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. 2014 Sep 9:7:449-57.
doi: 10.2147/IJGM.S61014. eCollection 2014.

The current status of opioid maintenance treatment in France: a survey of physicians, patients, and out-of-treatment opioid users

Amine Benyamina  1
Affiliations

The current status of opioid maintenance treatment in France: a survey of physicians, patients, and out-of-treatment opioid users

Amine Benyamina. Int J Gen Med. .

Abstract

Aim: Project Access France was a national survey designed to provide real-world observations on the status of opioid dependence treatment in France.

Methods: The views of physicians (n=100), patients (n=130), and out-of-treatment opioid users (n=33) were collected via interviews and questionnaires.

Results: Physicians reported being moderately satisfied with treatment programs in their area (rating 6.9 out of 10). Most physicians (82%) reported being concerned about misuse and diversion of medication-assisted treatment (MAT) medications and 50% identified psychosocial/behavioral counseling as the key change that would most improve patient care. Among patients, the mean number of previous MAT episodes was low (1.5); 78% reported that it was easy to access a doctor to undergo MAT; 14% reported regularly or sometimes using heroin; misuse and diversion were reported in 15% and 39% of patients, respectively; and 57% of patients were not receiving psychosocial help. Out-of-treatment opioid users reported using drugs on a regular basis (42% regularly used heroin) and cited 'not wanting to give up drugs completely' as the most frequent reason for staying out of MAT.

Conclusion: This survey highlights a number of positive features of the open-access, GP-based treatment model for opioid dependence in France. Challenges remain with regard to continued misuse/diversion of MAT medications and limited patient access to psychosocial support.

Keywords: France; buprenorphine; buprenorphine–naloxone; medication-assisted treatment; methadone; opioid maintenance treatment.

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Figures

Figure 1
Figure 1
Reasons given by patients for choosing to start medication-assisted treatment.
Figure 2
Figure 2
Rates of on-top illicit drug use: overall and heroin use. Notes: Patients were asked (A) ‘how often do you take illegal drugs in addition to or instead of your MAT?’ and (B) ‘which drugs or substances are you still currently taking in addition to your prescribed MAT?’; †50 patients in the ‘all patients’ group, 45 patients on buprenorphine, and five patients on methadone did not tick any option. Abbreviations: MAT, medication-assisted treatment; n, number.
Figure 3
Figure 3
Rates of misuse and diversion of MAT by patients. Notes: Patients were asked (A) ‘have you ever injected or snorted your MAT?’ and (B) ‘have you ever sold or given your MAT to someone else?’. Abbreviations: MAT, medication-assisted treatment; n, number.
Figure 4
Figure 4
General state of health reported by patients. Note: Patients were asked ‘how would you describe your general state of health at present?’. Abbreviation: n, number.
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References

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