Consumo abusivo de psicofármacos entre la población que acude a un servicio de urgencias

Abstract

Consumption of psychotropic drugs is progressively increasing in our society. More specifically, a rise in the use of anxiolytic and antidepressant drugs has been registered in recent years. Psychotropics are most commonly prescribed by primary healthcare providers who do not follow the recommendations of the clinical practice guidelines and who seem to be unaware of the alarming increase in the consumption of psychotropics nowadays. The current economic background has clearly affected the social welfare state leading to an increase in public health expenditure. As a consequence, the pharmaceutical industry has been placed in an advantageous position. In the emergency field, psychotropic drug consumption has resulted in drug interaction and acute poisoning (accidental or intentional) in most cases. AIM OF THE STUDY To find out whether psychotropic drug abuse is real in the case of antidepressant and anxiolytic medication among patients attending the hospital emergency department. MATERIAL AND METHODS. Design: Cross-sectional observational study. Study population: Anyone of legal age attending the emergency room at the public hospital Hospital Universitario de la Defensa Gómez Ulla in Madrid covering an estimated period from October 2013 to January 2014. Those patients whose clinical information was not verifiable or impossible to access were excluded. Consecutive non-probabilistic sampling was used. ANTIDEPRESSANT AND ANXIOLYTIC DRUG ABUSE: for the purposes of the present paper, consumption of self-administered antidepressant and anxiolytic drugs (without the supervision of healthcare professionals) or continued consumption of prescribed antidepressant and anxiolytic drugs for a period longer than 15 months. RESULTS. A sample of 745 patients was obtained, 327 men (43.9%) and 418 women (56.1%). 57% of them (427) did not take psychotropics; 7% were former users and 35.5% were active users (318); 98% of them taking antidepressant, anxiolytic or a combination of both. 58% (184) of consumers were drug abusers -one out of every four patients. Anxiety, depression and insomnia account for 95% of the underlying pathologies which led to drug taking. 61% of psychotropics were prescribed by primary healthcare providers; 19% by psychiatrists; 17% by other medical specialists and 2% were non- prescribed. 70% of patients were not told how to quit their medication; 22% were told to progressively reduce the dose according to a fixed pattern; and the remaining 7% never considered the possibility of withdrawal. There are several risk factors associated with the use of psychotropics: the use of regular medication (p<0.001); gender differences (being a woman <0.001); civil status (being widowed p(p= 0.009); working status (being unemployed p<0.009); and alcohol intake (p<0.001). CONCLUSIONS. An abusive use of psychotropic drugs was found among patients attending the emergency department in the Hospital Universitario de la Defensa Gómez Ulla (area 11). In order to avoid drug interaction and acute poisoning, a careful study of the medical history (anamnesis) should always be carried out. Awareness campaigns aimed at patients would be highly advisable in order to promote responsible drug use as well as to make consumers aware that psychotropic drugs are not as harmless as they might think.