[4-month follow-up of 198 heroin addicts by general practitioners]

This study aimed to describe the short term follow-up of a cohort of 198 i.v. heroin users by 44 highly motivated General Practitioners (GPs). The study showed that for these GPs, the work-load linked with the care of these patients was heavy. Nearly half of them saw at least one drug-addict every day. These GPs work within a network and stated they benefit from a regular training on drug addiction topics. The profile of i.v. heroin users, followed by these GPs, is different from the ones usually described in other health care structures (higher percentage of women and better social insertion). The two main motives to consult a GP are the demand of drugs concerning their addiction and medical concern (due to infectious diseases especially). The answer of GPs, concerning the demand of drugs, divide physicians into two groups: those who never prescribe morphine like drugs as substitution and those who do so. In addition, both of them often prescribe psychotropic drugs to some of their patients. Nevertheless, these prescriptions are just one of the elements of a follow-up contract between a GP and his patients. Morphine like prescription is more frequently described among long term drug-addicts already well-known by GPs. This selection prohibits a straight comparison of the results of two groups of patients (with and without morphine like substitution). But the main fact is that patients under morphine like substitution are followed better (in terms of continuity) after 4 months of observation.