Mezaache Salim, Turlure Franck, Fredon Nathalie, Le Brun Gadelius Maela, Micallef Joëlle, Frauger Elisabeth
Centre d'évaluation et d'information sur la pharmacodépendance-addictovigilance (CEIP-A) PACA Corse, service de pharmacologie clinique et pharmacovigilance, AP-HM-Timone, AMU, INS, Inserm UMR1106, 13000 Marseille, France.
Centre d'évaluation et d'information sur la pharmacodépendance-addictovigilance (CEIP-A) PACA Corse, service de pharmacologie clinique et pharmacovigilance, AP-HM-Timone, AMU, INS, Inserm UMR1106, 13000 Marseille, France.
Therapie. 2023 Nov-Dec;78(6):605-614. doi: 10.1016/j.therap.2023.03.008. Epub 2023 Mar 15.
In France, opioids are responsible for the majority of overdose deaths in France. The antidote naloxone is available in France in take home formulations since 2016. Addiction specialized centres are in front-line for naloxone diffusion. The objective was to provide an overview of professional practices, difficulties and needs regarding overdose prevention and naloxone diffusion in these centres of the Provence-Alpes-Côte d'Azur (PACA) region.
The POP programme "Prevention and harm reduction of opioid overdoses in PACA region" aims to improve the care of patients at risk of overdose and facilitate naloxone diffusion. The 75 addiction specialized centres of the PACA region were invited to respond to a semi-structured interview or a telephone questionnaire. Data collected included 2020 centres' activity and professionals' perceptions of overdose risk in their active file, their practices, difficulties and needs.
Overall, 33 centres answered. Among them, 22 were dispensing naloxone with a mean of 20 kits dispensed in 2020 (min-max: 1-100). Two strategies were pointed out: systematically offering of naloxone to all opioids users or targeting people considered at risk. Several difficulties limiting naloxone diffusion were expressed: a lack of knowledge from opioids users, refusal from people not feeling concerned or refusing the injectable formulation, a lack of training of some professionals to be comfortable with the tool or reglementary or time constraints.
Naloxone diffusion is incrementally getting into common practices. However barriers are persisting. On the basis of expressed difficulties and needs, information and training materials were co-designed and diffused.
在法国，阿片类药物导致了该国大部分过量用药死亡案例。自2016年起，解毒剂纳洛酮在法国有可供带回家使用的剂型。成瘾专科中心处于纳洛酮推广的前沿。目的是概述普罗旺斯-阿尔卑斯-蓝色海岸（PACA）地区这些中心在过量用药预防和纳洛酮推广方面的专业实践、困难和需求。
“PACA地区阿片类药物过量用药的预防与危害减少”（POP）项目旨在改善对有过量用药风险患者的护理，并促进纳洛酮的推广。邀请了PACA地区的75个成瘾专科中心回应半结构化访谈或电话问卷。收集的数据包括2020年各中心的活动情况以及专业人员对其活跃档案中过量用药风险的看法、他们的实践、困难和需求。
总体而言，有33个中心做出了回应。其中，22个中心在发放纳洛酮，2020年平均发放20套试剂盒（最小值 - 最大值：1 - 100）。指出了两种策略：向所有阿片类药物使用者系统性地提供纳洛酮，或针对被认为有风险的人群。表达了几个限制纳洛酮推广的困难：阿片类药物使用者缺乏相关知识、未感到担忧的人拒绝或拒绝注射剂型、一些专业人员缺乏使用该工具的培训，或存在监管或时间限制。
纳洛酮的推广正逐渐融入常规做法。然而障碍依然存在。基于所表达的困难和需求，共同设计并分发了信息和培训材料。
