Harmful use of non-addictive substances

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Classification according to ICD-10
F55.- Harmful use of non-addictive substances
F55.0 Antidepressants
F55.1 Laxatives
F55.2 Analgesics
F55.3 Antacids
F55.4 Vitamins
F55.5 Steroids and hormones
F55.6 Plants or natural remedies
F55.8 Other substances
F55.9 Substance unspecified
ICD-10 online (WHO version 2019)

Harmful use of non - addictive substances ( ICD-10 F55.-) describes the improper use of certain drugs , food supplements , phytopharmaceuticals or other substances to which no substance-related addiction potential is ascribed. The addiction is therefore an obsessive-compulsive or behavioral disorder with physical disorders and factorswith possible psychological and social problems; However, physical damage can also occur through the harmful effects of the substances. There is either no medical need to take these drugs, or they are taken more frequently or in higher doses than necessary. Affected people may have a strong desire for the substance and sometimes insist on continued use despite the damage that has occurred.

Definition of terms

Colloquially is often drug or drug misuse , abuse , addiction or dependence talk, but which describe the actual shape of the phenomenon insufficiently: The substances are not necessary medicines (eg vitamins.). In addition, terms such as to misuse , abuse or addiction because of their negative connotations avoided today, in order to respect the diverse causes of substance use.

The harmful use of non-addictive substances must be distinguished from the addiction syndrome caused by psychotropic substances . Likewise, possible complications when stopping the substances do not fall under the term of the withdrawal syndrome - related to psychotropic substances . This classification does not include any damage caused by the use of medication prescribed by a doctor , nor are there any drug side effects or treatment errors . A possible benefit of this type of self-medication has less weight than the harmful effect; in the case of medical care, the substances would therefore not be used or only used in a lower dose.

Origin and examples of substances used

Both psychological and social factors on the part of those affected and problematic prescribing behavior on the part of doctors can play a role. Expectations of social success, the need to function and an increase in the most varied of mood disorders can lead to problematic consumption.

Laxatives (laxatives)

The intended use of laxatives takes place temporarily for cleaning the intestines before X-ray examinations or surgical interventions; to achieve a soft stool with anal fissures and painful hemorrhoids ; after rectal-anal interventions or for the treatment of drug-related constipation (e.g. opiates for carcinoma pain or substitution treatment for opiate addiction) . Apart from these applications, there is improper use. In medicine today it is assumed that there is no relevant physical habituation effect due to laxatives. Hypokalaemia , a possible side effect , occurs only rarely and only when ingested in overdosed quantities.

Painkiller

Improper use of pain relievers is often a form of harmful use of non-addictive substances. However, there are indications that the pain reliever paracetamol is not only able to relieve physical pain, but also psychological suffering caused by social exclusion or rejection (so-called social pain ). There is therefore the possibility of a dependency syndrome due to psychotropic substances , which must be taken into account in the differential diagnosis .

Approximately 60 million people worldwide are taking over -the- counter nonsteroidal anti-inflammatory drugs (NSAIDs). It is estimated that in half of the people who take these drugs regularly, erosions and ulcers in the stomach and duodenum may arise. The risk of ulcer Conditional Marketing bleeding and perforations is increased to three times. When taking indomethacin , the maximum risk is reached after 14 days of intake, the relative risk is 2.25. With other NSAIDs, with a lower relative risk, the maximum risk of complications is reached after an intake of about 50 days.

If over-the-counter painkillers are taken regularly (on more than half of the days of a month), drug-induced persistent headaches can occur after just a few weeks, but usually only after years (on average after 4.7 years) . In the case of triptans , this time is reduced to 1.7 years.

Other drugs with psychotropic effects

The harmful use of non-addictive substances also includes the improper use of drugs with psychotropic effects such as antidementia , stimulants and antidepressants . Here, too, the possibility of a dependency syndrome due to psychotropic substances must be taken into account in the differential diagnosis .

frequency

According to the Drug and Addiction Report 2008 , an estimated 1.5 million people in Germany are “drug dependent”, other studies speak of 1.9 million people. Roughly as many can be classified as moderately to severely at risk of developing "drug addiction". However, 80% of the cases relate to a dependency on benzodiazepines , which have a high potential for dependence and are therefore more likely to be attributed to a dependence syndrome caused by psychotropic substances .

One problem in recording the prevalence figures is the variety of harmful uses of non-addictive substances. Of the approximately 10,000 drugs most frequently prescribed by prescription, around 4 to 5% have the potential for problematic use and the development of addiction. However, it does not record whether it is a dependence syndrome caused by psychotropic substances or a harmful use of non-addictive substances. These figures do not take into account the harmful use of substances that are not drugs.

See also

Web links

Individual evidence

  1. ^ German Institute for Medical Documentation and Information : ICD-10-GM Version 2014 Harmful use of non-addictive substances
  2. ↑ a b Factors in the development of drug addiction . Website of the German Medical Association . Retrieved December 15, 2013.
  3. ↑ German Society for Neurogastroenterology and Motility (DGNM) and German Society for Digestive and Metabolic Diseases (DGVS): S2k-Guideline Chronic Constipation: Definition, Pathophysiology, Diagnostics and Therapy ( Memento of August 22, 2017 in the Internet Archive ) (PDF; 588 kB); 2011.
  4. ↑ CN Dewall, G. Macdonald, GD Webster, CL Masten, RF Baumeister, C. Powell, D. Combs, DR Schurtz, TF Stillman, DM Tice, NI Eisenberger: Acetaminophen reduces social pain: behavioral and neural evidence . In: Psychol Sci . tape 21 , no. 7 , 2010, p. 931-937 , PMID 20548058 .
  5. ↑ CN Dewall: Hurt feelings? You could take a pain reliever ... In: Harv Bus Rev . tape 89 , no. 4 , 2011, p. 28-29 , PMID 21510517 .
  6. ↑ Janis Kelly. NSAID gastric damage: Treatment time is more important than specific drugs. Medscape, June 25, 2004
  7. ^ F. Richy: Time dependent risk of gastrointestinal complications induced by non-steroidal anti-inflammatory drug use: a consensus statement using a meta-analytic approach. In: Ann Rheum Dis . 2004; 63, pp. 759-766 doi : 10.1136 / ard.2003.015925
  8. ↑ Medicines - harmful use and dependence. Guide to medical practice. ( Memento of March 12, 2007 in the Internet Archive ) Published by the German Medical Association in cooperation with the Medicines Commission of the German Medical Association . 2007.
  9. ^ DAK Health : Health Report 2009. ( Memento from June 26, 2011 in the Internet Archive ) Analysis of incapacity data. Focus on doping in the workplace, p. 37.
  10. ↑ Drugs and Addiction Report 2008 (Germany)
  11. ↑ S2 guideline : drug addiction , AWMF register number 076/009 (online: full text ( memento of March 26, 2007 in the Internet Archive )), status 05/2006
  12. ↑ innovations-report.de: Study on drug abuse and addiction published: addiction reaches a level comparable to that of alcohol , November 13, 2006.
  13. ↑ Drug addiction ( Memento from January 16, 2013 in the Internet Archive ). Website of the German Medical Association . Retrieved December 15, 2013.