Aims and benefits

Refugees often report high levels of psychological distress due to post-migration difficulties and traumatic experiences before and during flight. Refugees with hazardous substance use or existing substance use disorder (SUD) are a particularly vulnerable group for whom few preventive and therapeutic measures are available.

The aim of this study is therefore to investigate the effectiveness of an integrative culturally sensitive group therapy approach (STARC-SUD) to improve affect regulation in refugees with substance-related problems.  

Additional study information

The study aims to include n = 286 male refugees with psychological distress (GHQ-2 <13) and hazardous substance use or SUD (AUDIT>7 or DUDIT>6), who were subject to psychological distress before or during flight. The intervention is offered to refugees with the support of interpreters in addiction aid facilities in six metropolitan regions on Germany. The effectiveness of STARC-SUD is compared with the treatment as usual (TAU) after the end of the intervention and three months later. It is assumed that STARC-SUD can more greatly reduce psychological distress than TAU. The primary endpoint is severity of psychological distress (GHQ-12).

Study procedures

The following timeline illustrates the course of the study, from preparation, through recruitment and randomization, to the intervention.

Organization of study centres, recruitment of prospects
Screening phase
Prospects complete T0 survey and are either included or excluded
Eligible refugees are assigned to treatment group or wait-list control group
Participants in the treatment group take part in the STARC-SUD intervention, participants in the wait-list control group are treated according to usual standard measures (TAU)
Follow-up phase
All participants are questioned after the STARC-SUD or the TAU (T1) and again three months later (T2)


Schäfer I, Albayrak S, Gaßmann R, Heinz A, Klein M, Lindert J, Lotzin A (2019) Prävention und Behandlung von Suchtproblemen bei geflüchteten Menschen -  der PREPARE-Verbund. Trauma & Gewalt (Suppl. DeGPT-Tagung), 63.

Grundmann J, Lotzin A, Liedl A, Koch T, Böttche M, Hiller P, Schäfer I (2019) Behandlung von posttraumatischen Belastungssymptomen und substanzbezogenen Störungen bei Geflüchteten – das Behandlungsprogramm „STARK-SUD“. Trauma & Gewalt (Suppl. DeGPT-Tagung), 63.

Lotzin A, Grundmann J, Liedl A, Koch T, Hiller P, Schäfer I (2020) STARK-SUD – Erste Erfahrungen mit einem kultursensiblen Behandlungsprogramm bei Geflüchteten mit traumatischen Erfahrungen und substanzbezogenen Störungen. Trauma & Gewalt (Suppl. DeGPT-Tagung), 115.

+49 40 7410 59290

Klinik für Psychiatrie und Psychotherapie
Universitätsklinikum Hamburg-Eppendorf
Martinistraße 52
20246 Hamburg



Prof. Dr. Ingo Schäfer, MPH. Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Psychiatrie und Psychotherapie & Zentrum für Interdisziplinäre Suchtforschung (ZIS) der Universität Hamburg

Prof. Dr. Annett Lotzin, Zentrum für Interdisziplinäre Suchtforschung (ZIS) der Universität Hamburg

Coordination and data management:
Dr. Philipp Hiller, Zentrum für Interdisziplinäre Suchtforschung (ZIS) der Universität Hamburg

Project Duration

02/2019 until 01/2026