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Screening for physical and behavioral dependence on non-opioid analgesics in a German elderly hospital population.

Authors
  • Bonnet, Udo1
  • Strasser, Johanna Cristina2
  • Scherbaum, Norbert3
  • 1 Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Academic Teaching Hospital of the University of Duisburg-Essen, D-44577 Castrop-Rauxel, Germany; LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Duisburg-Essen, D-45147 Essen, Germany. Electronic address: [email protected] , (Germany)
  • 2 Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Evangelisches Krankenhaus Castrop-Rauxel, Academic Teaching Hospital of the University of Duisburg-Essen, D-44577 Castrop-Rauxel, Germany. , (Germany)
  • 3 LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Duisburg-Essen, D-45147 Essen, Germany. , (Germany)
Type
Published Article
Journal
Addictive behaviors
Publication Date
Mar 01, 2019
Volume
90
Pages
265–271
Identifiers
DOI: 10.1016/j.addbeh.2018.11.009
PMID: 30472534
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To provide further evidence of dependence on non-opioid analgesics (NOAs). Post-hoc-analysis of a cross-sectional study of a ≥ -65-year-old non-demented German general hospital population. Four hundred in-patients (75 ± 6.4 years; 63% females) were included and screened for current and past dependence on NOAs using a structured interview (SKID-I) based on DSM-IV-TR. The addiction section of SKID-I was expanded to the following NOAs: gabapentinoids, acetaminophen, metamizole, flupirtine, and non-steroidal anti-inflammatory drugs (NSAIDs). We found twenty-eight seniors (7%) who fulfilled the criteria for a NOA-dependence. Of whom, twenty-four and four patients were currently dependent and in remission, respectively. According to SKID-I, twenty-one (75%) patients were mildly, five patients (17.9%) moderately, and two (7.1%) patients severely dependent on NOAs. All patients showed at least one sign of physical dependence (tolerance and/or withdrawal symptoms) and most of them reported additional behavioral dependence symptoms. Whereas there was one dependence on gabapentinoids or acetaminophen only, NSAIDs and metamizole were involved in the majority of cases (n = 25; 89.3%). Of note, ten (35.7%) seniors had a de-novo substance dependence exclusively on NOAs - including 2 females with signs of a de-novo dependence on metamizole, a NOA which yet has been not in the focus of addiction medicine. This cross-sectional study provides further evidence of the existence of a physical and behavioral dependence on NOAs including NSAIDs. Furthermore, preliminary evidence of a de-novo dependence on metamizole is provided which needs further verification. Copyright © 2018 Elsevier Ltd. All rights reserved.

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