Reduction in the number of lethal heroin overdoses in France since 1994. Focus on substitution treatments

Background. - Since 1994-1995, rapid development of widely available substi tution treatments has appeared to be a major healthcare step in heroin addi ction. Currently approximately 60000 patients are taking daily maintenance doses of oral methadone and about 7200 are taking sublingual buprenorphine. In parallel with the expansion of these treatments, the number of lethal o verdoses has fallen off regularly: 564 in 1994, 393 in 1996 and 143 in 1998 (-74.6% in 4 years), Aim of the study. - We searched for a correlation between the rise in the n umber of patients taking maintenance treatments and the decreased in record ed deaths due to heroin overdose. Other factors which may influence this de crease were also considered. Results and discussion. - A linear correlation was found between the increa sing number of patients on maintenance treatment thigh-dose buprenorphine o r methadone) and the decrease in fatal heroin overdoses in France between 1 994 and 1998, The importance of this correlation must be modulated by the p resence of other events such as political, social, healthcare and behaviora l events concerning drug users.