Bouchez J, Beauverie P, Touzeau D
Clinique Liberté, Paris, France.
Eur Addict Res. 1998;4 Suppl 1:8-12. doi: 10.1159/000052035.
In France, during the 1990s, there have been some rapid developments in the treatment of opioid addiction with the introduction of legal substitution agents. Originally, some patients were treated with morphine sulfate, but this was superseded by high dose buprenorphine (Subutex(R)) and methadone. This resulted in those patients originally treated with morphine being transferred to either of these two licensed products. A study investigating the effects of the transition from morphine to either buprenorphine or methadone was undertaken. Supplementary to this, a trial investigating transition between these new compounds was also conducted. The primary outcome measures for these trials were retention rate, which was assessed at 5, 9 and 12 months, and the precipitation of withdrawal symptoms. The studies showed that transferring patients between substitution agents can be accomplished without severe withdrawal symptoms, although specific management may be required for transfer from high doses of methadone to buprenorphine. High long-term retention rates were observed in the studies, with most drop-outs occurring directly after transfer. Results suggest that patients on long-term buprenorphine maintenance therapy may have good compliance in comparison with other agents.
20世纪90年代，法国在阿片类药物成瘾治疗方面随着合法替代药物的引入取得了一些快速进展。最初，一些患者接受硫酸吗啡治疗，但后来被高剂量丁丙诺啡（舒倍生）和美沙酮所取代。这使得那些原本接受吗啡治疗的患者转而使用这两种获批药物中的一种。开展了一项研究，调查从吗啡转换为丁丙诺啡或美沙酮的效果。此外，还进行了一项试验，研究这两种新化合物之间的转换。这些试验的主要结局指标是留存率，在第5、9和12个月进行评估，以及戒断症状的出现情况。研究表明，在替代药物之间转换患者可以在不出现严重戒断症状的情况下完成，尽管从高剂量美沙酮转换为丁丙诺啡可能需要特殊管理。研究中观察到较高的长期留存率，大多数退出情况直接发生在转换后。结果表明，与其他药物相比，接受长期丁丙诺啡维持治疗的患者可能具有良好的依从性。
