Advertisement

DNP - Der Neurologe & Psychiater

, Volume 20, Issue 1, pp 36–45 | Cite as

Behandlung von starken Schmerzen

Probleme der Opioidanalgetika-Therapie aus psychiatrischer Sicht

  • Dirk K. WolterEmail author
Zertifizierte Fortbildung
First Online:
  • 84 Downloads

Zusammenfassung

Opioidanalgetika haben einen festen Stellenwert in der Behandlung von Tumorschmerzen, werden aber auch zunehmend bei nicht tumorbedingten Schmerzen eingesetzt. Da die Erfahrungen aus der Tumorschmerztherapie hier nicht 1 : 1 übertragbar sind, ergeben sich bisher nicht berücksichtigte Probleme, insbesondere ein bislang unterschätztes Abhängigkeits- und Missbrauchsrisiko. Dieses Risiko muss bereits bei der Initiierung der Behandlung berücksichtigt werden und Maßnahmen zur Prävention sind zu treffen.

This is a preview of subscription content, log in to check access.

Literatur

  1. 1.
    Zenz M, Schwarzer A, Willweber-Strumpf A. Taschenbuch Schmerz. Ein diagnostischer und therapeutischer Leitfaden. (4. Aufl.) Stuttgart, Wissenschaftliche Verlagsgesellschaft 2013Google Scholar
  2. 2.
    Ballantyne JC, Kalso E, Stannard C. WHO analgesic ladder: a good concept gone astray. BMJ 2016;352:i20PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Schubert I, Ihle P, Sabatowski R. Zunahme der Opioidverordnungen in Deutschland zwischen 2000 und 2010: Eine Studie auf der Basis von Krankenkassendaten. (Increase in opiate prescription in Germany between 2000 and 2010 - a study based on insurance data.)} Dtsch Arztebl Int 2013;110(4): 45–51PubMedPubMedCentralGoogle Scholar
  4. 4.
    Hoffmann F, Glaeske G, Windt R. Verordnung von starken Opioiden im Jahr 2011. Schmerz 2012;26:707–14PubMedCrossRefPubMedCentralGoogle Scholar
  5. 5.
    Wolter DK. Schmerzen und Schmerzmittelabhängigkeit im Alter. Die gerontopsychiatrische Perspektive. Stuttgart, Kohlhammer 2017Google Scholar
  6. 6.
    Zin CS, Chen LC, Knaggs RD. Changes in trends and pattern of strong opioid prescribing in primary care. Eur J Pain 2014; 18(9):1343–51PubMedPubMedCentralCrossRefGoogle Scholar
  7. 7.
    Palmer RE, Carrell DS, Cronkite D, Saunders K, Gross DE, Masters E, Donevan S, Hylan TR, Von Kroff M. The prevalence of problem opioid use in patients receiving chronic opioid therapy: computer-assisted review of electronic health record clinical notes. Pain 2015;156(7):1208–14PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    Werber A, Marschall U, L’hoest H, Häuser W, Moradi B, Schiltenwolf M. Opioid therapy in the treatment of chronic pain conditions in Germany. Pain Physician 2015;18(3):E323–31PubMedPubMedCentralGoogle Scholar
  9. 9.
    Passik SD, Kirsh KL, Webster L. Pseudoaddiction revisited: a commentary on clinical and historical considerations. Pain Manag 2011;1(3):239–48PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Sehgal N, Manchikanti L, Smith HS. Prescription opioid abuse in chronic pain: a review of opioid abuse predictors and strategies to curb opioid abuse. Pain Physician 2012;15(3 Suppl):ES67–92PubMedPubMedCentralGoogle Scholar
  11. 11.
    Deyo RA, von Korff M, Duhrkoop D. Opioids for low back pain. BMJ 2015; 350:g6380PubMedCrossRefPubMedCentralGoogle Scholar
  12. 12.
    Mehendale AW, Goldman MP, Mehendale RP. Opioid overuse pain syndrome (OOPS): the story of opioids, prometheus unbound. J Opioid Manag 2013;9(6):421–38PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Ballantyne JC, Mao J. Opioid therapy for chronic pain. N Engl J Med 2003; 349(20):1943–53PubMedCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Manchikanti L, Helm S 2nd, Fellows B, Janata JW, Pampati V, Grider JS, Boswell MV. Opioid epidemic in the United States. Pain Physician 2012;15(3 Suppl):ES9–38PubMedPubMedCentralGoogle Scholar
  15. 15.
    Volkow ND, Frieden TR, Hyde PS, Cha SS Medication-assisted therapies—tackling the opioid-overdose epidemic. N Engl J Med 2014;370(22):2063–6PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    Alexander L, Mannion RO, Weingarten B, Fanelli RJ, Stiles GL. Development and impact of prescription opioid abuse deterrent formulation technologies. Drug Alcohol Depend. 2014;138:1–6PubMedCrossRefPubMedCentralGoogle Scholar
  17. 17.
    Coplan PM, Kale H, Sandstrom L et al. Changes in oxycodone and heroin exposures in the National Poison Data System after introduction of extended-release oxycodone with abuse-deterrent characteristics. Pharmacoepidemiol Drug Saf 2013;22(12):1274–82PubMedPubMedCentralCrossRefGoogle Scholar
  18. 18.
    Havens JR, Leukefeld CG, DeVeaugh-Geiss AM et al. The impact of a reformulation of extended-release oxycodone designed to deter abuse in a sample of prescription opioid abusers. Drug Alcohol Depend 2014; 139:9–17PubMedCrossRefPubMedCentralGoogle Scholar
  19. 19.
    Sessler NE, Downing JM, Kale H, et al. Reductions in reported deaths following the introduction of extended-release oxycodone (OxyContin) with an abuse-deterrent formulation. Pharmacoepidemiol Drug Saf 2014;23(12):1238–46PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    Dart RC, Surratt HL, Cicero TJ, et al. Trends in opioid analgesic abuse and mortality in the United States. N Engl J Med 2015; 372(3):241–8PubMedCrossRefPubMedCentralGoogle Scholar
  21. 21.
    Degenhardt L, Bruno R, Ali R, et al. The introduction of a potentially abuse deterrent oxycodone formulation: Early findings from the Australian National Opioid Medications Abuse Deterrence (NOMAD) study. Drug Alcohol Depend 2015;151:56–67PubMedCrossRefPubMedCentralGoogle Scholar
  22. 22.
    Peacock A, Degenhardt L, Hordern A, et al. Methods and predictors of tampering with a tamper-resistant controlled-release oxycodone formulation. Int J Drug Policy 2015; 26(12):1265–72PubMedCrossRefPubMedCentralGoogle Scholar
  23. 23.
    Ballantyne JC, LaForge KS. Opioid dependence and addiction during opioid treatment of chronic pain. Pain 2007;129(3):235–55PubMedCrossRefPubMedCentralGoogle Scholar
  24. 24.
    Shei A, Rice JB, Kirson NY, et al. Sources of prescription opioids among diagnosed opioid abusers. Curr Med Res Opin 2015; 31(4):779–84PubMedCrossRefPubMedCentralGoogle Scholar
  25. 25.
    Inciardi JA, Surratt HL, Cicero TJ, Beard RA. Prescription opioid abuse and diversion in an urban community: the results of an ultrarapid assessment. Pain Med 2009;10(3):537–48PubMedPubMedCentralCrossRefGoogle Scholar
  26. 26.
    Lankenau SE, Teti M, Silva K, et al. Initiation into prescription opioid misuse amongst young injection drug users. Int J Drug Policy 2012;23(1):37–44PubMedCrossRefPubMedCentralGoogle Scholar
  27. 27.
    Bohnert AS, Eisenberg A, Whiteside L, et al. Prescription opioid use among addictions treatment patients: nonmedical use for pain relief vs. other forms of nonmedical use. Addict Behav 2013;38(3):1776–81PubMedCrossRefPubMedCentralGoogle Scholar
  28. 28.
    Dowling GJ, Weiss SR, Condon TP. Drugs of abuse and the aging brain. Neuropsychopharmacology 2008;33(2):209–18PubMedCrossRefPubMedCentralGoogle Scholar
  29. 29.
    Volkow ND, McLellan TA, Cotto JH, et al. Characteristics of opioid prescriptions in 2009. JAMA 2011;305(13):1299–301PubMedPubMedCentralCrossRefGoogle Scholar
  30. 30.
    Frenk SM, Porter KS, Paulozzi LJ. Prescription Opioid Analgesic Use Among Adults: United States, 1999–2012. NCHS Data Brief No. 189, February 2015 http://www.cdc.gov/nchs/data/dataBriefs/db189.pdf Zugriff 11.6.2018
  31. 31.
    Fischer B, Keates A, Bühringer G, et al. Non-medical use of prescription opioids and prescription opioid-related harms: why so markedly higher in North America compared to the rest of the world? Addiction 2014; 109(2):177–81PubMedCrossRefPubMedCentralGoogle Scholar
  32. 32.
    European Monitoring Centre for Drugs and Drugs Addicition. Europäischer Drogenbericht 2016. Luxemburg: Amt für Veröffentlichungen der Europäischen Union.Google Scholar
  33. 33.
    van Amsterdam J, van den Brink W. The Misuse of Prescription Opioids: A Threat for Europe? Curr Drug Abuse Rev 2015;8(1):3–14PubMedCrossRefPubMedCentralGoogle Scholar
  34. 34.
    Chou R, Turner JA, Devine EB, et al. The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop. Ann Intern Med 2015;162(4):276–86PubMedCrossRefPubMedCentralGoogle Scholar
  35. 35.
    Reinecke H, Weber C, Lange K, et al. Analgesic efficacy of opioids in chronic pain: recent meta-analyses. Br J Pharmacol 2015; 172(2):324–33PubMedCrossRefPubMedCentralGoogle Scholar
  36. 36.
    Sites BD, Beach ML, Davis MA. Increases in the use of prescription opioid analgesics and the lack of improvement in disability metrics among users. Reg Anesth Pain Med 2014;39(1):6–12PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Dowell D, Hegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain - United States, 2016. JAMA 2016; 315(15): 1624–45PubMedCrossRefPubMedCentralGoogle Scholar
  38. 38.
    Manchikanti L, Kaye AM, Knezevic NN, et al. Responsible, Safe, and Effective Prescription of Opioids for Chronic Non-Cancer Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines. Pain Physician 2017;20(2S):S3–S92PubMedPubMedCentralGoogle Scholar
  39. 39.
    Häuser W, Bock F, Engeser P, et al. Klinische Leitlinie: Langzeitanwendung von Opioiden bei nichttumorbedingten Schmerzen (Clinical practice guideline: Long-term opioid use in non-cancer pain). Dtsch Arztebl Int 2014;111:732–40PubMedPubMedCentralGoogle Scholar
  40. 40.
    Brennan MJ. The effect of opioid therapy on endocrine function. Am J Med 2013; 126(3 Suppl 1):S12–8PubMedCrossRefPubMedCentralGoogle Scholar
  41. 41.
    Davis MP, Mehta Z. Opioids and Chronic Pain: Where Is the Balance? Curr Oncol Rep 2016;18(12):71PubMedCrossRefPubMedCentralGoogle Scholar
  42. 42.
    Solomon DH, Rassen JA, Glynn RJ, et al. The Comparative Safety of Opioids for Nonmalignant Pain in Older Adults. Arch Intern Med 2010;22:1979–86CrossRefGoogle Scholar
  43. 43.
    Sacerdote P, Franchi S, Panerai, AE. Non-analgesic effects of opioids: mechanisms and potential clinical relevance of opioid-induced immunodepression. Current Pharmaceutical Design 2012;18(37):6034–42PubMedCrossRefPubMedCentralGoogle Scholar
  44. 44.
    Brack A, Rittner, HL, Stein C. Immunosuppressive effects of opioids — clinical relevance. J Neuroimmune Pharmacology 2011; 6(4):490–502CrossRefGoogle Scholar
  45. 45.
    Dublin S, Walker RL, Jackson ML, et al. Use of opioids or benzodiazepines and risk of pneumonia in older adults: a population-based case-control study. J Am Geriatr Soc 2011;59(10):1899–907PubMedPubMedCentralCrossRefGoogle Scholar
  46. 46.
    Webster LR, Choi Y, Desai H, et al. Sleepdisordered breathing and chronic opioid therapy. Pain Med 2008;9(4):425–32PubMedCrossRefPubMedCentralGoogle Scholar
  47. 47.
    Scherrer JF, Salas J, Sullivan MD, et al. The influence of prescription opioid use duration and dose on development of treatment resistant depression. Prev Med 2016;91:110–6PubMedPubMedCentralCrossRefGoogle Scholar
  48. 48.
    Hooten WM, Lamer T.J, Twyner C. Opioid-induced hyperalgesia in community-dwelling adults with chronic pain. Pain 2015; 156(6):1145–52PubMedPubMedCentralGoogle Scholar
  49. 49.
    Lee HJ, Yeomans DC. Opioid induced hyperalgesia in anesthetic settings. Korean J Anesthesiol 2014;67(5):299–304PubMedPubMedCentralCrossRefGoogle Scholar
  50. 50.
    Bannister K. Opioid-induced hyperalgesia: where are we now? Current Opinon in Supportive and Palliative Care 2015;9(2):116–21CrossRefGoogle Scholar
  51. 51.
    Savage SR. Assessment for addiction in pain-treatment settings. Clin J Pain 2002; 18(4 Suppl):S28–38PubMedCrossRefPubMedCentralGoogle Scholar
  52. 52.
    Højsted J, Sjøgren P. Addiction to opioids in chronic pain patients: a literature review. Eur J Pain 2007;11(5):490–518PubMedCrossRefPubMedCentralGoogle Scholar
  53. 53.
    Kirsh KL, Whitcomb LA, Donaghy K, Passik SD. Abuse and addiction issues in medically ill patients with pain: attempts at clarification of terms and empirical study. Clin J Pain 2002;18(4 Suppl):S52–60PubMedCrossRefPubMedCentralGoogle Scholar
  54. 54.
    Kamen LB, Feeko KJ. Opioid syndrome: failed opioid therapy for chronic noncancer pain. Phys Med Rehabil Clin N Am 2014; 25(2):375–95PubMedCrossRefPubMedCentralGoogle Scholar
  55. 55.
    Ballantyne JC, Sullivan MD, Kolodny A. Opioid Dependence vs Addiction: A Distinction Without a Difference? Arch Intern Med 2012;172(17):1342–3PubMedCrossRefPubMedCentralGoogle Scholar
  56. 56.
    Ballantyne JC. Opioid Therapy in Chronic Pain. Phys Med Rehabil Clin N Am 2015; 26(2):201–18PubMedCrossRefPubMedCentralGoogle Scholar
  57. 57.
    Ballantyne JC. Assessing the prevalence of opioid misuse, abuse, and addiction in chronic pain. Pain 2015;156(4):567–8PubMedCrossRefPubMedCentralGoogle Scholar
  58. 58.
    Garland EL, Froeliger B, Zeidan F, et al. The downward spiral of chronic pain, prescription opioid misuse, and addiction: cognitive, affective, and neuropsychopharmacologic pathways. Neurosci Biobehav Rev 2013; 37(10 Pt 2):2597–607PubMedPubMedCentralCrossRefGoogle Scholar
  59. 59.
    Chang YP, Compton P. Management of chronic pain with chronic opioid therapy in patients with substance use disorders. Addict Sci Clin Pract 2013;8:21PubMedPubMedCentralCrossRefGoogle Scholar
  60. 60.
    Hashmi JA, Baliki MN, Huang L, et al. Shape shifting pain: chronification of back pain shifts brain representation from nociceptive to emotional circuits. Brain 2013; 136:2751–68PubMedPubMedCentralCrossRefGoogle Scholar
  61. 61.
    Chen L, Vo T, Seefeld L, et al. Lack of correlation between opioid dose adjustment and pain score change in a group of chronic pain patients. J Pain 2013;14(4):384–92PubMedPubMedCentralCrossRefGoogle Scholar
  62. 62.
    Højsted J, Nielsen PR, Guldstrand SK, et al. Classification and identification of opioid addiction in chronic pain patients. Eur J Pain 2010;14(10):1014–20PubMedCrossRefPubMedCentralGoogle Scholar
  63. 63.
    Papaleontiou M, Henderson CR Jr, Turner BJ, et al. Outcomes associated with opioid use in the treatment of chronic noncancer pain in older adults: a systematic review and meta-analysis. J Am Geriatr Soc 2010; 58(7): 1353–69PubMedPubMedCentralCrossRefGoogle Scholar
  64. 64.
    Vowles KE, McEntee ML, Julnes PS, et al. Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis. Pain 2015;156(4):569–76PubMedCrossRefPubMedCentralGoogle Scholar
  65. 65.
    Carmichael AN, Morgan L, Del Fabbro E. Identifying and assessing the risk of opioid abuse in patients with cancer: an integrative review. Subst Abuse Rehabil 2016;7:71–9PubMedPubMedCentralGoogle Scholar
  66. 66.
    Ciesielski T, Iyengar R, Bothra A, et al. A Tool to Assess Risk of De Novo Opioid Abuse or Dependence. Am J Med 2016;129(7):699–705.e4PubMedPubMedCentralCrossRefGoogle Scholar
  67. 67.
    Edlund MJ, Martin BC, Fan MY, et al. Risks for opioid abuse and dependence among recipients of chronic opioid therapy: results from the TROUP study. Drug Alcohol Depend 2010;112(1-2):90–8PubMedPubMedCentralCrossRefGoogle Scholar
  68. 68.
    Edlund MJ, Martin BC, Russo JE, et al. The role of opioid prescription in incident opioid abuse and dependence among individuals with chronic noncancer pain. Clin J Pain 2014;30(7):557–64PubMedPubMedCentralGoogle Scholar
  69. 69.
    Katz C, El-Gabalawy R, Keyes KM, et al. Risk factors for incident nonmedical prescription opioid use and abuse and dependence: results from a longitudinal nationally representative sample. Drug Alcohol Depend 2013;132(1-2):107–13PubMedPubMedCentralCrossRefGoogle Scholar
  70. 70.
    Hser YI, Mooney LJ, Saxon AJ, et al. Chronic pain among patients with opioid use disorder: Results from electronic health records data. J Substance Abuse Treatment 2017;77: 26–30CrossRefGoogle Scholar
  71. 71.
    Hah JH, Bateman BT, Ratliff J, et al. Chronic Opioid Use After Surgery: Implications for Perioperative Management in the Face of the Opioid Epidemic. Anesth Analg 2017; 125:1733–40PubMedPubMedCentralCrossRefGoogle Scholar
  72. 72.
    Belgrade MJ, Schamber CD, Lindgren BR. The DIRE score: predicting outcomes of opioid prescribing for chronic pain. J Pain 2006;7(9):671–81PubMedCrossRefPubMedCentralGoogle Scholar
  73. 73.
    Larochelle MR, Zhang F, Ross-Degnan D, Wharam JF. Trends in opioid prescribing and co-prescribing of sedative hypnotics for acute and chronic musculoskeletal pain: 2001-2010. Pharmacoepidemiol Drug Saf 2015;24(8):885–92PubMedCrossRefPubMedCentralGoogle Scholar
  74. 74.
    Nielsen S, Lintzeris N, Bruno R, et al. Benzodiazepine use among chronic pain patients prescribed opioids: associations with pain, physical and mental health, and health service utilization. Pain Med 2015;16(2):356–66PubMedCrossRefPubMedCentralGoogle Scholar
  75. 75.
    Højsted J, Ekholm O, Kurita GP, et al. Addictive behaviors related to opioid use for chronic pain: a population-based study. Pain 2013;154(12):2677–83PubMedCrossRefPubMedCentralGoogle Scholar
  76. 76.
    Calcaterra S, Glanz J, Binswanger IA. National trends in pharmaceutical opioidrelated overdose deaths compared to other substance related overdose deaths: 1999-2009. Drug Alcohol Depend 2013;131(3):263–70PubMedPubMedCentralCrossRefGoogle Scholar
  77. 77.
    Day C. Benzodiazepines in Combination with Opioid Pain Relievers or Alcohol: Greater Risk of More Serious ED Visit Outcomes. The CBHSQ Report. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014Google Scholar
  78. 78.
    Gressler LE, Martin BC, Hudson TJ, Painter JT. Relationship between concomitant benzodiazepine-opioid use and adverse outcomes among US veterans. Pain 2018; 159(3): 451–9PubMedPubMedCentralGoogle Scholar
  79. 79.
    Brady KT, McCauley JL, Back SE. Prescription Opioid Misuse, Abuse, and Treatment in the United States: An Update. Am J Psychiatry 2016;173(1):18–26PubMedCrossRefPubMedCentralGoogle Scholar
  80. 80.
    Dreifuss JA, Griffin ML, Frost K, et al. Patient characteristics associated with buprenorphine/naloxone treatment outcome for prescription opioid dependence: Results from a multisite study. Drug Alcohol Depend 2013;131(1-2):112–8PubMedPubMedCentralCrossRefGoogle Scholar
  81. 81.
    Nicholas MK, Blyth FM. Are self-management strategies effective in chronic pain treatment? Pain Manag 2016;6(1):75–88PubMedCrossRefPubMedCentralGoogle Scholar
  82. 82.
    Beiglböck W. Wirkfaktoren achtsamkeitsbasierter Suchttherapie. Suchttherapie 2015; 16(02):59–68CrossRefGoogle Scholar
  83. 83.
    Day MA, Jensen MP, Ehde DM, Thorn BE. Toward a theoretical model for mindfulness-based pain management. J Pain 2014; 15(7):691–703PubMedCrossRefPubMedCentralGoogle Scholar
  84. 84.
    Grant JA. Meditative analgesia: the current state of the field. Ann N Y Acad Sci. 2014; 1307:55–63PubMedCrossRefPubMedCentralGoogle Scholar
  85. 85.
    Gu J, Strauss C, Bond R, Cavanagh K. How do mindfulness-based cognitive therapy and mindfulness-based stress reduction improve mental health and wellbeing? A systematic review and meta-analysis of mediation studies. Clin Psychol Rev 2015;37:1–12PubMedCrossRefPubMedCentralGoogle Scholar
  86. 86.
    Heidenreich T, Michalak T. Achtsamkeitsbasierte Psychotherapie — Chancen und Grenzen der dritten Generation der Verhaltenstherapie. Sucht 2014;60(1):7–12CrossRefGoogle Scholar
  87. 87.
    Garland EL, Thomas E, Howard MO. Mindfulness-oriented recovery enhancement ameliorates the impact of pain on self-reported psychological and physical function among opioid-using chronic pain patients. J Pain Symptom Manage. 2014;48(6):1091–9PubMedPubMedCentralCrossRefGoogle Scholar
  88. 88.
    Garland EL, Froeliger B, Howard MO. Effects of Mindfulness-Oriented Recovery Enhancement on reward responsiveness and opioid cue-reactivity. Psychopharmacology 2014;231(16):3229–38PubMedPubMedCentralCrossRefGoogle Scholar
  89. 89.
    Garland EL, Manusov EG, Froeliger B, et al. Mindfulness-oriented recovery enhancement for chronic pain and prescription opioid misuse: results from an early-stage randomized controlled trial. J Consult Clin Psychol 2014;82(3):448–59PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Abteilung Gerontopsychiatrie und PsychotherapieLVR-Klinik BonnBonnDeutschland

Personalised recommendations

Cite article

Buy options