Titre : | French field experience with buprenorphine (2004) |
Titre traduit : | (L'expérience française en matière de buprénorphine) |
Auteurs : | M. AURIACOMBE ; M. FATSEAS ; J. DUBERNET ; J. P. DAULOUEDE ; J. TIGNOL |
Type de document : | Article : Périodique |
Dans : | American Journal on Addictions (Vol.13, Suppl.1, May-June 2004) |
Article en page(s) : | S17-S28 |
Langues: | Anglais |
Discipline : | TRA (Traitement et prise en charge / Treatment and care) |
Mots-clés : |
Thésaurus mots-clés BUPRENORPHINE ; PRESCRIPTION MEDICALE ; INCIDENCE ; MORTALITE ; SURDOSE ; GROSSESSE ; MESUSAGEThésaurus géographique FRANCE |
Résumé : |
ENGLISH :
In most European countries, methadone treatment is provided to only 20-30% of opiate abusers who need treatment due to regulations and concerns about safety. To address this need in France, all registered rnedical doctors since 1995 have been allowed to prescribe buprenorphine (BUP) without any special education or licensing. This led to treating approximately 65,000 patients per year with BUP, about ten times more than with more restrictive methadone policies. French physician compensation mechanisms, pharmacy services, and medical insurance funding all minimized barriers to BUP treatment. About 20% of all physicians in France are using BUP to treat about half of the estimated 150,000 probem heroin users. Daily supervised dosing by a phamacist for the first six months resulted in significantly better treatment retention (80% vs 46%) and lower heroin use. Intravenous diversion of BUP may occur in up to 20% of BUP patients and has led to various infections and relatively rare overdoses in combination with sedatives. Opiate overdose deaths have declined substantially (by 79%) since BUP was introduced in 1995. Newborn opiate withdrawal in mothers treated with buprenorphine compared to methadone was reported to be less frequent, less severe, and of shorter duration. Although some of the public health benefits seen during the time of buprenorphine expansion in France might be contingent upon characteristics of the French health and social services system, the French model raises questions about the value of tight regulations on prescribing BUP imposed by many countries throughout the world. (Review' s abstract) |
Domaine : | Drogues illicites / Illicit drugs |
Refs biblio. : | 65 |
Affiliation : | Department of Psychiatry and Addiction, Victor Pachon Medical School, Université Victor Segalen Bordeaux 2, Bordeaux, France |
Numéro Toxibase : | 207449 |
Centre Emetteur : | 02 Coordonnateur |
Cote : | Abonnement |
Lien : | http://dx.doi.org/10.1080/10550490490440780 |
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