[Computer simulation of the 10-year outcome of a cohort of heroin addicts in Ile-de-France].

The aim of this study is to develop a computer simulation model to describe imaginary cohorts of heroin users in the Ile de France (greater Paris) region. Because of the lack of well-designed cohort studies in France, this model is based on epidemiological data found in various different studies. The results of the simulation reveal horrifying outcomes in ten years' time: in the more optimistic scenario (an annual non-Aids mortality rate of 1%, an annual rate of permanent addiction curtailment of 10% and a syringe exchange rate of 10%), only 50% of heroin users curtail their consumption permanently without being HIV carriers after 10 years, 16% are HIV carriers and 10% have died. In conclusion, medical care should play an important part in the management of drug users, and secondary prevention aimed at reducing the health problems involved in heroin use should be intensified.