Subscribe to RSS
DOI: 10.1055/a-1326-1031
Heroinintoxikationen: Risikofaktoren zur Notfallanamnese aus Expertensicht
Heroin Intoxications: Risk Factors for Initial Anamnesis from an Expertʼs Point of ViewZusammenfassung
Ziel der Studie Heroinintoxikationen nehmen in der Notfallmedizin seit Jahren den 1. Platz unter allen Drogennotfällen ein.
Methodik Zwischen April und Oktober 2019 wurden bundesweit 107 ExpertInnen aus 36 Einrichtungen in 23 Städten mit beruflichen Erfahrungen mit Heroinintoxikationen im Rahmen eines interdisziplinären und multiprofessionellen Rankingverfahrens zu den wichtigsten Risikofaktoren solcher Drogennotfälle befragt.
Ergebnisse Im Rahmen der Notfallanamnese sollten aus Expertensicht vor allem folgende Risikofaktoren berücksichtigt werden: Wiederaufnahme des Konsums nach längerer Abstinenz oder reduzierter Heroinaufnahme, Mischintoxikationen respektive Beikonsum von Benzodiazepinen, Alkohol, Pregabalin und/oder illegalen Drogen, Applikation, Menge und Reinheit des Heroins sowie ein akutes soziales Stressereignis.
Schlussfolgerung Unser Beitrag gibt Hinweise, welche Rahmenbedingungen der Notarzt im Rahmen der Notfallanamnese vor allem erfragen und dokumentieren sollte.
Abstract
Objective For years heroin intoxications are ranked first among all drug emergencies in emergency medicine.
Methods Between April and October 2019, 107 experts from 36 facilities in 23 cities with professional experience with heroin intoxications were interviewed in a nationwide interdisciplinary and multi-professional ranking procedure on the most important risk factors of such drug emergencies.
Results In the context of the initial anamnesis, the following risk factors should be taken into account according to expertsʼ point of view: Resumption of use after prolonged abstinence or reduced heroin intake, mixed intoxication or concomitant use of benzodiazepines, alcohol, pregabalin and/or illegal drugs, application, quantity and purity of heroin, and an acute social stress event.
Conclusion Our paper gives hints, which basic conditions the emergency physician should ask for and document in the context of the emergency anamnesis.
Publication History
Article published online:
17 December 2020
© 2020. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
Literatur
- 1 Wirtz S. Der Drogennotfall. Notf Rett Med 2004; 7: 435-454 doi:10.1007/s10049-004-0686-2
- 2 Europäische Beobachtungsstelle für Drogen und Drogensucht. Europäischer Drogenbericht 2017: Trends und Entwicklungen. Luxemburg: Amt für Veröffentlichungen der Europäischen Union; 2017
- 3 Darke S, Williamson A, Ross J. et al. Patterns of Nonfatal Heroin Overdose Over a 3-Year Period: Findings From the Australian Treatment Outcome Study. J Urban Health 2007; 84: 283-291 doi:10.1007/s11524-006-9156-0
-
4
Die Drogenbeauftragte der Bundesregierung.
Drogen- und Suchtbericht 2019 (Oktober 2019). Die Bundesregierung. Im Internet (Stand: 16.06. 2020): https://www.bundesregierung.de/breg-de/service/publikationen/drogen-und-suchtbericht-2019-1688896
- 5 Mars SG, Fessel JN, Bourgois P. et al. Heroin-related overdose: The unexplored influences of markets, marketing and source-types in the United States. Soc Sci Med 2015; 140: 44-53 doi:10.1016/j.socscimed.2015.06.032
- 6 Warner-Smith M, Darke S, Lynskey M. et al. Heroin overdose: causes and consequences. Addiction 2001; 96: 1113-1125 doi:10.1046/j.1360-0443.2001.96811135.x
- 7 Strang J. Death matters: understanding heroin/opiate overdose risk and testing potential to prevent deaths. Addiction 2015; 110: 27-35 doi:10.1111/add.12904
- 8 Blackburn NA, Lancaster KE, Ha TV. et al. Characteristics of persons who inject drugs and who witness opioid overdoses in Vietnam: a cross-sectional analysis to inform future overdose prevention programs. Harm Reduct J 2017; 14: 1-9 doi:10.1186/s12954-017-0188-4
- 9 Dietze P, Jolley D, Cvetkovski S. Patterns and characteristics of ambulance attendance at heroin overdose at a local-area level in Melbourne, Australia: Implications for service provision. J Urban Health 2003; 80: 248-260 doi:10.1093/jurban/jtg028
- 10 Kerr T, Small W, Hyshka E. et al. ‘Itʼs more about the heroin’: injection drug usersʼ response to an overdose warning campaign in a Canadian setting. Addiction 2013; 108: 1270-1276 doi:10.1111/add.12151
- 11 Roxburgh A, Hall WD, Gisev N. et al. Characteristics and circumstances of heroin and pharmaceutical opioid overdose deaths: Comparison across opioids. Drug Alcohol Depend 2019; 205: 107533 doi:10.1016/j.drugalcdep.2019.06.035
- 12 Williams CT, Latkin CA. Neighborhood Socioeconomic Status, Personal Network Attributes, and Use of Heroin and Cocaine. Am J Prev Med 2007; 32: 203-210 doi:10.1016/j.amepre.2007.02.006
- 13 Schneider S, Richter C, Beisel L. Überdosierungen von Heroin. Public Health Forum 2020; 28: 288-291 doi:10.1515/pubhef-200-0080
- 14 Nutt D, King LA, Saulsbury W. et al. Development of a rational scale to assess the harm of drugs of potential misuse. Lancet 2007; 369: 1047-1053 doi:10.1016/S0140-6736(07)60464-4
- 15 van Amsterdam J, Opperhuizen A, Koeter M. et al. Ranking the Harm of Alcohol, Tobacco and Illicit Drugs for the Individual and the Population. Eur Addict Res 2010; 16: 202-207 doi:10.1159/000317249
-
16
Lenzner T,
Neuert C,
Otto W.
Kognitives Pretesting (Januar 2015). GESIS – Leibniz-Institut für Sozialwissenschaften (GESIS Survey Guidelines). Im Internet (Stand: 16.06. 2020): https://www.gesis.org/gesis-survey-guidelines/instruments/qualitaet-von-umfragedaten/kognitives-pretesting/
- 17 Osbourne JW. Best Practices in Exploratory Factor Analysis: Four Recommendations for Getting the Most From Your Analysis. Scotts Valley, CA: CreateSpace Independent Publishing; 2014
- 18 Paschen H, Stuhr M, Kerner T. Vergiftungen im Rettungsdienst – Diagnose und Therapie. Notarzt 2013; 30: 49-57 doi:10.1055/s-0034-1369892
- 19 Brugal MT, Barrio G, De LF. et al. Factors associated with non-fatal heroin overdose: assessing the effect of frequency and route of heroin administration. Addiction 2002; 97: 319-327 doi:10.1046/j.1360-0443.2002.00058.x
- 20 Darke S, Hall W. Heroin overdose: Research and evidence-based intervention. J Urban Health 2003; 80: 189-200 doi:10.1093/jurban/jtg022
- 21 Yin L, Qin G, Ruan Y. et al. Nonfatal Overdose Among Heroin Users in Southwestern China. Am J Drug Alcohol Abuse 2007; 33: 505-516 doi:10.1080/00952990701407223
- 22 Dietze P, Jolley D, Fry CL. et al. When is a little knowledge dangerous? Circumstances of recent heroin overdose and links to knowledge of overdose risk factors. Drug Alcohol Depend 2006; 84: 223-230 doi:10.1016/j.drugalcdep.2006.02.005
- 23 Burns JM, Martyres RF, Clode D. et al. Overdose in young people using heroin: associations with mental health, prescription drug use and personal circumstances. Med J Aust 2004; 181: 25-28
- 24 Darke S, Marel C, Mills KL. et al. Patterns and correlates of non-fatal heroin overdose at 11-year follow-up: Findings from the Australian Treatment Outcome Study. Drug Alcohol Depend 2014; 144: 148-152 doi:10.1016/j.drugalcdep.2014.09.001
- 25 Darke S. Heroin overdose. Addiction 2016; 111: 2060-2063 doi:10.1111/add.13516
- 26 McGregor C, Darke S, Ali R. et al. Experience of non-fatal overdose among heroin users in Adelaide, Australia: circumstances and risk perceptions. Addiction 1998; 93: 701-711 doi:10.1046/j.1360-0443.1998.9357016.x