Search

Objective: In order to develop demand-driven health information about z-drugs and benzodiazepines, we aimed to identify information needs of people at risk of dependency., Methods: We conducted three focus groups with different target groups: Younger people with sleep disorders (N=7), middle-aged women with occasional/regular intake of z-drugs or benzodiazepines (N=6) and older people with regular drug intake., Results: The information needs primarily refer to the areas "sleep disorders" (esp. alternative treatment options), "z-drugs and benzodiazepines" (esp. risks of intake) and "offers of assistance" (esp. contact points)., Conclusion: The thematic overlaps indicate that all affected groups can profit from general information about sleep disorders, different treatment options and risks. Additionally, information services should also focus on guidance and referral in the help system., Competing Interests: Uwe Verthein erhielt innerhalb der letzten 3 Jahre Vortrags-, Beratungshonorar und Reisekostenerstattungen von Mundipharma GmbH sowie finanzielle Projektförderung und Reisekostenerstattungen von CAMURUS GmbH. Die anderen Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Objective: The majority of medication-dependent persons uses sedatives and hypnotics for many years. In this study we describe trends of benzodiazepine and z-drug prescriptions over a 10-years period., Methods: Prescriptions from 2006 to 2015 (based on German statutory health insurances) from the North German Pharmacy Computing Centre (NARZ) were analysed for the Federal states Schleswig-Holstein, Hamburg, Lower Saxony and Bremen. Data were classified as appropriate (in accordance with the guideline) or inappropriate/risky prescription patterns., Results: In a 10-years period 1.64 Million patients received benzodiazepine and/or z-drug prescriptions. Two thirds were women (65.3 %). More than half were 60 years or older. The percentage of patients with appropriate prescriptions (less than 2 months) increased from 51.7 % in 2006 to 60.2 % in 2015. The rate of inappropriate or risky prescription patterns which can be indicative of misuse or dependence dropped from 34.8 % in 2006 to 27.1 % in 2015., Conclusion: Over the past years the amount of inappropriate or risky benzodiazepine and z-drug prescriptions (which are not in accordance with the guideline) among patients with statutory health insurance is steadily decreasing. However, two fifths of the patients still received prescriptions for long-term intake or in higher doses. It remains unclear to what extent private prescriptions are used for inappropriate or long-term prescriptions of benzodiazepines and z-drugs., Competing Interests: Uwe Verthein erhielt innerhalb der letzten 3 Jahre Vortrags- und Beratungshonorar von Mundipharma GmbH sowie Reisekostenerstattungen von Mundipharma GmbH und CAMURUS GmbH. Die anderen Autoren hatten keine Verbindungen i. o. g. Sinne., (© Georg Thieme Verlag KG Stuttgart · New York.)

Whilst internationally benzodiazepines are first choice for treatment of alcohol withdrawal syndrome, Germany has a long tradition with clomethiazole. This study explores effectiveness of clomethiazole versus oxazepam in the treatment of alcohol withdrawal syndrome within an observational, stratified, non-inferiority study in routine care. Main outcome criterion was severity of the alcohol withdrawal syndrome (Alcohol Withdrawal Syndrome [AWS]) Scale in the first five days. Additionally, the association between the detoxification protocol (five vs. ten days) and AWS-Score was examined. 453 patients (74.2 % male, average age 47.1 years [± 9.2]) took part; 249 received oxazepam (55.0 %) and 204 clomethiazole (45.0 %). The average duration of inpatient treatment was 14.0 days (± 6.3) in both groups. The average AWS-score was lower in the oxazepam group compared to the clomethiazole group (50.0 [± 26.5] vs. 56.2 [± 31.5]; p < .05; effect size d = - .25). Patients with a shorter detoxification protocol had a lower AWS sum score compared to patients with a longer protocol (p < .001; d = - .46). In treatment of alcohol withdrawal syndrome in routine care oxazepam yields at least comparable results to clomethiazole., Competing Interests: Diese Studie wurde von Asklepios proresearch finanziell unterstützt. Uwe Verthein erhielt innerhalb der letzten 3 Jahre Vortrags- und Beratungshonorar sowie Reisekostenerstattungen von Mundipharma GmbH. Jens Reimer erhielt innerhalb der letzten 3 Jahre Vortrags-, Autoren- und Beratungshonorar, Reisekostenerstattungen sowie Forschungsunterstützung von Molteni Farmaceutici, Reckitt-Benckiser, Undivor, Sanofi-Aventis und Mundipharma GmbH. Die anderen Autoren hatten keine Verbindungen im oben genannten Sinne., (© Georg Thieme Verlag KG Stuttgart · New York.)

Objective: The present study investigates the hypothesis of a relationship between mental disorders and symptoms on the one hand and the extent of drug consumption and the addiction-related problems of opiate dependents on the other hand., Methods: In a five-year follow-up study in Hamburg among 350 opiate dependents who, at the time of the initial survey, were in contact with the drug help system, 219 clients (63%) could be interviewed at (so far) three different times of investigation. Standardised questionnaires like the EuropASI, CIDI, SCL-90-R, STAI and BDI were used for the interviews., Results: The general life situation of the surveyed persons has on the whole improved in the course of the last two to three years. Also the average drug consumption clearly decreased. Between mental disorders/disturbances and drug dependence or drug-related problems, a linear correlation could be found: An unfavourable course of mental disorders and symptoms correlates with a problematic current life situation of the client. There is also a global relationship between increased drug consumption and the emergence of mental symptoms like depressiveness and anxiety and the psychosocial functional level., Conclusions: The expected relationship between mental disturbances and the extent of drug consumption is not very marked. This is in support of the basic assumption that specific constellations of drug consumption and mental disorders do not exist isolated, but that they are related, as elements of a complex pattern, to the development of other areas of life.

The controversy caused by the debate on treatment and substitution strategies in drug addiction is unchanged. This is particularly true concerning the use of codein-based drugs in the substitution of heroin abusers. However, only a few studies on the effects of this old and widely used method of substitution have been carried out. This article presents one retrospective and prospective study on the effects of the codein-based substitution in heroin abusers (n = 416). With respect to the issues addressed by this study such as somatic and psychic health, social integration, delinquincy and consumption patterns, patients as well as clinicians report an improvement in general health and fewer of the problems usually associated with heroin abuse, similar to the results from substitution treatment elsewhere.