Sucht

Sucht is a German noun referring to addiction, understood as a chronic disease characterized by compulsive seeking and use of a substance or engagement in a behavior despite adverse consequences. The term covers substance-related disorders—as alcohol, nicotine, opioids, cannabis and stimulants—and behavioral addictions such as gambling, and, in ICD-11 and some classifications, gaming. It is used in medical and social contexts to describe problems that impair health, functioning and relationships.

Etiology and course: Sucht arises from an interaction of genetic vulnerability, neurobiological changes in reward and stress systems, and environmental factors such as trauma, upbringing, and poverty. It typically follows a relapsing course with phases of initiation, escalation, withdrawal and recovery. Early recognition and integrated treatment improve prognosis.

Diagnosis and types: Substances use disorders are diagnosed using criteria from DSM-5 or ICD-11, focusing on patterns of use, loss of control, tolerance, withdrawal and impairment. Gambling disorder is recognized as a behavioral addiction in DSM-5, while gaming disorder is listed in ICD-11, reflecting expanding concepts of addiction.

Treatment: Effective management is multidisciplinary and individualized. It may include medically supervised detoxification; pharmacotherapies for specific substances (for example opioid agonist therapy with methadone or buprenorphine; naltrexone or acamprosate for alcohol; nicotine replacement or varenicline for tobacco) and psychosocial interventions such as motivational interviewing, cognitive-behavioral therapy, contingency management and family therapy. Long-term support and harm-reduction strategies are common.

Public health and policy: Sucht affects people across ages and backgrounds; stigma and barriers to treatment remain challenges. Prevention emphasizes education, screening and early intervention; treatment systems include specialized clinics, peer support groups and social services. Economic costs include health care, lost productivity and criminal justice impacts.