The initial prescription of methadone in health establishments
Tendances n° 60, OFDT, 4 p.
Since the 30th of January 2002, any doctor practising in ahealth establishment is authorised to suggest a methadone-based substitution treatment to adult, opioid-dependent addicts. Up until then, this possibility had been reserved for doctors working in specialised drug addiction treatment centres (CSSTs), working for associations or hospitals, and operating in open or penal environments. The growth in the Initial Prescription of Methadone (FPM) in both hospitals and penal facilities has been included among the government's plans to combat illegal drugs, tobacco and alcohol (2004-2008).
The French Drug and Drug Addiction Observatory (OFDT - Observatoire Français des Drogues et des Toxicomanies) was appointed by the Department of Hospital Care and Treatment Organisation (DHOS), the Directorate General for Health (DGS) and the Interministerial Mission against Drugs andDrug Addiction (MILDT) to carry out an assessment of the impact of the 2002 circular. Its purpose was to examine the noticeable changes six years later, exploring the twin aspects of the accessibility of methadone and the medical practices used in the medical treatment services now authorised to issue initial prescriptions. The first aspect of the survey focused on measuring the application of the circular in the 107 hospital departments identified as methadone prescribers (out of around a thousand hospital departments in France). The second identified the 152 treatment units operating in penal environments which were not previously authorised to prescribe methadone (in mainland France and the overseas départements) and consequently excluding the 16 centres with CSSTs issuing initial prescriptions from prior to 2002, representing a quarter of the reception capacity in penal environments.
Ivana Obradovic, Tiphaine Canarelli
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