Benzodiazepine und Z-Substanzen – Analyse der kassenärztlichen Verschreibungen von 2006 bis 2015

Verthein, Uwe; Buth, Sven; Holzbach, Rüdiger; Neumann-Runde, E; Martens, Marcus-Sebastian

doi:10.1055/a-0961-2371

Cited by 6 publications

(3 citation statements)

References 41 publications

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“…The decreasing trend in the intake of hypnotics/ sedative and the small amount of fluctuation in the numbers of associated dependence disorders point to a possible delayed positive effect. This development is confirmed by a recent study based on an evaluation of prescriptions supplied to statutorily insured patients (40). According to the authors, the numbers of persons receiving prescriptions for benzodiazepines and z-drugs and the numbers of prescriptions that deviate from guidelines are decreasing in the statutorily insured population.…”

Section: Medicationsmentioning

confidence: 74%

Trends in Substance Use and Related Disorders

Seitz

Lochbühler

Atzendorf³

et al. 2019

Deutsches Ärzteblatt International

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In the years 2006 and 2016, tobacco use was the leading global risk factor for early death and loss of life years due to disability (e1). In 1990, tobacco had occupied third place among 86 comparable risk factors. Alcohol consumption was the fourth most important risk factor in 2016 (fifth in 1990), while illegal drugs were listed in 18 th place (21 st in 1990). In the USA the prescription of painrelieving drugs has been debated in connection with the threefold increase in opioid overdoses between 2010 and 2014 (1, 2) and a related decrease in life expectancy (3).Observations of changes in the use of psychoactive substances and medications and in the occurrence of substance-related disorders enable assessment of the magnitude of the anticipated negative consequences for the population and are thus of wide-reaching importance for health policy (e2). Given the causal connection between use and negative consequences such as illness and death, trends in indicators of consumption permit conclusions regarding the future development of such consequences. In Germany, the Epidemiological Survey of Substance Abuse (Epidemiologischer Suchtsurvey; ESA) has been conducting regular cross-sectional surveys of substance use and related disorders in the adult population (18 to 64 years) since 1995 (4).The study reported here was designed to analyze:• Trends in use of tobacco, alcohol, cannabis, and other illegal drugs together with intake of analgesics and hypnotics/sedatives• Trends in substance-related disorders as coded according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). MethodsThe data came from nine ESA surveys carried out between 1995 and 2018 (every 3 years from 1997 onwards). Owing to changes in the age range surveyed during the observation period, all analyses were restricted to the age range 18 to 59 years. (Information on the individual ESA surveys can be found in the eMethods.) The data were collected in written form or by means of a combination of paper and internet-based questionnaires or telephone interviews. (For details of the complex sampling techniques, see the eMethods.) Information was collected on consumption and patterns of use (amount) of tobacco and alcohol, the use of SummaryBackground: Changes in the use of psychoactive substances and medications and in the occurrence of substance-related disorders enable assessment of the magnitude of the anticipated negative consequences for the population.Methods: Trends were analyzed in the consumption of tobacco, alcohol, cannabis and other illegal drugs, analgesics, and hypnotics/sedatives, as well as trends in substance-related disorders, as coded according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). The data were derived from nine waves of the German Epidemiological Survey of Substance Abuse (Epidemiologischer Suchtsurvey, ESA) from 1995 to 2018. The data were collected in written form or by means of a combination of paper and internet-based questionnaires or telephone interviews.Results: The estimated prev...

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Section: Medicationsmentioning

confidence: 74%

Trends in Substance Use and Related Disorders

Seitz

Lochbühler

Atzendorf³

et al. 2019

Deutsches Ärzteblatt International

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“…In most countries use of benzodiazepines increases with age and is more common among women 20–24 . A systematic review by Votaw et al found conflicting reports on whether benzodiazepine misuse was associated with age or gender 25 .…”

Section: Discussionmentioning

confidence: 99%

Non‐medical use of benzodiazepines and GABA analogues in Europe

Hockenhull

Amioka

Black

et al. 2020

Brit J Clinical Pharma

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We investigated the prevalence of non-medical use (NMU) of benzodiazepines and GABA analogues in Europe. Methods: Data were collected using the online Non-Medical Use of Prescription Drugs (NMURx) survey from France, Germany, Italy, Spain and the UK. Results: The study included 55 223 eligible surveys which, after post-stratification weights were applied, represented approximately 260 million European adults. Lifetime NMU of benzodiazepines was highest in Spain (6.5%, 95% CI: 6.07.0) and lowest in Germany (1.7%, 1.52.0). Lifetime NMU of GABA analogues was highest in Germany (5.4%, 5.05.7) and lowest in France (2.2%, 1.92.5) and the UK (2.2%, 1.92.6) While no notable difference was observed for France or the UK, there was a higher prevalence of last 12-month NMU of benzodiazepines compared to GABA analogues in Italy (2.4 times higher) and Spain (3.0 times higher) and a higher prevalence of NMU of GABA analogues compared to benzodiazepines in Germany (2.6 times higher). Conclusion: This study shows that there is variation in NMU of benzodiazepines and GABA analogues among countries. Of particular interest is the high incidence of GABA analogue NMU in Germany and benzodiazepine NMU in Spain. Further research to identify factors and motivations responsible for the higher prevalence observed are essential to inform public health policies in those countries. K E Y W O R D S addiction, drug abuse, public health 1 | INTRODUCTION Non-medical use (NMU) of prescription medicines is a global issue and, while much of the attention is focused on NMU of prescription opioids, there are other drug classes that warrant investigation. 1,2 A previous study by Novak et al. investigating NMU of prescription drugs in Denmark, Germany, Great Britain, Spain and Sweden found that, while opioids were the most commonly reported medication for lifetime NMU (13.5% of respondents after weighting, compared to 10.9% for sedative drugs [benzodiazepines and tranquilisers]), sedative drugs were most commonly reported for past-year NMU (5.8% compared to 5.0% for opioids). 3 Benzodiazepines have been widely used for their sedative and anxiolytic properties globally for decades, while more recently the

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“…Furthermore, the likelihood of multiple types of physicians being involved – especially anaesthesiologists who are the specialists in pain management – increases with the number of prescriptions. Indeed, receiving OA prescriptions from several doctors (for non-medical use) appears to play a less important role compared with benzodiazepines (BZD) or Z-drug prescriptions ( Verthein et al, 2019 ). Also, Hulme et al (2018) found in their meta-analysis that the main source of pharmaceutical opioids for non-medical use are friends and family and that illegitimate practices such as ‘doctor shopping’ are mainly uncommon.…”

Section: Discussionmentioning

confidence: 99%

Trends in risky prescriptions of opioid analgesics from 2011 to 2015 in Northern Germany

et al. 2020

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Introduction: Due to their euphoric and sedative effects, opioid analgesics have high potential for abuse and dependence. In the last decade in the USA and many Western European Countries the prescription rates of opioid analgesics have steadily increased. Objective: This study describes 5-year trends in the prescription of opioid analgesics and risk indicators such as duration, dose and ‘doctor shopping’ in Northern Germany. Methods: The annual rates of opioid analgesic prescriptions have been analysed for patients with statutory health insurance processed by the North German Pharmacy Data Center for the years 2011–2015. A distinction was made between non-cancer patients and cancer patients, and different groups according to prescription duration and dose level. Results: Between 2011 and 2015, the annual number of patients with opioid analgesic prescriptions increased from 500,000 to 550,000. About half of non-cancer-patients (85% of the total sample) and cancer patients received opioid analgesics for 90 days or less. The rates for long-term prescriptions (⩾9 months) ranged between 6–7% for non-cancer patients and 7–8% for cancer patients. Between 1.2–1.8% received opioid analgesics in doses of more than two defined daily doses. The majority of non-cancer patients with opioid analgesic prescriptions were female. The average age of non-cancer patients was 66 years. About 80% of non-cancer patients with first opioid analgesic prescription received World Health Organization step II medication. Conclusion: For the first time, this study provides comprehensive patient-related analyses of opioid analgesic prescriptions in Germany over a 5-year period. Despite a slight increase in the overall number of opioid analgesic prescriptions, an epidemic spread of opioid analgesics cannot be observed.

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Benzodiazepine und Z-Substanzen – Analyse der kassenärztlichen Verschreibungen von 2006 bis 2015

Cited by 6 publications

References 41 publications

Trends in Substance Use and Related Disorders

Trends in Substance Use and Related Disorders

Non‐medical use of benzodiazepines and GABA analogues in Europe

Trends in risky prescriptions of opioid analgesics from 2011 to 2015 in Northern Germany

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