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French general practitioners' attitudes toward maintenance drug abuse treatment with buprenorphine
J P Moatti1, M Souville, N Escaffre
1INSERM Research Unit 379, Institut Paoli-Calmettes, Marseille, France. u379@marseille.inserm.fr
Aims:
To assess attitudes of general practitioners (GPs) toward buprenorphine maintenance drug abuse treatment just after its introduction in French ambulatory care (February, 1996).
Design:
Cross-sectional survey by telephone interviews in a national random sample of French GPs (n = 1,186; response rate = 70.3%) carried out in April 1996.
Measurements:
GPs' experience with care for IDU patients and HIV infection during the last 12 months. Logistic regression model to identify GPs' characteristics associated with readiness to prescribe buprenorphine for maintenance treatment.
Findings:
A minority (24.0%) of GPs took care of IDU patients and 30.8% of these were prepared to prescribe buprenorphine (vs. only 7.5% in the rest of the sample). A positive attitude toward buprenorphine was related to GPs' experience with care for IDUs and with prescription of opiates for pain management and palliative care, tolerance toward drug use and personal characteristics such as tobacco use and interest in psychoanalysis.
Conclusions:
Giving general freedom of prescription of buprenorphine (rather than methadone) to all GPs did not lead to widespread acceptance of the drug's use in treating IDUs. The development of organized networks between specialist services for drug abuse treatment and motivated GPs may be necessary to maximize appropriate prescribing practices.