[Substitution therapy with diamorphine]

After a long lead time the substitution with diamorphine was taken into the German catalogue of statutory health insurance in 2010. Currently about 570 patients are treated this way in 9 ambulances in Germany. The study phase as well as the clinical practice are showing the success of this therapy concerning physical and mental health of patients and their circumstances of social life. Thereby substitution with diamorphine is underlying very strict admission criteria regarding patients on the one hand and particular organizational requirements of the medical institution on the other hand. This article explains these criteria in detail as well as neurobiological information and clinical workflow is presented. Improvement of mandatory requirements could lead to a better reaching of patients who benefit from substitution with diamorphine.