Hundreds of thousands of children and adolescents suffer from addiction disorders, whether through media consumption or drug use. With the closure of Germany’s largest detoxification clinic, the already scarce help available threatens to shrink further—to 25 rehab beds. And this across Germany.
“A structural systemic failure,” says the operator of the Dietrich-Bonhoeffer Clinic, which will close its services on June 30. The problem: The therapy offerings are funded by health and pension insurances. The insurers’ rates, however, are too low to operate a clinic like the Dietrich-Bonhoeffer Clinic.
There is “no financial solution” whereby a qualitative and for the patient group targeted continuation of the clinic’s operations would be possible, says Wolfgang Vorwerk, a member of the board of the Leinerstift Group, which runs the clinic.
The children who come to the clinic have already undergone detoxification or withdrawal. However, that is not enough for addicted children and adolescents, says Rainer Thomasius. He established the German Center for Addiction Research in Childhood and Adolescence at the University Medical Center Hamburg-Eppendorf and is regarded as an expert on youth addiction: “The success rate at qualified withdrawal clinics is 25 percent, so 75 percent relapse.”
Million-Dollar Deficits Force the Clinic to Close
That is precisely why there is a need for offerings like those of the Dietrich-Bonhoeffer Clinic in the Lower Saxon town of Ahlhorn. With individualized therapy options, medical care, and an integrated school, children and adolescents are supported on their path out of addiction. Also with regard to future vocational training, the patients are supported.
It costs money. For several months, the patients are accommodated on site. The daily rate the clinic currently receives per bed from the pension or health insurance is 320 euros. The actual costs are about 70 percent higher, according to Leinerstift when asked.
The consequence is a substantial deficit. The clinic is said to have posted a loss of more than one million euros in 2025; for this year a loss of 1.5 million euros is expected. The clinic had already been insolvent in 2024. The diaconal Leinerstift stepped in to rescue the operation. “From many sides we were told that this offering is absolutely necessary,” says Wolfgang Vorwerk.
“For more than a year we have worked intensively to reach workable agreements with the various payers and policymakers. Unfortunately, we were proven wrong,” is his sobering conclusion. At the same time, the importance of his clinic in politics has indeed penetrated.
“The rehabilitative medical care for children and adolescents with addiction is necessary and it is worth preserving,” says Hendrik Streeck, the Federal Government’s Commissioner for Addiction and Drugs. Especially for young people, early and qualified help often decides whether a life can get back on track or whether a severe crisis becomes a lasting dependency. “The current situation is all the more alarming,” says Streeck.
The German Pension Insurance refers to the nationwide statutory framework under which it pays the benefits
That there are so few offerings is not due to a lack of demand but to a fragmented sense of responsibility, Streeck continues. This is also demonstrated by the figures from the youth addiction expert Thomasius: 1,200 children and adolescents require treatment in a rehab clinic for addiction each year. Only 110 of them can be served with the current capacities. If the 60 places at the Dietrich-Bonhoeffer Clinic disappear, there will be even fewer in the future.
Therefore, Streeck sees the states, payers, but also the federal government as responsible. While the latter cannot replace every single facility, “but it does bear responsibility that the legal and financial framework conditions do not cause young people to fall between the systems,” says Streeck.
Hence he is “pushing with emphasis for this care not to be further thinned out.” He wants to articulate a “clear expectation” in discussions with the payers and the political responsible parties.
In the case of the Dietrich-Bonhoeffer Clinic, this may come too late. It was not least a structural reform of the German Pension Insurance on January 1, 2026 that pushed matters over the edge. This signals that “from 2027 again a reduction in the daily rate by the pension insurance and thus an increase in the deficit on our side” will occur, says Karen Landwehr, responsible for corporate communications at Leinerstift. More than three million euros would be missing for the clinic in 2027.
Too much to keep the operation running. The German Pension Insurance points to the nationwide statutory framework under which it pays the benefits. For 2026, a reimbursement rate was negotiated with the Dietrich-Bonhoeffer Clinic that “corresponds to the clinic’s particularities and financial needs.” Why the clinic cannot continue its operation can “only be answered by the facility or its sponsor.”
Future Care Remains Unclear
In the future, the German Pension Insurance intends, within the framework of its care mandate, to ensure that “all young people receive a rehab placement when they need it.” The demand situation is currently being clarified through talks at the Federal Ministry of Health with the relevant players.
This undertaking is unlikely to be made easier by the closure of Germany’s largest rehab clinic for addicted children and adolescents. Accommodation in other facilities, such as those for adults, does not seem to be an alternative, says Thomasius. Children and adolescents would need a qualified, targeted treatment.
Also Come In in Hamburg, which offers rehab slots for children and adolescents, fights with the care rate it receives. It can only continue to exist through the cross-subsidization of its sponsor. Should the structurally underfunded system fail to stabilize permanently, further offerings could in the future be at stake, says the Hamburg rehab clinic.
