Gaëtan Gentile1, Elisabeth Frauger2, Adeline Giocanti3, Vanessa Pauly3, Véronica Orleans3, Despina Amaslidou2, Xavier Thirion3, Joëlle Micallef2. 1. Département universitaire de médecine générale, faculté de médecine, Aix-Marseille université, 13385 Marseille, France. Electronic address: gaetan.gentile@univ-amu.fr. 2. UMR 7289, service de pharmacologie clinique et pharmacovigilance, CNRS, CEIP - addictovigilance PACA Corse, institut des neurosciences Timone, secteur PiiCi, CHU Timone, Assistance publique-Hôpitaux de Marseille, Aix-Marseille université, 13385 Marseille, France. 3. Laboratoire de santé publique EA 3279, centre d'évaluation de la pharmacodépendance-addictovigilance (CEIP-A) de Marseille (PACA Corse) associé, faculté de médecine, Aix-Marseille université, 13005 Marseille, France.
Abstract
AIM: The objective of the study is to describe the characteristics of subjects under opiate maintenance treatment by general practionners (GPs). METHOD: Data analysis from observatory for pharmacodependency in ambulatory medicine survey (observation des pharmacodépendances en médecine ambulatoire [OPEMA]) program in 2013 of the subjects under high dosage buprenorphine (HDB) and methadone prescribed or obtained illegally reported by GPs in France. RESULTS: Survey concerned consumers with 862, 433 and 429 of high dosage buprenorphine and respectively methadone. The average age is 39±9 years respectively, and 36±8 years; over 70% are male; 55% have paid employment and over 30% report social benefits; 9% are in temporary housing. In both groups, more than 50% have anxiety and depression; over 25% have associated somatic disorders and digestive diseases, respiratory, pain is the most common. Almost 99% use oral route; nearly 100% have a daily consumption and about 20% of the alcohol concomitantly; 24% of HDB use benzodiazepines and 18% of the methadone group (P=0.06); 33% of the population using methadone consume illicit psychoactive substances and 21% for HDB population (P<0.0001), in particular cannabis (P<0.0001). Heroin and cocaine are also consumed. CONCLUSION: The population consuming opiate maintenance treatments shows social, somatic and psychiatric vulnerability. Misuse associated forms and consumption of other psychoactive substances and illegal drugs are observed. Despite the complexity of management of these patients, general practitioners have a major role to play.
AIM: The objective of the study is to describe the characteristics of subjects under opiate maintenance treatment by general practionners (GPs). METHOD: Data analysis from observatory for pharmacodependency in ambulatory medicine survey (observation des pharmacodépendances en médecine ambulatoire [OPEMA]) program in 2013 of the subjects under high dosage buprenorphine (HDB) and methadone prescribed or obtained illegally reported by GPs in France. RESULTS: Survey concerned consumers with 862, 433 and 429 of high dosage buprenorphine and respectively methadone. The average age is 39±9 years respectively, and 36±8 years; over 70% are male; 55% have paid employment and over 30% report social benefits; 9% are in temporary housing. In both groups, more than 50% have anxiety and depression; over 25% have associated somatic disorders and digestive diseases, respiratory, pain is the most common. Almost 99% use oral route; nearly 100% have a daily consumption and about 20% of the alcohol concomitantly; 24% of HDB use benzodiazepines and 18% of the methadone group (P=0.06); 33% of the population using methadone consume illicit psychoactive substances and 21% for HDB population (P<0.0001), in particular cannabis (P<0.0001). Heroin and cocaine are also consumed. CONCLUSION: The population consuming opiate maintenance treatments shows social, somatic and psychiatric vulnerability. Misuse associated forms and consumption of other psychoactive substances and illegal drugs are observed. Despite the complexity of management of these patients, general practitioners have a major role to play.
Keywords:
Consommation de substances psychoactives; Drug use; General practitioners; Misuse; Médecins généralistes; Mésusage; Opiate maintenance treatment; Pharmaco-épidémiologie; Pharmacoepidemiology; Traitements de substitution aux opiacés