{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T17:23:25Z","timestamp":1767633805818,"version":"3.48.0"},"reference-count":39,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacy"],"abstract":"<jats:p>Substance use disorder (SUD) is a chronic and clinically complex condition, frequently complicated by significant organic and psychiatric comorbidities. Most patients are polymedicated and require opioid substitution programs (OSPs). This complexity is further exacerbated by drug\u2013drug interactions, therapeutic duplication, and fragmentation of the healthcare system. This retrospective observational study analyses the prevalence of polypharmacy and associated pharmacotherapeutic risks in a cohort of 1050 patients with SUD treated at Drug Care Units (DCUs) in Tenerife (Canary Islands, Spain). Prescriptions were dominated by methadone (62%), antidepressants, and antipsychotics, often in combination with benzodiazepines. Significant polypharmacy (&gt;10 active prescriptions) was observed in 2.3% of patients, while 8.1% received 6\u201310 medications and 37.2% were using 2\u20135 medications. Women showed a higher pharmacological burden, with 3.5% experiencing significant polypharmacy (&gt;10 different prescriptions) compared with 1.1% of men. Overall, 31% of patients received antidepressants, 31% were treated with antipsychotics\u2014frequently with concurrent use of multiple agents\u2014and 6.4% received opioids outside the OSP. Therapeutic duplication was observed in 15.6% of patients for psycholeptics, 14.2% for psychoanaleptics, and 3.2% for antiepileptics. Additionally, 25.2% of patients reported self-medication, predominantly with benzodiazepines. These findings underscore the need for integrated pharmaceutical care programs incorporating individualized therapeutic review and deprescribing strategies to enhance the safety and efficacy of SUD treatment.<\/jats:p>","DOI":"10.3390\/pharmacy14010004","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T11:11:46Z","timestamp":1767352306000},"page":"4","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Addiction: Burden of Polypharmacy and Risk in Frail Patients with Substance Use Disorder"],"prefix":"10.3390","volume":"14","author":[{"given":"L. Goretti","family":"Santiago Guti\u00e9rrez","sequence":"first","affiliation":[{"name":"Addiction Treatment Unit, San Miguel Addictions, Avenida Trinidad 57, 38204 La Laguna, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2481-7405","authenticated-orcid":false,"given":"Daida","family":"Alberto Armas","sequence":"additional","affiliation":[{"name":"Environmental Toxicology and Food and Pharmacological Safety Research Group, Universidad de La Laguna, 38071 La Laguna, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1272-4850","authenticated-orcid":false,"given":"Ver\u00f3nica","family":"Hern\u00e1ndez Garc\u00eda","sequence":"additional","affiliation":[{"name":"Environmental Toxicology and Food and Pharmacological Safety Research Group, Universidad de La Laguna, 38071 La Laguna, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6877-9734","authenticated-orcid":false,"given":"Juan Ram\u00f3n","family":"Santana Ayala","sequence":"additional","affiliation":[{"name":"Environmental Toxicology and Food and Pharmacological Safety Research Group, Universidad de La Laguna, 38071 La Laguna, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0385-1532","authenticated-orcid":false,"given":"Roberto Garc\u00eda","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias Biomedicas y de la Salud, Departamento de Psicolog\u00eda, Universidad Europea de Canarias, 38010 La Orotava, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soraya","family":"Paz Montelongo","sequence":"additional","affiliation":[{"name":"Environmental Toxicology and Food and Pharmacological Safety Research Group, Universidad de La Laguna, 38071 La Laguna, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1581-0850","authenticated-orcid":false,"given":"\u00c1ngel J.","family":"Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Environmental Toxicology and Food and Pharmacological Safety Research Group, Universidad de La Laguna, 38071 La Laguna, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arturo","family":"Hardisson de la Torre","sequence":"additional","affiliation":[{"name":"Environmental Toxicology and Food and Pharmacological Safety Research Group, Universidad de La Laguna, 38071 La Laguna, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8774-5870","authenticated-orcid":false,"given":"Carmen Rubio","family":"Armend\u00e1riz","sequence":"additional","affiliation":[{"name":"Environmental Toxicology and Food and Pharmacological Safety Research Group, Universidad de La Laguna, 38071 La Laguna, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2013). 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