title: [Buprenorphin and benzodiazepines, an association with high risk. Reality of co-prescriptions by the general practitioners].
abstract: BACKGROUND
  The buprenorphine (BHD) is an effective maintenance treatment for opioid dependence, used in France until 1996. From 1996 to 2001, it is involved in 137 deaths by respiratory depression including 91 attributable to the benzodiazepines (BDZ) association. The number of deaths caused by the BHD and BDZ, when they are taken jointly, is probably underestimated. The reasons for this association are the misuse, the self-medication and the co-prescription.
  
  
  OBJECTIVE
  The objective of this study was to assess the co-prescription of these two drugs by the general practitioners (GPs) of Nancy (France).
  
  
  METHODS
  A survey was conducted during the first semester 2007. Using the datas of the Caisse Primaire d'Assurance Maladie (the French national health service), all the requests for a reimbursement of BHD in Nancy were analysed.
  
  
  RESULTS
  1655 BHD consumers were included in this survey. Thirty-one percent of them asked for the reimbursement of at least one BZD at the same time. The BZD consumers were old, consulted more than one prescriber or chemist and more often consumed high dosages of BHD.
  
  
  CONCLUSIONS
  The BZD consumption is often associated to BHD intake (31%). GPs need a better training on the subject: "How to take care of patients who depend on opiod". This would reduce the risks. A better information for the BHD users would be necessary as well as a lowest prescription of BZD by the GPs. Before any BHD prescription, the GPs should assess a possible co-dependence to BZD in order to improve the BHD prescription.
authors.affiliation: Centres de soins d'accompagnement et de prévention en addictologie (CSAPA), Inserm CIC 9501. paolo.di-patrizio@wanadoo.fr
authors.forename: Paolo
authors.initials: P
authors.lastname: Di Patrizio
authors.forename: Sophie
authors.initials: S
authors.lastname: Houille
authors.forename: Raymund
authors.initials: R
authors.lastname: Schwan
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Boivin
mesh_terms: D001569:Benzodiazepines / Q000008:administration & dosage*; D002047:Buprenorphine / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000706:statistics & numerical data; D005602:France; D058006:General Practice; D006801:Humans; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians'; D012306:Risk
chemical_list: D009292:Narcotic Antagonists; D001569:Benzodiazepines; D002047:Buprenorphine