Titre : | Maintenance therapy and 3-year outcome of opioid-dependent prisoners: a prospective study in France (2003-06) (2009) |
Auteurs : | J. N. MARZO ; M. ROTILY ; F. MEROUEH ; M. VARASTET ; C. HUNAULT ; I. OBRADOVIC ; A. ZIN ; RECAMS Study group |
Type de document : | Article : Périodique |
Dans : | Addiction (Vol.104 n°7, July 2009) |
Article en page(s) : | 1233-1240 |
Langues: | Anglais |
Discipline : | TRA (Traitement et prise en charge / Treatment and care) |
Mots-clés : |
Thésaurus géographique FRANCEThésaurus mots-clés TRAITEMENT DE MAINTENANCE ; BUPRENORPHINE ; METHADONE ; COHORTE ; ETUDE PROSPECTIVE ; PRISON ; OPIACES ; PRESCRIPTION MEDICALE ; RECIDIVE ; PSYCHOTROPES |
Résumé : |
AIMS: To describe the profile of imprisoned opioid-dependent patients, prescriptions of maintenance therapy at imprisonment and 3-year outcome in terms of re-incarceration and mortality.
DESIGN: Prospective, observational study (France, 2003-06). SETTING: Health units of 47 remand prisons. PARTICIPANTS: A total of 507 opioid-dependent patients included within the first week of imprisonment between June 2003 and September 2004, inclusive. MEASUREMENTS: Physicians collected socio-demographic data, penal history, history of addiction, maintenance therapy and psychoactive agent use, general health status and comorbidities. Prescriptions at imprisonment were recorded by the prison pharmacist. Re-incarceration data were retrieved from the National Register of Inmates, survival data and causes of death from the National Registers of vital status and death causes. FINDINGS: Prison maintenance therapy was delivered at imprisonment to 394/507 (77.7%) patients. These patients had poorer health status, heavier opioid use and prison history and were less socially integrated than the remaining 113 patients. Over 3 years, 238/478 patients were re-incarcerated [51.3 re-incarcerations per 100 patient-years, 95% confidence interval (CI) 46.4-56.2]. Factors associated independently with re-incarceration were prior imprisonment and benzodiazepine use. After adjustment for confounders, maintenance therapy was not associated with a reduced rate of re-incarceration (adjusted relative risk 1.28, 95% CI 0.89-1.85). The all-cause mortality rate was eight per 1000 patient-years (n = 10, 95% CI 4-13). CONCLUSIONS: Prescription of maintenance therapy has increased sharply in French prisons since its introduction in the mid-1990s. However, the risk of re-imprisonment or death remains high among opioid-dependent prisoners. Substantial efforts are needed to implement more effective preventive policies. (Author's abstract) |
Domaine : | Drogues illicites / Illicit drugs |
Refs biblio. : | 26 |
Affiliation : | Réseau d'Etudes sur les Conduites Addictives, Médicament et Société, Paris, France |
Centre Emetteur : | 13 OFDT |
Cote : | Abonnement |
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