Health service utilization and benzodiazepine use among heroin users: findings from the Australian Treatment Outcome Study (ATOS)

FRANÇAIS :
Le taux dutilisation des services de santé par les usagers dhéroïne et le type de prescription quils demandent ainsi que la part des benzodiazépines dans ces demandes, sont explorés parmi 615, usagers dhéroïne, participant au programme ATOS. La conclusion de létude montre que la prescription de médicaments est courante pour ses usagers et quelle concerne des médicaments psychotropes, notamment des benzodiazépines. Malgré les mises en garde vis-à-vis des dangers liés aux benzodiazépines, leur prescription est encore largement répandue chez les usagers dhéroïne.
ENGLISH :
Aims: To determine levels of health service utilization among heroin users, the types of prescription drugs obtained by heroin users and the contribution of benzodiazepine use in health service utilization and prescribed drug use. Design: Cross-sectional survey Setting Sydney, Australia. Participants: A total of 615 current heroin users recruited for the Australian Treatment Outcome Study (ATOS). Findings: Sixty per cent of subjects had consulted a general practitioner (GP) and 7% a specialist in the preceding month. An ambulance had attended 11% of subjects in the preceding month. Forty-eight per cent of subjects had prescriptions dispensed for medication in the preceding month. Thirty-nine per cent of participants had prescriptions dispensed for psychotropic medications, representing 80% of all prescriptions. Twenty per cent of subjects had prescriptions dispensed for non-psychotropic medications (20% of prescriptions). The most commonly prescribed drugs were benzodiazepines (59% of prescriptions), which had been obtained by 30%, of subjects. Benzodiazepine users had more GP and psychiatrist visits, were more likely to have had an ambulance attendance and had significantly more dispensed prescriptions. Conclusions: There were high levels of health utilization among heroin users. Prescription drug use was common, and dominated by psychotropic drugs. Benzodiazepine use was a dominant factor in the use of services and in prescriptions dispensed. Despite increased awareness of the harms associated with benzodiazepines, they continue to be prescribed widely to heroin users. (Author' s abstract)