In France, opiate-addicted patients are mainly managed by general practitioners (GPs). Because on-site abuse drugs urinary screening tests (ODUTs) are now on the market, we investigated French GPs’ knowledge and practices concerning drug tests with a focus on ODUTs. We conducted a descriptive cross-sectional study in ambulatory practice. Postal questionnaires were sent to a random sample of GPs in the Midi-Pyrénées area of France in December 2009. Of the 482 GPs in the sample, 116 (24.1%) regularly treated opiate- addicted patients. Only 31 of them (26.7%) used drug tests and 4 of them (3.4%) performed ODUTs in their consultation rooms. Most of the GPs did not perform ODUTs because they were unaware of whether such tests were reliable or available. Many French GPs treating opiate-addicted patients regularly did not perform ODUTs and lacked knowledge of them.

1.
Baumevieille M, Daveluy A, Maurain C, Bégaud B, Haramburu F: Medicines submitted to narcotics regulations in France, 1992–2007. Fundam Clin Pharmacol 2009;23:345–349.
2.
Fatseas M, Auriacombe M: Why buprenorphine is so successful in treating opiate addiction in France. Curr Psychiatry Rep 2007;9:358–364.
3.
OFDT: Approche régionale de la substitution aux opiacés. 1999–2002. Pratiques et disparités à travers 13 sites français. http://www.ofdt.fr/BDD/publications/docs/epfxack6.pdf (Last access on June 27, 2011).
4.
Commission nationale des stupéfiants et des psychotropes: Compte rendu de la 87ième réunion du 18 février 2010. http://www.afssaps.fr/var/afssaps_site/storage/original/application/1c22bdaa6ccc4499a26635bb67c4bd4b.pdf (Last access on June 27, 2011).
5.
HAS: Réduire les mauvaises utilisations des médicaments de substitution. 2004 http://www.has-sante.fr/portail/upload/docs/application/pdf/opiaces_recos.pdf (Last access on June 27, 2011).
6.
HAS: Stratégie thérapeutique pour les personnes dépendantes des opiacés: place des traitements de substitution. 2004. http://www.has-sante.fr/portail/upload/docs/application/pdf/TSO_%20long.pdf (Last access on June 27, 2011).
7.
Jaffee WB, Trucco E, Teter C, Levy S, Weiss RD: Focus on alcohol and drug abuse: ensuring validity in urine drug testing. Psychiatr Serv 2008;59:140–142.
8.
Falchi A, Lasserre A, Gallay A, Blanchon T, Sednaoui P, Lassau F, Massari V, Turbelin C, Hanslik T: A survey of primary care physician practices in antibiotic prescribing for the treatment of uncomplicated male gonococcal urethritis. BMC Fam Pract 2011;12:35.
9.
Mercier A, Kerhuel N, Stalnikiewitz B, Aulanier S, Boulnois C, Becret F, Czernichow P: Obstacles to effective treatment of depression. A general practitioners’ postal survey in the north-west region of France. Encephale 2010;36(suppl 2):D73–D82.
10.
Perdoncini-Roux A, Blanchon T, Hanslik T, Lasserre A, Turbelin C, Dorleans Y, Cabane J, Fardet L: General practitioners’ perception of the impact of corticosteroid-induced adverse events. Rev Epidemiol Sante Publique 2009;57:93–97.
11.
Verdoux H, Cougnard A, Grolleau S, Besson R, Delcroix F: How do general practitioners manage subjects with early schizophrenia and collaborate with mental health professionals? A postal survey in South-Western France. Soc Psychiatry Psychiatr Epidemiol 2005;40:892–898.
12.
French General Medical Council: Atlas de la Démographie Médicale en Région Midi Pyrénées. Situation au 1er janvier 2009. http://www.conseil-national.medecin.fr/sites/default/files/Midi-Pyrenees.pdf (Last access on June 27, 2011).
13.
Strang J, Sheridan J, Hunt C, Kerr B, Gerada C, Pringle M: The prescribing of methadone and other opioids to addicts: national survey of GPs in England and Wales. Br J Gen Pract 2005;55:444–451.
14.
Gossop M, Stewart D, Browne N, Marsden J: Methadone treatment for opiate dependent patients in general practice and specialist clinic settings: outcomes at 2-year follow-up. J Subst Abuse Treat 2003;24:313–321.
15.
Hotham E, Roche A, Skinner N, Dollman B: The general practitioner pharmacotherapy prescribing workforce: examining sustainability from a systems perspective. Drug Alcohol Rev 2005;24:393–400.
16.
Feroni I, Peretti-Watel P, Masut A, Coudert C, Paraponaris A, Obadia Y: French general practitioners’ prescribing high-dosage buprenorphine maintenance treatment: is the existing training (good) enough? Addict Behav 2005;30:187–191.
17.
Bourgine J, Ma LL, Le Boisselier R, Paillet-Loilier M, Albessard F, Lelong-Boulouard V, Vigneau C, Jolliet P, Debruyne D, Coquerel A: Comparison between analytic and anamnestic data about drug consumption among opiate addicts with substitutes therapy. A feasibility study. Therapie 2009;64:269–277.
18.
Lavie E, Fatséas M, Denis C, Auriacombe M: Benzodiazepine use among opiate-dependent subjects in buprenorphine maintenance treatment: correlates of use, abuse and dependence. Drug Alcohol Depend 2009;99:338–344.
19.
Laqueille X, Launay C, Dervaux A, Kanit M: Abuse of alcohol and benzodiazepine during substitution therapy in heroin addicts: a review of the literature. Encephale 2009;35:220–225.
20.
Michel L: Opioid substitution therapy in France: a physician’s overview. Ann Pharm Fr 2009;67:369–373.
21.
Walley AY, Alperen JK, Cheng DM, Botticelli M, Castro-Donlan C, Samet JH, Alford DP: Office-based management of opioid dependence with buprenorphine: clinical practices and barriers. J Gen Intern Med 2008;23:1393–1398.
22.
Roche AM, Bywood P, Pidd K, Freeman T, Steenson T: Drug testing in Australian schools: policy implications and considerations of punitive, deterrence and/or prevention measures. Int J Drug Policy 2009;20:521–528.
23.
Cashman CM, Ruotsalainen JH, Greiner BA, Beirne PV, Verbeek JH: Alcohol and drug screening of occupational drivers for preventing injury. Cochrane Database Syst Rev 2009;2:CD006566.
24.
Katz NP, Sherburne S, Beach M, Rose RJ, Vielguth J, Bradley J, Fanciullo GJ: Behavioral monitoring and urine toxicology testing in patients receiving long-term opioid therapy. Anesth Analg 2003;97:1097–1102.
25.
Manchikanti L, Manchukonda R, Pampati V, Damron KS, Brandon DE, Cash KA, McManus CD: Does random urine drug testing reduce illicit drug use in chronic pain patients receiving opioids? Pain Physician 2006;9:123–129.
26.
Tenenbein M: Do you really need that emergency drug screen? Clin Toxicol (Phila) 2009;47:286–291.
27.
Eisen JS, Sivilotti MLA, Boyd KU, Barton DG, Fortier CJ, Collier CP: Screening urine for drugs of abuse in the emergency department: do test results affect physicians’ patient care decisions? CJEM 2004;6:104–111.
28.
Bagøien G, Morken G, Zahlsen K, Aamo T, Spigset O: Evaluation of a urine on-site drugs of abuse screening test in patients admitted to a psychiatric emergency unit. J Clin Psychopharmacol 2009;29:248–254.
29.
Pesce A, Rosenthal M, West R, West C, Crews B, Mikel C, Almazan P, Latyshev S: An evaluation of the diagnostic accuracy of liquid chromatography-tandem mass spectrometry versus immunoassay drug testing in pain patients. Pain Physician 2010;13:273–281.
30.
Mordal J, Holm B, Mørland J, Bramness JG: Recent substance intake among patients admitted to acute psychiatric wards: physician’s assessment and on-site urine testing compared with comprehensive laboratory analyses. J Clin Psychopharmacol 2010;30:455–459.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.