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Cited by 39Opioid Use Disorder TreatmentSubstance Abuse Treatment and OutcomesPain Management and Opioid Use

Practice-based buprenorphine maintenance treatment (BMT): how do French healthcare providers manage the opiate-addicted patients?

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Vignau, Jean, Duhamel, Alain, Catteau, Jacques, Legal, Guy, Huynh, Anh, Grailles, Isabelle, Beauvillain, Jacques, Petit, Philippe +2 more·2001·Journal of Substance Abuse Treatment
DOI 10.1016/s0740-5472(01)00189-1
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Abstract

Unlabelled France was the first country to promote the extensive use of buprenorphine for the treatment of drug-addicted subjects through the primary care system. To assess both professional commitment and patients' characteristics, all the physicians and pharmacists of a French area having prescribed/dispensed buprenorphine from 2/12/96 (the official release date) to 1/31/98 were identified from data files of the Health Insurance and then interviewed. During the first 61 weeks of buprenorphine maintenance treatment (BMT), 27.5% of physicians and 51.2% of pharmacists of that area were involved; 142 patient records were documented. Features of the clinical routines spontaneously implemented for practice-based BMT were: a high level of on-site supervised dispensation by the pharmacist (71% at treatment induction and 23% thereafter); the absence of objective measurement of illicit drug use; and a low buprenorphine dosage. These features are consistent with the lack of physicians' experience and training, and also the relatively good status of the population treated (no HIV-positives, heroin use duration averaging 4.2 +/- 3.1 years, and 81.7% with stable accommodations). Despite liberal regulations guiding BMT, a negligible proportion of cases had a "nomadic" attitude (multiple buprenorphine prescribers/deliverers). The treatment outcomes (no deaths, three drug overdoses, improvement in occupational status) are encouraging.Conclusion Practice-based BMT appears to be a safe and acceptable response to moderate heroin addiction, but further training of the professionals involved and longitudinal investigations of individual outcomes are needed.

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  • Participants' demographic characteristics were similar to those reported in other U.S. and international studies of office-based buprenorphine/naloxone maintenance.

    “While participants’ demographic characteristics were similar to those reported in other U.S. and international studies of office-based buprenorphine/naloxone maintenance, our study sample is not necessarily representative of all opioid-dependent patients.13–15”

    From Patient Satisfaction with Primary Care Office-Based Buprenorphine/Naloxone Treatment (2007) · cites this paper as [15]

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  1. Emmanuelli, J. (2000). Contribution a `l'e ´valuation de la politique de re ´- duction des risques SIAMOIS. Bulletin de l'Institut de Veille Sanitaire, 1, 15 -37.
  2. Fudala, P. J., Bridge, P., Herbert, S., Leiderman, D., and Chiang, C.N. (1999). A multi-site efficacy evaluation of a buprenorphine/naloxone product for opiate dependence treatment. Problems of Drug Depend- ence, 1998: Proceedings from the 60th Annual Scientific Meeting of the College on Problems of Drug Dependence. NIDA Res. Monogr. Ser. (RM 179).
  3. Lepe `re, B., Gourarier, L., Sanchez, M., Peyret, E., Nordmann, F., Bensous- sen, P., Gieselbrecht, M., & Lowenstein, W. (2001). Diminution du nombre des surdoses mortelles a `l'he ´roı ¨ne en France depuis 1994: a ` propos du ro ˆle des traitements de substitution. Decrease of heroin lethal overdoses en France since 1994: role of substitution treatments. Annales de Medecine Interne, 152, in press.
  4. Umbricht, A., Huestis, M. A., Cone, E. J., & Preston, K. L. (1999). Safety of buprenorphine: No clinically relevant cardio-respiratory depression at high IV doses. Problems of Drug Dependence, 1998: Proceedings from the 60th Annual Scientific Meeting of the College on Problems of Drug Dependence. NIDA Res. Monogr. Ser. (RM 179)

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Authors
Vignau, J., Duhamel, A., Catteau, J., Legal, G., Huynh, A., Grailles, I., Beauvillain, J., Petit, P., Beauvillain, P., & Parquet, P. J.
Affiliations
  • Centre Hospitalier Universitaire de Lille (FR)
  • Université de Lille (FR)
  • Clinique de l'Yvette (FR)
Corresponding author
Vignau, Jean
ORCID
Venue
Journal of Substance Abuse Treatment
Publisher
Elsevier BV
Published
2001-10
Volume
21
Issue
3
Pages
135-144
ISSN
0740-5472 (ISSN-L)
DOI
10.1016/s0740-5472(01)00189-1
OpenAlex
W2033345384
Cited by
39
References
47
Citations by year
2024: 1 · 2018: 1 · 2017: 2 · 2016: 1 · 2015: 1 · 2014: 2 · 2013: 2
FWCI
2.31
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Substance Abuse Treatment (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
buprenorphine maintenance treatment, opioid use disorder, heroin addiction, primary care, pharmacist involvement, physician training, treatment outcomes, drug overdose, occupational status
MeSH terms
Adult, Buprenorphine, Family Practice, Female, France, Heroin Dependence, Humans, Male, Narcotic Antagonists, National Health Programs, Pharmacies, Surveys and Questionnaires, Retrospective Studies, Outcome Assessment, Health Care, Drug Utilization Review

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