oral morphine (SROM) has been approved for opioid agonist treatment (OAT) in Germany. Experimental studies show that benefits of SROM over methadone include less heroin craving, better tolerability, and higher patient satisfaction and mental stability. The SROMOS study (Efficacy and Tolerability of Slow-Release Oral Morphine in Opioid Substitution Treatment) aims to investigate the long-term effects (effectiveness and safety) of morphine substitution under routine care in Germany.Material and Methods: This is a prospective, noninterventional, naturalistic, observational study. Between July 2016 and November 2017, this study recruited patients in OAT who decided to switch to SROM from 23 outpatient addiction treatment centers in Germany. The study collected data on mental health (Brief Symptom Inventory - BSI-18), substance use, somatic health (Opiate Treatment Index Health-Symptoms-Scale - OTI-HSS), opioid craving (visual analogue scale), and withdrawal symptoms (Short Opiate Withdrawal Scale) at baseline (t0) and after 3 (t3), 6 (t6) and 12 (t12) months. Physicians documented side effects as adverse events (AEs) and adverse drug reactions (ADRs).Results: Three-quarters of the enrolled study participants (N = 180) were male. The average age was 44.4 years. Patients were opioid-dependent for 23 years and had been in OAT for almost seven years on average. After 12 months, 60.6% were still being treated with SROM. Mental health improved significantly under SROM treatment between t0 and t12. The intention-to-treat (ITT), as well as the per-protocol (PP) analysis, shows a statistically significant improvement of the mean Global Severity Index (GSI) of the BSI-18 value of 20% (ITT) and 24% (PP). Physical health also improved significantly under SROM treatment. There were no statistically significant changes in the use of cannabis, cocaine, amphetamines, and tranquillizers in the past 30 days, but heroin use, intravenous consumption, and the number of drinking days significantly decreased.Conclusions: This study provides some of the first long-term data on OAT with SROM under routine care conditions. SROM treatment is an effective alternative for a subgroup of opioid-dependent patients with an unsatisfactory course of OAT or in cases where undesirable side effects due to alternative substances have occurred.Ethical Statement: The study protocol was approved by the Ethics Committee of the Chamber of Physicians in Hamburg in March 2016 (No. PV5222). The study was conducted by following the Declaration of Helsinki and is registered with the German Register of Clinical Trials (DRKS, ID: DRKS00010712). [ABSTRACT FROM AUTHOR]