[Trends in Abuse of Biogenic Drugs in Parts of Germany 2007-2013]. / Entwicklung des Missbrauchs psychotroper Pflanzen und Pilze in Deutschland ­ Interpretation der Zahlen aus 3 Giftinformationszentren für die Jahre 2007­2013.

AIM OF THE STUDY: Based on an abundance of information on the internet, psychotropic plants and mushrooms are of increasing relevance as legal and cheap alternatives to other illicit drugs. Due to the lack of a German database, the abuse of selected biogenic drugs using reported exposures to 3 German Poison Information Centres (PICs) was examined. METHODS: Information on abuse of biogenic drugs was collected from the German PICs in Berlin, Erfurt and Fribourg (2007-2013). RESULTS: 602 drug abuses were reported to the selected PICs. 52% reported consumption of tropane alkaloid-containing plants (Angel's trumpet, Thorn apple, Belladonna), 25% of psilocybin-containing mushrooms and 10% of nutmeg. Angel's trumpet was identified as the most abused plant. Consumers of tropane alkaloid-containing plants were mainly adolescents, whereas the majority of the abusers of psilocybin-containing mushrooms and nutmeg were rather young grown-ups and school children, respectively. A preponderance of moderate and severe effects (55%) could be noticed for exposures to tropane alkaloid-containing plants. More than 90% of suspected cases of tropane alkaloid-containing as well as psilocybin-containing plants abuse resulted in the treatment recommendation 'surveillance in hospital'. Mydriasis, hallucinations, tachycardia and agitation were the main symptoms after the abuse of biogenic drugs. CONCLUSIONS: The data from the PICs suggest abuse of biogenic drugs in parts of Germany. A decreasing trend is observed, probably caused by the competition with new synthetic designer drugs. The results underline the dominance of Angel's trumpet in the abuse of biogenic drugs and emphasize the importance of easy accessibility for the abuse of biogenic drugs. Unexpectedly, the number of nutmeg abuse cases increased during the investigated period.

Excessive medical information increase in package inserts.

OBJECTIVES: Package inserts are the most frequent source of patient information about medicines aside from doctors and pharmacists. MATERIALS AND METHODS: A representative selection of 271 German package inserts available in 2005 was investigated, using 152 validated quality criteria and by measuring 242 further values. RESULTS: A significant increase in package insert texts over recent years was found; standing at an average of 2,005 words. This is associated with the significant increase in complicated medical information being communicated; with on an average of 114.1 difficult words and 46.3 non quantifiable phrases per package insert. Only 60.1% of the package inserts offered all dosages as number of tablets or other amounts of the ready to use medicine, while just 29.5% listed the maximum daily dose for all users. 54.6% provided actions for all possible side effects and 24.2% the frequencies of side effects in numerical form. CONCLUSION: The significantly increased volume of medical information provided in package inserts does not meet the requirements of patients. Major efforts are required by pharmaceutical companies, authorities and legislative bodies in order to reduce information to that which is essential for patients and to ensure that this is provided in short, precise and easily comprehensible texts.