Substanzkonsum und substanzbezogene Störungen: Trends in Deutschland 1980 – 2012

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Abstract

Ziel: Untersucht wurden geschlechts- und altersspezifische Trends des Konsums von Alkohol, Tabak und Cannabis und der Einnahme von Schmerz-, Schlaf- und Beruhigungsmitteln sowie Trends substanzbezogener Störungen nach DSM-IV im Zeitraum 1980 bis 2012. Methodik: Grundlage sind Daten aus zehn Erhebungen des Epidemiologischen Suchtsurveys (ESA). Die Datenerhebung erfolgte schriftlich bzw. im Methodenmix. Die Antwortraten variierten zwischen 45 % und 65 %. Ergebnisse: Die durchschnittlich pro Tag konsumierte Menge Reinalkohol reduzierte sich bei Männern signifikant gegenüber dem Jahr 1995, während der Konsum unter Frauen auf niedrigerem Niveau stabil blieb. Die Anteile der aktuellen Raucher zeigen bei beiden Geschlechtern mit wenigen Ausnahmen einen klaren rückläufigen Trend. Die 12-Monats-Prävalenz des Cannabiskonsums war im Jahr 2012 höher als im Jahr 1995. Die regelmäßige Einnahme von Schmerzmitteln zeigt mit wenigen Ausnahmen eine Zunahme über die Zeit. Es wurden Anstiege in der Prävalenz der Abhängigkeit von Alkohol (1997 bis 2012), Tabak (2000 bis 2012) und Beruhigungsmitteln (2000 bis 2012) beobachtet. Schlussfolgerungen: Der Konsum legaler Substanzen ist in Deutschland insgesamt rückläufig. Mehr Anstrengungen sind nötig, um den Konsum von Cannabis und Schmerzmitteln sowie substanzbezogene Störungen auf Bevölkerungsebene zu reduzieren.

Substance Use and Substance Use Disorders: Trends in Germany 1980 – 2012

Aims: This study assessed gender- and age-specific trends in the use of alcohol, tobacco, cannabis, analgesics, tranquilizers and sedatives as well as trends in substance use disorders according to DSM-IV within the period 1980 to 2012. Methods: Ten waves of the German Epidemiological Survey of Substance Abuse (ESA) were used. Data were collected using paper-and-pencil questionnaires or mixed-mode designs. Response rates varied between 45 % and 65 %. Results: Average volume of ethanol intake decreased in males since 1995 while it remained stable at lower levels in females. With the exception of specific subgroups, the proportion of current smokers showed a steady decline in both genders. 12-months cannabis use prevalence was higher in 2012 compared to 1995. Repeated use of analgesics increased over time in most population subgroups. Increases could be observed for alcohol dependence (1997 to 2012), tobacco dependence (2000 to 2012) and sedative dependence (2000 to 2012). Conclusions: The use of legal substances in Germany is generally decreasing. More effort is needed to reduce the prevalence of cannabis and analgesics use as well as substance use disorders.

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Generalized modeling approaches to risk adjustment of skewed outcomes data.

Willard G Manning, Anirban Basu, John Mullahy (2005)

There are two broad classes of models used to address the econometric problems caused by skewness in data commonly encountered in health care applications: (1) transformation to deal with skewness (e.g., ordinary least square (OLS) on ln(y)); and (2) alternative weighting approaches based on exponential conditional models (ECM) and generalized linear model (GLM) approaches. In this paper, we encompass these two classes of models using the three parameter generalized Gamma (GGM) distribution, which includes several of the standard alternatives as special cases-OLS with a normal error, OLS for the log-normal, the standard Gamma and exponential with a log link, and the Weibull. Using simulation methods, we find the tests of identifying distributions to be robust. The GGM also provides a potentially more robust alternative estimator to the standard alternatives. An example using inpatient expenditures is also analyzed.

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Hardening and the hard-core smoker: concepts, evidence, and implications.

Kenneth Warner, David Burns (2003)

A nascent debate pits researchers who believe that hard-core smokers are coming to dominate the remaining population of smokers against others who perceive the hardening of the target as a far more distant concern. At stake is the future emphasis of tobacco control: should we alter the current allocation of resources between treatment of individual smokers and modification of the psychosocial environment through public education and policy measures? We review the evidence and conclude that: (1) hardening is probably occurring in the sense that, compared with earlier generations, many of today's smokers possibly do have greater difficulty quitting, or are inherently less willing to do so. (2) Hardening may be most usefully construed in the context of specific groups of smokers, such as the mentally ill, who may constitute a growing fraction of the remaining smoking population. (3) Using conventional measures, however, we find little evidence that the population of smokers as a whole is hardening. Cessation rates have not decreased. (4) Truly hard-core smokers necessarily constitute a very small fraction of the population. Quitting-susceptible smokers continue to dominate the smoking population. (5) Hardening and the potential existence of true hard-core smokers recommend creative thinking about, and devotion of resources to, finding new ways to help the most dependent smokers to quit. (6) Sound research recommends the expansion of comprehensive tobacco-control programs in both the public and private sectors, and does not support reallocation of resources from such programs toward more intensive individualized treatment. We can afford both.

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Mortality, morbidity and costs attributable to smoking in Germany: update and a 10-year comparison.

Katharina Buesch, M. Neubauer, Reiner Leidl … (2006)

To assess the negative health consequences and associated costs of cigarette smoking in Germany in 2003 and to compare them with the respective results from 1993. The number of deaths, years of potential life lost (YPLL), direct medical and indirect costs caused by active cigarette smoking in Germany in 2003 is estimated from a societal perspective. The method is similar to that applied by Welte et al, who estimated the cost of smoking in Germany in 1993. Therefore, a direct comparison of the results was possible. Methodological and data differences between these two publications and their effect on the results are analysed. In 2003, 114,647 deaths and 1.6 million YPLL were attributable to smoking. Total costs were euro21.0 billion, with euro7.5 billion for acute hospital care, inpatient rehabilitation care, ambulatory care and prescribed drugs; euro4.7 billion for the indirect costs of mortality; and euro8.8 billion for costs due to work loss days and early retirement. From 1993 to 2003, the proportionate mortality attributable to smoking remained relatively stable, rising from 13.0% to 13.4%. The smoking-attributable deaths in men is lowered by 13.7% whereas that in women increased by 45.3%. Total real direct costs rose by 35.8%, and total real indirect costs declined by 7.1%, rendering an increase of 4.7% to real total costs. Accountable factors are changes in cigarette smoking prevalence and in disease-specific mortality and morbidity, as well as a rise in general healthcare expenditure. Despite the growing knowledge about the hazards of smoking, the smoking-attributable costs increased in Germany. Further, female mortality attributable to smoking is much higher than it was in 1993.

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Journal

Journal ID (publisher-id): suc

Title: SUCHT

Subtitle: Die Zeitschrift für Wissenschaft und Praxis

Publisher: Hogrefe AG, Bern

ISSN (Print): 0939-5911

ISSN (Electronic): 1664-2856

Publication date (Print): Januar 2013

Volume: 59

Issue: 6

Pages: 333-345

Affiliations

[ ¹ ] IFT Institut für Therapieforschung, München

[ ² ] Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, Stockholm

Author notes

Prof. Dr. Ludwig Kraus, IFT Institut für Therapieforschung, Parzivalstr. 25, 80804 München, Deutschland, Tel.: +49 (0)89 – 360804 – 30, Fax: +49 (0)89 – 360804 – 49, kraus@ 123456ift.de

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Apa ID: suc_59_6_333

DOI: 10.1024/0939-5911.a000276

SO-VID: 047077cf-0457-4553-8a5f-4f8327b39e10

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Substanzkonsum und substanzbezogene Störungen: Trends in Deutschland 1980 – 2012

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Substance Use and Substance Use Disorders: Trends in Germany 1980 – 2012

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Most cited references 44

Generalized modeling approaches to risk adjustment of skewed outcomes data.

Hardening and the hard-core smoker: concepts, evidence, and implications.

Mortality, morbidity and costs attributable to smoking in Germany: update and a 10-year comparison.

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