[High-dose buprenorphine substitution during incarceration.]

Catherine Reynaud-Maurupt, Yves Caer, Noëlle Escaffre, Murielle Gagneau, Anne Galinier, Jean-Noël Marzo, Fadi Meroueh
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Abstract

MANAGEMENT OF OPIATE ADDICTS: OBJECTIVE: To describe the social and medical profiles of incarcerated (in detention or after sentencing) opiate addicts, whether or not they had already begun substitution treatment at arrival, and assess the impact of high-dose buprenorphine substitution therapy on the health of prisoners and the course of their incarceration. METHODS: A prospective survey was conducted on opiate addicts on admission to prison and after 2 months of incarceration, from December 2001 to February 2003, in 6 prison centres in the South East of France. RESULTS: During incarceration, no significant difference (other than in medical follow-up) appeared between the prisoners receiving substitution treatment and those who went through withdrawal on arrival. The first group differed from the second in several respects: their occupational history before incarceration was less stable, their history of drug addiction and incarceration was more serious (injection, psychotropic use, number of prior incarcerations, early age at first incarceration). The buprenorphine patients also differed in their more intense use of medical follow-up before incarceration. CONCLUSION: The impact of buprenorphine substitution therapy during incarceration could not be demonstrated, but prisoners receiving this treatment had a substantially different profile than those who were not receiving treatment when they arrived in prison.

[监禁期间大剂量丁丙诺啡替代]
阿片类成瘾者的管理:目的:描述在押(在押或判刑后)阿片类成瘾者的社会和医疗概况,无论他们在抵达时是否已经开始替代治疗,并评估大剂量丁丙诺啡替代治疗对囚犯健康及其监禁过程的影响。方法:从2001年12月到2003年2月,对法国东南部6个监狱中心的阿片类成瘾者进行了一项前瞻性调查。结果:在监禁期间,除医疗随访外,接受替代治疗的囚犯与抵达后戒断的囚犯之间没有显着差异。第一组与第二组在几个方面有所不同:他们入狱前的职业史不太稳定,他们的吸毒史和入狱史更严重(注射、精神药物使用、先前入狱次数、首次入狱年龄)。丁丙诺啡患者在监禁前更严格地使用医疗随访方面也存在差异。结论:丁丙诺啡替代疗法在监禁期间的影响无法证明,但接受这种治疗的囚犯与未接受治疗的囚犯在抵达监狱时具有本质上不同的特征。
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