• Der Schmerz · Feb 2022

    Review

    [Critical discussion of new data regarding prevalence of opioid use disorder in patients with chronic pain in Germany].

    • Johannes Just, F Petzke, N Scherbaum, L Radbruch, K Weckbecker, and W Häuser.
    • Department für Humanmedizin, Institut für Allgemeinmedizin und ambulante Gesundheitsversorgung (IAMAG), Universität Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58448, Witten, Deutschland. johannes.just@uni-wh.de.
    • Schmerz. 2022 Feb 1; 36 (1): 13-18.

    BackgroundThere is no opioid crisis in Germany. However, new studies involving patients with chronic noncancer pain (CNCP) in Germany show an unexpectedly high prevalence of opioid use disorder according to DSM‑5 (Diagnostic and Statistical Manual for Psychiatric Diseases).ObjectivesCritical discussion of new study results on the prevalence of opioid use disorder in CNCP patients in Germany.Materials And MethodsSelective literature search and multiprofessional classification of results by an expert panel (pain therapy, neurology, psychiatry, palliative medicine, general medicine and addiction therapy).ResultsThe DSM‑5 criteria for the diagnosis of "opioid use disorder" have limited applicability to patients with CNCP, but may raise awareness of problematic behavior. The diagnosis of opioid use disorder is not the same as the diagnosis of substance dependence according to ICD-10, as the DSM‑5 diagnosis covers a much broader spectrum (mild, moderate, severe). Risk factors for opioid use disorder include younger age, depressive disorders, somatoform disorders, and high daily opioid doses. The interdisciplinary guideline on long-term opioid use for CNCP (LONTS) includes recommendations intended to reduce the risk for opioid use disorder.ConclusionAn adaptation of the DSM‑5 diagnostic criteria of opioid use disorder to the specific situation of CNCP patients and a validation of these criteria could help to collect more accurate data on opioid use disorders of patients with chronic pain in Germany in the future. Prescribers should be sensitized to this problem without pathologizing or even stigmatizing patients. Further research is needed to classify this previously underestimated phenomenon.© 2021. The Author(s).

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