Why buprenorphine is so successful in treating opiate addiction in France.
In France, all registered medical doctors have been allowed to prescribe buprenorphine without any special education or licensing since 1995. This has led to a rapidly increasing number of opiate-dependent users under buprenorphine treatment in primary care. French physician compensation mechanisms, pharmacy services, and medical insurance funding all have contributed to minimizing barriers to buprenorphine treatment. Approximately 20% of all physicians in France are prescribing buprenorphine to treat more than one half of the estimated 180,000 problem heroin users. Intravenous diversion of buprenorphine may occur in up to 20% of buprenorphine patients and has led to relatively rare overdoses in combination with sedatives, whereas total opiate overdose deaths have declined substantially. In France, buprenorphine maintenance treatment for problem opiate users was feasible and safe through office-based prescriptions in a relaxed regulatory environment.
Fatseas
M
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Département d'Addictologie, Centre Carreire, 121 rue de la Béchade, 33076 Bordeaux Cedex, France.
Auriacombe
Marc
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D002047:Buprenorphine / Q000008:administration & dosage / Q000506:poisoning / Q000627:therapeutic use*; D002423:Cause of Death; D003430:Cross-Sectional Studies; D017277:Drug Approval / Q000331:legislation & jurisprudence; D062787:Drug Overdose / Q000401:mortality; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005602:France; D006556:Heroin Dependence / Q000534:rehabilitation; D006801:Humans; D008134:Long-Term Care / Q000706:statistics & numerical data; D009294:Narcotics / Q000008:administration & dosage / Q000506:poisoning / Q000627:therapeutic use*; D009313:National Health Programs / Q000331:legislation & jurisprudence; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D011320:Primary Health Care / Q000331:legislation & jurisprudence; D015819:Substance Abuse, Intravenous / Q000534:rehabilitation
D009294:Narcotics; D002047:Buprenorphine