[Reduction in the number of lethal heroin overdoses in France since 1994. Focus on substitution treatments].
BACKGROUND
Since 1994-1995, rapid development of widely available substitution treatments has appeared to be a major healthcare step in heroin addiction. Currently approximately 60000 patients are taking daily maintenance doses of oral methadone and about 7200 are taking sublingual buprenorphine. In parallel with the expansion of these treatments, the number of lethal overdoses has fallen off regularly: 564 in 1994, 393 in 1996 and 143 in 1998 (-74.6% in 4 years).


OBJECTIVE
We searched for a correlation between the rise in the number of patients taking maintenance treatments and the decreased in recorded deaths due to heroin overdose. Other factors which may influence this decrease were also considered.


CONCLUSIONS
A linear correlation was found between the increasing number of patients on maintenance treatment (high-dose buprenorphine or methadone) and the decrease in fatal heroin overdoses in France between 1994 and 1998. The importance of this correlation must be modulated by the presence of other events such as political, social, healthcare and behavioral events concerning drug users.
Lepère
B
B
Unité de Médecine des Addictions, Service de Médecine Interne, Centre Monte Cristo, Hôpital Européen G.-Pompidou, 20, rue Leblanc, 75015 Paris.
Gourarier
L
L
Sanchez
M
M
Adda
C
C
Peyret
E
E
Nordmann
F
F
Ben Soussen
P
P
Gisselbrecht
M
M
Lowenstein
W
W
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology / Q000517:prevention & control; D001294:Attitude to Health; D002047:Buprenorphine / Q000627:therapeutic use*; D062787:Drug Overdose / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends*; D005260:Female; D005602:France / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D003932:Heroin / Q000506:poisoning*; D006556:Heroin Dependence / Q000188:drug therapy* / Q000401:mortality* / Q000517:prevention & control / Q000523:psychology; D006801:Humans; D016014:Linear Models; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009026:Mortality / Q000639:trends; D009294:Narcotics / Q000627:therapeutic use*; D011159:Population Surveillance; D012307:Risk Factors
D009294:Narcotics; D002047:Buprenorphine; D003932:Heroin; D008691:Methadone