title: The management of opiate use disorders in France: results of an observational survey of general practitioners.
abstract: BACKGROUND
  When opioid-agonist treatments were approved in France in 1995, opiate use disorders began to be managed and treated by general practitioners (GPs), who have since then been encouraged to treat substance use disorders (SUDs) for heroin and other illegal substances. The objective of this study was to describe rates of: 1) SUDs in general practices in France; 2) characteristics of GPs treating SUDs; and 3) clinical practices surrounding SUDs. To place these data in the context of SUD treatment, we also gathered information from practicing SUD specialists.
  
  
  METHODS
  Between December 2011 and January 2012, a nationally representative sample of GPs and SUD specialists were interviewed by phone, using a 12-item questionnaire that covered number of SUD patients, types of SUDs, and treatments. Data collected were confidential, and analysis was blinded with regard to physician identity.
  
  
  RESULTS
  Forty-four percent of GPs and 68 % of specialists were included in the analysis. The mean number of patients estimated to have been seen at least once in the previous year was 3036 for GPs and 920 for specialists. Ninety-six percent of GPs reported having patients with SUDs. Tobacco, alcohol, and psychoactive drugs were the SUDs most frequently encountered by GPs, whereas tobacco, alcohol, heroin, and cannabis were most frequently encountered by specialists. Forty-three percent of GPs saw at least one patient with a heroin use disorder (HUD), and 82 % of GPs treating patients with HUDs had prescribed an opioid-agonist treatment during the previous 12 months.
  
  
  CONCLUSIONS
  The results of this study suggest that a large number of GPs now treat patients with opiate use disorders and that doctors appear to be convinced of the benefits of opioid-agonist therapy and have overcome their initial concerns. This represents a significant change in practice patterns since the introduction of opioid-agonist treatments in France.
authors.affiliation: Hôpitaux Universitaires Paris Seine St Denis, Site René Muret, Avenue du Dr Schaeffner, Sevran, 93270, France. pierre.polomeni@rmb.aphp.fr.
authors.forename: Pierre
authors.initials: P
authors.lastname: Poloméni
authors.affiliation: , 2 rue de Haslach, 67200, Strasbourg, France. dr.cbronner@wanadoo.fr.
authors.forename: Claude
authors.initials: C
authors.lastname: Bronner
authors.affiliation: CSAPA Dune, Parvis de la préfecture, Immeuble les Oreades, 95000, Cergy, France. frederick.fry@centre-dune.fr.
authors.forename: Fréderic
authors.initials: F
authors.lastname: Fry
authors.affiliation: , 151 Bis rue de Courcelles, 51100, Reims, France. bruno.ravoninjatovo@orange.fr.
authors.forename: Bruno
authors.initials: B
authors.lastname: Ravoninjatovo
authors.affiliation: Laboratoire de psychiatrie, Département d'addictologie, Centre hospitalier Charles Perrens, 146 bis, rue Léo Saignat, Bordeaux, 33076, France. melina.fatseas@u-bordeaux2.fr.
authors.forename: Mélina
authors.initials: M
authors.lastname: Fatseas
mesh_terms: D000328:Adult; D005260:Female; D005602:France; D058005:General Practitioners / Q000706:statistics & numerical data*; D006556:Heroin Dependence / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000188:drug therapy*; D010865:Pilot Projects; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000628:therapy