Mancini Julien, Thirion Xavier, Masut Alain, Ronflé Eléonore, Coudert Christine, Pradel Vincent, Frauger Elisabeth, Micallef Joëlle
Laboratoire de Santé Publique, CEIP Marseille, PACA-Corse, Centre associé, Faculté de Médecine, 27, boulevard Jean-Moulin, 13385 Marseille Cedex 5.
Ann Med Interne (Paris). 2003 Jun;154 Spec No 1:S7-14.
Several reports have focused on prescription of high-dose buprenorphine using data electronically transmitted to the French health reimbursement system. This study deals with high-dose buprenorphine prescriptions in the Bouches-du-Rhone region between 1999 and 2001. We determined the number of maintained patients followed by practitioners (either short- or long-term care), the doses administered, and the associated prescription of psychotropic treatments. The number of general practitioners involved in 84% of the prescriptions of high-dose buprenorphine grew with a high turnover (20%). More than 25% of the general practitioners in the region prescribed this drug, but only 38% of them were involved in long-term follow-up of more than one maintained patient. The number of maintained patients and the mean daily treatment dose delivered (13.4 mg/d during 2001) increased. The associated prescriptions of benzodiazepines concerned 47% of the patients during 2001 (on the rise), but the associated prescription of flunitrazepam tended to decrease (29% of the subjects during 2001 versus 32% during 2000). This study shows a tendency for deviant behaviors to increase, constituting a public health concern.