Universität zu Köln

Bonnet, Udo, Specka, Michael, Soyka, Michael, Alberti, Thomas, Bender, Stefan, Grigoleit, Torsten, Hermle, Leopold, Hilger, Joerg, Hillemacher, Thomas, Kuhlmann, Thomas, Kuhn, Jens, Luckhaus, Christian, Ludecke, Christel, Reimer, Jens, Schneider, Udo, Schroeder, Welf, Stuppe, Markus, Wiesbeck, Gerhard A., Wodarz, Norbert, McAnally, Heath and Scherbaum, Norbert (2020). Ranking the Harm of Psychoactive Drugs Including Prescription Analgesics to Users and Others-A Perspective of German Addiction Medicine Experts. Front. Psychiatry, 11. LAUSANNE: FRONTIERS MEDIA SA. ISSN 1664-0640

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Abstract

Background: Over the past 15 years, comparative assessments of psychoactive substance harms to both users and others have been compiled by addiction experts. None of these rankings however have included synthetic cannabinoids or non-opioid prescription analgesics (NOAs, e.g., gabapentinoids) despite evidence of increasing recreational use. We present here an updated assessment by German addiction medicine experts, considering changing Western consumption trends-including those of NOAs. Methods: In an initial survey, 101 German addiction medicine physicians evaluated both physical and psychosocial harms (in 5 dimensions) of 33 psychoactive substances including opioids and NOAs, to both users and others. In a second survey, 36 addiction medicine physicians estimated the relative weight of each health and social harm dimension to determine the overall harm rank of an individual substance. We compared our ranking with the most recent European assessment from 2014. Results: Illicit drugs such as methamphetamine, heroin, cocaine and also alcohol were judged particularly harmful, and new psychoactive drugs (cathinones, synthetic cannabinoids) were ranked among the most harmful substances. Cannabis was ranked in the midrange, on par with benzodiazepines and ketamine-somewhat more favorable compared to the last European survey. Prescribed drugs including opioids (in contrast to the USA, Canada, and Australia) were judged less harmful. NOAs were at the bottom end of the ranking. Conclusion: In Germany, alcohol and illicit drugs (including new psychoactive substances) continue to rank among the most harmful addictive substances in contrast to prescribed agents including opioid analgesics and NOAs. Current laws are incongruent with these harm rankings. This study is the first of its kind to include comparative harm rankings of several novel abused substances, both licit/prescribed and illicit.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bonnet, Udo UNSPECIFIED UNSPECIFIED UNSPECIFIED Specka, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Soyka, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Alberti, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Bender, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Grigoleit, Torsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Hermle, Leopold UNSPECIFIED UNSPECIFIED UNSPECIFIED Hilger, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Hillemacher, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhlmann, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Luckhaus, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Ludecke, Christel UNSPECIFIED UNSPECIFIED UNSPECIFIED Reimer, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Schneider, Udo UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, Welf UNSPECIFIED UNSPECIFIED UNSPECIFIED Stuppe, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Wiesbeck, Gerhard A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wodarz, Norbert UNSPECIFIED UNSPECIFIED UNSPECIFIED McAnally, Heath UNSPECIFIED UNSPECIFIED UNSPECIFIED Scherbaum, Norbert UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-314325
DOI:	10.3389/fpsyt.2020.592199
Journal or Publication Title:	Front. Psychiatry
Volume:	11
Date:	2020
Publisher:	FRONTIERS MEDIA SA
Place of Publication:	LAUSANNE
ISSN:	1664-0640
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language USE DISORDER; PREGABALIN; DEPENDENCE; MECHANISMS; ABUSE; RISK Multiple languages Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31432