Drugs: Highly ingesting opioids

With the massive increase in the prescription of strong-acting painkillers, the need 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 regulations for private insured persons and the consultation hours were not included in the statistics and will be added.

The use of strong analgesics( opioids) increased significantly in 2015 across Germany.(Image: denisismagilov / fotolia.com) 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 points out in the current press release that the 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 generally takes place 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 acetaminophen, which are available over the counter in some doses or pack sizes." The pharmacists have a special responsibility here in the consultation. In addition to the analgesics, the doctor may prescribe co-medications whose active ingredients were originally developed for other conditions such as depression or epilepsy, the ABDA reports.

Concomitant medication against side effects
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. The fiber-rich diet alone is not enough to relieve opioid-induced constipation, and laxative intake is essential in most patients. But even 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

preparations without prior consultation
Patients should also be aware of 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.

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Caution when using pain plasters
Become the strong-acting painkiller by patchUsed on the skin, the effect occurs slowly and then stops for several days. But for pain plasters to work properly and not stronger than intended, Dr. Some pine."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.

Increasing the amount of documentation required by pharmacists
ABDA further explains that many strong painkillers are legally narcotics that are prescribed for a three-part yellow prescription that only lasts for seven days. In pharmacies, the narcotics have to be stored 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 Pharmacists Association also spoke out in favor of an increase in the documentation fee, which has been unchanged for about 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)

use of opioids significantly increased in 2015
More and more Germans are taking strong-acting painkillers in the form of so-called opioids, according to the latest release from the 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 Drug Testing Institute e. V.( DAPI).This is an extremely worrying development, as the use of opioids can have drastic side effects.

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