[Risk factors of early drop-out during induction of high-dose buprenorphine substitution therapy. A study of 1085 opiate addicts].
BACKGROUND
The revelation of an acceptable rate of users still treated one year after initiation of a substitution program with high-dose buprenorphine (HDB) has contributed in the validation of the interest of the molecule in this indication. However the frequency of early drop-outs (after the first consultation), when treatment is set-up, is frequently evoked, although undocumented, by general practitioners.


OBJECTIVE
During analysis of a survey on the follow-up of opiate addicts starting substitution therapy with HDB, we attempted to assess the frequency of early drop-outs and identify the contributing factors.


METHODS
Among the 1085 patients included in the study and in whom induction therapy had been prescribed, 656 were assessed after 12 months' follow-up.


RESULTS
Age, precariousness, lack of social support and partial access to care (lack of health insurance, previous contact with the prescriber) were significantly associated with early drop-out. The consumption of psychoactive products and their administration mode, during the 30 days prior to the first consultation of those loss to follow-up, also differed from those of patients who remained within the care system.


CONCLUSIONS
Knowledge of the factors related to frequent early drop-out during induction of HDB substitution therapy, and bearing this in mind, would permit the organisation of more attentive management and hence reduce the drop-out rate.
Batel
P
P
UTAMA, Hôpital Beaujon, Clichy (92).
Reynaud-Maurupt
C
C
Lavignasse
P
P
Constant
M V
MV
Kopp
P
P
Jourdain
J J
JJ
Videau
B
B
Mucchielli
A
A
Riff
Bertrand
B
Lowenstein
W
W
D000328:Adult; D000367:Age Factors; D001294:Attitude to Health; D002047:Buprenorphine / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology; D006297:Health Services Accessibility; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D008297:Male; D017533:Marital Status; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D010352:Patient Dropouts / Q000523:psychology / Q000706:statistics & numerical data*; D011619:Psychotropic Drugs / Q000008:administration & dosage; D012307:Risk Factors; D012944:Social Support
D009292:Narcotic Antagonists; D011619:Psychotropic Drugs; D002047:Buprenorphine