French general practitioners' prescribing high-dosage buprenorphine maintenance treatment: is the existing training (good) enough?

Addict Behav. 2005 Jan;30(1):187-91. doi: 10.1016/j.addbeh.2004.04.019.

Abstract

In France, since 1996, any general practitioner (GP) can prescribe high-dosage buprenorphine maintenance treatment (BMT) for opioid-dependent patients. The health authorities initially provided mandatory specific training, but since 1998, such training is only delivered by specialized networks and the pharmaceutical industry. Among a random sample of GPs from southeastern France (N=345), we found that many untrained GPs, as well as a significant minority of trained GPs, were likely to prescribe an ineffective dosage of buprenorphine or a potentially dangerous treatment (BMT+a short half-life benzodiazepine). These results highlight the necessity to edit clear guidelines, especially concerning situations of polyaddiction and psychiatric comorbidity, and to extend and improve BMT training in France with a renewed involvement of health authorities for quality control of such training. They even suggest that GPs' participation to specialized training sessions should become a mandatory prerequisite for prescribing BMT.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Buprenorphine / administration & dosage*
  • Drug Prescriptions / standards
  • Education, Medical, Continuing / standards*
  • Family Practice / education*
  • Female
  • France
  • Health Care Surveys
  • Humans
  • Male
  • Middle Aged
  • Opioid-Related Disorders / rehabilitation*
  • Physicians, Family / psychology
  • Practice Guidelines as Topic
  • Receptors, Opioid, mu / agonists
  • Substance Withdrawal Syndrome / drug therapy
  • Surveys and Questionnaires

Substances

  • Receptors, Opioid, mu
  • Buprenorphine