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Medicines Highly increasing intake of opioids
More and more Germans are taking strong painkillers in the form of so-called opioids, according to the latest release from the Federal Association of German Pharmacists Associations (ABDA). The dispensing of appropriate drugs has increased in the past year by 4.5 percent to a total of 18.4 million packages, reports the ABDA, citing the figures of the German Pharmacopoeia e. V. (DAPI). This is a very worrying development, as the use of opioids can have drastic side effects.
With the massive increase in the prescription of strong-acting painkillers, the demand for advice in pharmacies has increased significantly, according to the ABDA. The total number of packs dispensed correspond to approximately 900 million tablets, capsules, patches or other drug units. "On average, more than 12 of these units per year are attributed to each of the 72 million legally insured persons", emphasizes Dr. med. Andreas Kiefer, President of the Federal Chamber of Pharmacists and Chairman of the DAPI. The private insured regulations and consultation hours were not recorded in the statistics and are still to come.
The use of strong analgesics (opioids) increased significantly in 2015 across Germany. (Image: denisismagilov / fotolia.com) Combination therapy always advised
The Federal Association of German Pharmacist Associations also refers in the current press release to the fact that opioids should "always be used in combination with other medicines". There are two main reasons for this. On the one hand, according to the recommendation of the World Health Organization (WHO), pain therapy is basically carried out in three stages, whereby opioids are assigned to levels 2 and 3. According to this level scheme, they should be combined with Level 1 painkillers. According to Dr. Jaws contain Stage 1 painkillers, among others, "the active ingredients ibuprofen or paracetamol, which are available over the counter in some doses or pack sizes." The pharmacists have a special responsibility here in the consultation. In addition, the doctor may prescribe an adjunctive medication in addition to the analgesics, whose active ingredients were originally developed for other diseases such as depression or epilepsy, the ABDA continues.
Accompanying medication against side effect
The second reason for the combination therapy when using the opioids is the avoidance or remedy of side effects. For example, strong-acting pain relievers often cause constipation, which makes continuous use of a laxative unavoidable. Pine. The over-the-counter laxatives are in such cases at the expense of the statutory health insurance institutions prescriptive. Diets high in fiber alone are not enough to relieve opioid-induced constipation, and taking laxatives is essential in most patients. But over-the-counter laxatives are often unsuitable for long-term use. According to Kiefer, a consultation in the pharmacy to choose the right laxative is recommended.
Do not divide specimens without prior consultation
The patients should also be informed about the correct use of the preparations. Because there are different dosage forms for strong painkillers, with many preparations release their active ingredient only delayed. This intentional delay (retardation) can be destroyed if you break the tablet, warns. Pine. "Whether you can share a tablet depends on the particular preparation and may vary for the same active ingredient depending on the manufacturer," explains the expert. Therefore, before a tablet is divided, the expertise of the pharmacist should be obtained, Kiefer continues.
Take care when using pain plasters
If the strong-acting painkillers are applied to the skin with a plaster, the effect will be slow to begin and then last a few days. But for pain plasters to work properly and not stronger than intended, Dr. Some pine be noticed. "The plaster may e.g. only be glued to uninjured skin and must not be cut, "emphasizes the expert. If you need pain plasters, you should also seek thorough advice in the pharmacy.
Increased documentation effort at pharmacies
The ABDA goes on to explain that many strong painkillers are legally narcotics that are prescribed for a three-part yellow prescription that only lasts for seven days. In the pharmacies, the narcotics must be kept in the vault and the handling of them must be meticulously documented. This documentation effort is very large for narcotics, which is why the Federal Association of German Pharmacist Associations also pleaded for an increase in the documentation fee, which has been unchanged for more than 40 years at 26 cents per pack.
Increase in opioid prescriptions critical
However, the increasing release of opioids remains to be discussed not only from an economic point of view. The regulation should also take greater account of alternative treatment methods. Because the painkillers often help only temporarily and according to recent study results, they can also be long-term triggers for chronic pain. In addition there are massive other side effects and the risk of fatal overdoses. An increase in prescriptions of 4.5 percent within one year is therefore extremely critical from this point of view. (Fp)