title: Illicit drug use and injection practices among drug users on methadone and buprenorphine maintenance treatment in France.
abstract: OBJECTIVE
  To evaluate the associations between methadone and high-dose buprenorphine maintenance treatment and illicit drug use and injection among drug users in France.
  
  
  METHODS
  A cross-sectional study. Data were gathered using a questionnaire administered containing closed-ended questions.
  
  
  METHODS
  Drug dependence clinics (DDC) and general practitioners' (GPs) offices in three French cities.
  
  
  METHODS
  Drug users undergoing maintenance treatment with methadone (n = 197) and buprenorphine (n = 142).
  
  
  METHODS
  Interviews covered the use of illicit drugs (heroin, cocaine or crack) and injection practices (illicit drugs and/or substitution drugs) during the last month, current treatment modalities, socio-demographic and health characteristics. Bivariate analysis and multivariate logistic regressions were conducted.
  
  
  RESULTS
  Overall, 35.4% of respondents (34.5% in the methadone group, 36.6% in the buprenorphine group, P= 0.69) had used at least one illicit drug, 25.7% reported having injected drugs and 15.3% had injected the substitution drug. Injection was more common among buprenorphine-maintained individuals (40.1%) than among users on methadone (15.2%) (P < 0.01). Multivariate analyses indicate that the type of substitution drug (buprenorphine versus methadone) was not associated with illicit drug use (OR = 1.1; 95% CI = 0.7-1.8). In the buprenorphine group, injection was related independently to social situation, as measured by housing (unstable versus stable housing, OR = 4.3; 95% CI = 1.6-11.5), but this was not the case in the methadone group. The risk of injection increased with buprenorphine dosage (high/low dosage OR = 6.2; 95% CI = 2.0-19.7), but this association was not observed in the methadone group.
  
  
  CONCLUSIONS
  Further studies comparing the benefits of these two types of treatment should be carried out, taking outcomes such as physical health, mental health and social functioning into consideration.
authors: French Institute of Health and Medical Research (INSERM U88), Hôpital National de Saint-Maurice, St-Maurice, France. anne.guichard@st-maurice.inserm.fr
authors: Anne
authors: A
authors: Guichard
authors: France
authors: F
authors: Lert
authors: Christine
authors: C
authors: Calderon
authors: Hind
authors: H
authors: Gaigi
authors: Olivier
authors: O
authors: Maguet
authors: Jérôme
authors: J
authors: Soletti
authors: Jean-Marc
authors: JM
authors: Brodeur
authors: Lucie
authors: L
authors: Richard
authors: Mike
authors: M
authors: Benigeri
authors: Maria-Victoria
authors: MV
authors: Zunzunegui
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002047:Buprenorphine / Q000627:therapeutic use*; D004812:Epidemiologic Methods; D005260:Female; D005602:France; D006798:Housing; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D012959:Socioeconomic Factors; D016320:Substance Abuse Treatment Centers; D015819:Substance Abuse, Intravenous / Q000534:rehabilitation*; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D002047:Buprenorphine; D008691:Methadone