One hundred and twenty-five patients prescribed injectable opiates in the North West of England

FRANÇAIS :
Les informations sur le passé et les pratiques d'injection, les prescriptions courantes, les caractéristiques démographiques et l'opinion de 125 patients en traitement par opiacés injectables sont collectées dans une clinique du Nord-Est de l'Angleterre. La maintenance est effectuée par méthadone (85%) ou héroïne (13%) injectable. L'héroïne injectable est toutefois souhaitée par 50% du groupe étudié. La cohorte de patients a un passé important d'usages de drogues à risque, avec des conséquences graves sur la santé et la contamination virale. 25% des patients continuent leurs usages d'héroïne de rue, mais l'usage quotidien demeure rare. 40% s'injectent les drogues dans les veines fémorales, une pratique qui rend difficile l'analyse du rapport risque/bénéfice de la prescription contrôlée d'opiacés.
ENGLISH:
This study describes the demographics, drug-using history, current prescription, current illicit drug use, injecting practice and opinion of treatment of 125 patients prescribed injectable opiates at a clinic in the North West of England. The prescribing policy at the clinic has resulted in maintenance treatment with several opiate drugs, dominated by injectable methadone and injectable diamorphine (heroin). Injectable methadone (85.6% (107/125)) was more frequently prescribed than injectable diamorphine (12.8% (16/125)). Injectable heroin was desired by many who were prescribed injectable methadone, since it was the current drug of choice for 50.4% of the sample (61/12 1). The patient cohort gave a history of risky drug use in the past, both with regard to immediate physical health and blood borne viruses. Current self-reported risk behaviour for blood-borne viruses was low. Twenty-rive percent (29/121) of patients continued to use street heroin, of whom only four did so on a daily basis. This patient cohort has very low levels of daily illicit drug use; 40.5% (49/121) of patients currently used their femoral veins to inject, a practice which highlights the difficult risk-benefit analysis which is inherent in injectable prescribing. (Author's abstract.)