Abhängigkeitspotenzial und andere Risiken von Opioidanalgetika im Alter

Dirk K. Wolter*

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftReviewForskningpeer review

Resumé

Objective: To review dependence liability and other adverse effects of prescription opioid analgesics (OA) in old age. Methods: The author employed a narrative review and did a literature search in Pub Med (terms: opioid analgesics AND abuse; opioid analgesics AND dependence; opioid analgesics AND addiction; opioid analgesics AND adverse effects; in each case AND elderly) as well as in more recent relevant textbooks. Selection was made with respect to salience from a geriatric veiwpoint and topicality. Results: Prescription of OA has dramatically increased over the past 25 years, and by far most prescriptions are among the elderly and for chronic nonmalignant pain (CNTS). The diagnostic criteria of ICD-10 and DSM-5 do not sufficiently cover the specific problems of OA use in CNTS. Here a specific kind of dependence may occur that cannot be equated with street addiction to heroin. Preexisting substance use disorders and other mental disorders are the most important risk factors. But other adverse effects must be considered. Pain treatment in substance use disorders means a certain challenge. Conclusions: It is mandatory to thoroughly determine the indication for OA treatment in CNTS. This specific kind of OA dependence has to date been scarcely noticed, and there is only insufficient research on it.

OriginalsprogTysk
TidsskriftSucht
Vol/bind63
Udgave nummer2
Sider (fra-til)99-114
ISSN0939-5911
DOI
StatusUdgivet - apr. 2017

Fingeraftryk

Prescriptions
Heroin Dependence
International Classification of Diseases
Chronic Pain
Geriatrics
Research

Emneord

  • Aberrant drug related behaviors
  • Abuse
  • Adverse effects
  • Noncancer pain
  • Pain treatment

Citer dette

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Abhängigkeitspotenzial und andere Risiken von Opioidanalgetika im Alter. / Wolter, Dirk K.

I: Sucht, Bind 63, Nr. 2, 04.2017, s. 99-114.

Publikation: Bidrag til tidsskriftReviewForskningpeer review

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AB - Objective: To review dependence liability and other adverse effects of prescription opioid analgesics (OA) in old age. Methods: The author employed a narrative review and did a literature search in Pub Med (terms: opioid analgesics AND abuse; opioid analgesics AND dependence; opioid analgesics AND addiction; opioid analgesics AND adverse effects; in each case AND elderly) as well as in more recent relevant textbooks. Selection was made with respect to salience from a geriatric veiwpoint and topicality. Results: Prescription of OA has dramatically increased over the past 25 years, and by far most prescriptions are among the elderly and for chronic nonmalignant pain (CNTS). The diagnostic criteria of ICD-10 and DSM-5 do not sufficiently cover the specific problems of OA use in CNTS. Here a specific kind of dependence may occur that cannot be equated with street addiction to heroin. Preexisting substance use disorders and other mental disorders are the most important risk factors. But other adverse effects must be considered. Pain treatment in substance use disorders means a certain challenge. Conclusions: It is mandatory to thoroughly determine the indication for OA treatment in CNTS. This specific kind of OA dependence has to date been scarcely noticed, and there is only insufficient research on it.

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