DIFFERENCES BETWEEN GENERAL-PRACTITIONER-PRESCRIBED AND ADDICTION-CENTER-PRESCRIBED BUPRENORPHINE SUBSTITUTION THERAPY IN FRANCE

The treatment of heroin addiction in France relies on either general p ractitioners (GP) or specialist Addiction Centres (ACs). Tn general, t he GPs offer a more flexible approach regarding frequency of consultat ions, urine tests and dosing regimen while the AC approach is more str uctured. A cohort study was undertaken to compare the treatment strate gies of buprenorpbine therapy between these medical environments. To d etermine the efficacy of each treatment, a number of outcomes were mea sured including the Addiction Severity: Index, retention rates at 90 a nd 180 days, the average dose prescribed, quality of life assessment, body weight and two self-reported measures: treatment perception and p redictive total duration. A total of 69 patients were enrolled; 32 tre ated by GPs and 37 treated in ACs. Significant differences, including average age, addiction severity and employment status were apparent be tween each group. Nevertheless, significant improvements in the social and medical status were observed in all patients after 3 months, cont inuing after 6 months in both groups. Treatment retention was good in both groups with 65% of the total sample remaining after 180 days. The usually more flexible GP approach was more rigid in this study, resul ting in an equally positive treatment outcome as seen in the ACs. The study highlights the effectiveness of buprenorphine in addicts with di fferent social and medical backgrounds, regardless of the therapeutic approach.