Overdose da oppiacei. 63,600 morti negli Usa, 1,394 in Germania.
Giuseppe Sandro Mela.
2018-03-24.
Pochi giorni or sono la Cnn usciva con un titolo sconsolato:
«tens of thousands of Americans die».
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«opioid manufacturers are paying physicians huge sums of money — and the more opioids a doctor prescribes, the more money he or she makes.»
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A ruota è seguito, quasi fosse stato ordine di scuderia, il The Local:
«Germany risks suffering an opioid epidemic similar to that seen in the USA»
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«The use of opioids per person in Germany is already shockingly high and is barely distinguishable from the US, .... Even for a relatively minor operation patients are sent home with big packs of opioids because the doctor wants to be sure that the patient is satisfied»
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«The first factor is that there are much higher requirements here for prescribing opioids. While they are a useful prescription against tumours for people who suffer from cancer, they should never be prescribed for chronic pains, like back pains»
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«In 2016 a total of 1,333 people died in Germany due to drug overdoses, a far cry from the 63,600 recorded deaths in the US in the same year»
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Gli oppioidi, specialmente la morfina, sono potenti antidolorifici che danno assuefazione ed esprimono severi effetti collaterali: la loro indicazione terapeutica è il tentativo di controllare dolori severi in patologie allo stadio terminale, quali per esempio i tumori in fase avanzata.
Altre tipologie di impiego sono largamente controproducenti.
«they should never be prescribed for chronic pains, like back pains»
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Se l'uso degli oppiacei ha un suo razionale nel trattamento del dolore, sotto le condizioni prima ricordate: il sovradosaggio che conduca a decesso per overdose è fatto da codice penale.
Il problema è vasto e richiederebbe un trattato denso di dati sperimentali.
In questa sede sembrerebbe utile sottolineare come nella popolazione Occidentale circa il 3.6% della popolazione adulta assuma cronicamente cocaina, il 9.6% utilizzi la cannabis ed il 2.5% utilizzi l'ecstasy.
Come risultato, almeno il 15.7% della popolazione adulta è dedita all'uso di sostanze stupefacenti.
Gli effetti dell'uso cronico di simili droghe, ricordiamo come cannabis ed ecstasy non siano oppiacei, sono devastanti, portando in breve tempo a decadimento irreversibile della facoltà mentali.
Sono molte le formazioni politiche che hanno sostenuto, e continuano a sostenere, la depenalizzazione dell'uso, detenzione e spaccio di sostanze stupefacenti.
Responsabilità grave e severa, della quale un giorno saranno chiamate a rendere ragione.
A startling report in one of Germany’s leading national newspapers on Thursday suggested the country was on the brink of an opioid crisis. But a leading expert The Local spoke to was more circumspect.
“Germany risks suffering an opioid epidemic similar to that seen in the USA,” Christoph Stein, director of the anaesthesiology department at Charite hospital in Berlin told Die Welt.
In the US deaths related to the consumption of opioid painkillers has risen sharply in recent years. Addiction to legal painkillers now causes more deaths in the US than heroin, which is also opioid based.
Prescriptions of opioid-based painkillers by doctors in the US more than doubled between 1992 and 2012, a fact which has been held responsible for the steep rise in mortality. Studies suggest that people who become addicted to the painkillers sometimes turn to heroin, which is cheaper to buy on the street.
Stein warned that a similar crisis could soon await Germany.
“The use of opioids per person in Germany is already shockingly high and is barely distinguishable from the US,” he said. “Even for a relatively minor operation patients are sent home with big packs of opioids because the doctor wants to be sure that the patient is satisfied.”
What the Die Welt article neglects to mention though, is that actual death rates due to drug overdoses in Germany are far lower than in the US and also are not on the rise.
In 2016 a total of 1,333 people died in Germany due to drug overdoses, a far cry from the 63,600 recorded deaths in the US in the same year. Opioids were responsible for just under 800 of the German deaths, as opposed to an estimated 50,000 opioid related deaths in the US.
Meanwhile, the number of drug-related deaths has remained stable in Germany in recent years, despite a headline grabbing 15 percent rise between 2015 and 2016. When one compares the 2016 figure to the 1,394 people who died of drug overdoses in 2007, or the 1,449 who died in 2008, it becomes clear that there is little evidence of an upwards trend.
Peter Raiser, deputy CEO of the German Centre for Addiction, told The Local that he did not see it as likely that Germany was on the verge its own opioid crisis.
Raiser acknowledged that between 200,000 and 300,000 Germans are estimated to be dependant on opioids, but said that "there are two central factors that differentiate Germany from the US.”
“The first factor is that there are much higher requirements here for prescribing opioids. While they are a useful prescription against tumours for people who suffer from cancer, they should never be prescribed for chronic pains, like back pains.”
The second factor he named was a greater awareness among German doctors about when patients are becoming dependant on painkillers and what can be done to wean them off the drugs.
Saarbrücken, Mainz, Chemnitz, and of course Berlin are just a few of the German cities found by a new study to have some of the hardest drug habits in Europe.
The data came out of the latest wastewater analysis study of 56 European cities in 19 countries undertaken by sewage analysis centre Score and the EU drugs agency in March 2017.
The study analyzed daily wastewater samples in the catchment areas of treatment plants over a one-week period, testing the wastewater of 43 million people for traces of four drugs: amphetamine, cocaine, MDMA (ecstasy) and methamphetamine (crystal meth).
The results, released by the European Monitoring Centre for Drugs and Drugs addiction (Emcdda) on Wednesday, show that German cities made up half of the top ten for amphetamine use.
Saarbrucken, a town near the French border, came third on the amphetamine ranking, with Mainz (5), Dortmund (7), Rostock (8) and Berlin (9) also featured.
German cities were also over represented in the table on methamphetamine use. Chemnitz and Erfurt came in first and second on this ranking, with Dresden and Nuremberg also in the top ten.
German police regularly warn of meth being cooked in the Czech Republic and then smuggled into towns such as Chemnitz and Dresden which lie near the border.
The Emcdda said methamphetamine use remains generally low. Traditionally concentrated in the Czech Republic and Slovakia, it is now present in Cyprus, the east of Germany and northern European countries such as Finland and Norway.
Berlin came sixth in the ranking of cities with the highest levels of MDMA use. But the 49.8 mg per 1,000 residents found in the German capital’s waterways was dwarfed by Amsterdam’s result - 230.3 mg of the party drug per 1,000 residents.
The study found that levels of cocaine and ecstasy in wastewater rise sharply at weekends in most cities, while amphetamine use appears to be more evenly distributed throughout the week.
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