Misuse of drugs: the French hits
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Misuse of drugs: the French hits

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Drugs
23/04/2005

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Published 23 April 2005
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Language English
Misuse of drugs: The French hits C. Gatignol1, E. Frauge1r, J. Arditti2, S. Djezza3r, M. Lapeyre Mestr4e, X. Thirion5 1teP yshcféaitn sAgence Fotropes  ed ucéSçnaresiaaiit pretérian SiustrPdoel suo r nUputS éti de Santé (Afssaps) St Deni2 Marseille,sC, EIP3CEIP PARIS,4CEIP Toulouse, 5CEIP Marseille-centre associé, France
ec Obj tiveProducts Safety Agency (Afssaps) is the head of the national monitoringThe French Health system of drug dependence with a network of expert centers (Centers of Evaluation and Misuse of drugs is frequent and is an indicator of drug dependence liability. Information on Pharmacodependence: CEIP). Signal of misuse comes from different sources: Drugs may be misused for different purposes: recreative use, addictive effect, criminal use, oirnstitutions (e.g Afssaps, Ministry of Sports, Interior Affairs Ministries, OFDT), or from health doping. They can be supplied with falsified prescription, deal, “doctor shopping”, or on websitepsr.ofessionals. Different epidemiological approaches carry out a hit of the main misused drugs. Misuse of drugs needs to be monitored because of its risk on individual or collective health The objective of the study is to carry out a hit of the main misused drugs with the different (morbidity, mortality…). Moreover, it costs a lot for the society. epidemiological approaches.
Methods and Results
OSIAP (Forged Prescriptions Indicating Potential Abuse) Hits OSIAP:
2001 (n=414) 2002 (n=400)
Flunitrazepam (79) Buprenorphine (39) Zolpidem (33)
Flunitrazepam (60) Zolpidem (41) Buprenorphine (27)
2003 (n=521) Flunitrazepam (54) Buprenorphine (50) Zolpidem (47)
Hits OSIAP/ the diversion rate in 2003: The most mentioned drugs osnt olenprescriptions, which represent 8,3% global prescriptions, are: buprenorphine, flunitrazepam, morphine sulphate, clorazepate, testosterone, zolpidem. When “diversion rate” is calculated (>5) -million of DDD/day: flunitrazepam (33) > morphine sulphate (24) > mianserine (12) triazolam (12) > sumatriptan (9) > buprenorphine (8) > dihydrocodeine (7) > clonazepam (7)
DRAMES (Drug Abuse Related Deaths)
2000 (n=154) 2002 (n=130) 2003 (n=64) Narcotic drugs 7 (5%) 16 (12%) 1 (1.5%) Substitution treatments 53 (34%) 40 (31%) 18 (28%)  17 10Methadone 27 associated with other psychoactive substances 23 (BZD 50%) 16 (BZD 75%) 9 (BZD 89%) Buprenorphine 26 9 23 associated with other psychoactive substances 24 (BZD 80%) 23 (BZD 100%) 8 (BZD 87.5%)
OPPIDUM database(Monitoring of Illicit or Abused –Medicinal or not-Psychoactive Substances): Cases of illicit supply of medicines (percentage of quoted medicine) Drug 2001 2002 2003 Medicines (% All Drugs) 4 171 (70%) 6 875 (68%) 6 894 (69%) Ketamine 7 (100%) 7 (100%) 9 (100%) Flunitrazepam 55 (48%) 64 (64%) 55 (51%) Morphine sulfate 18 (47%) 28 (49%) 29 (63%) Trihexyphenidyl 6 (46%) 5 (38.5%) 8 (57%) Clonazepam 17 (29%) 23 (29.5%) 25 (28%) Clorazepate dipotassique 54 (38%) 39 (27%) 37 (23%) Zolpidem 5 (8%) 6 (12%) 5 (8%) Methadone 30 (3%) 98 (8%) 57 (5%) Buprenorphine 210 (16%) 217 (14.5%) 198 (16%)
CHEMICAL SUBMISSION ie administration of a psychoactive substance for criminal purposes 1993/2000 (n=143) 2001/2002 (n=53) Forensic Results 215 substances 57 substances Benzodiazepines 96 37
Antihistaminic agents GHB
Other medicinal drugs Others
12
4
6
97
9 2 -9
Conclusion
The combination of the different indicators allow a better monitoring of the drug misuse and dependence liability. Consequently, Afssaps takes measures in order to limit the misuse of drugs: Control Measures and Its Impacts: • for example, in the case of flunitrazepam, some lawful measurements on conditions of its regulations and deliveries were carried out and explain the decreasing cases. • concerning ketamine and tiletamine, the raw material was classified as a narcotic, and the drugs are submitted to the mandatory notification of stealing and misuse cases.
Information: • Dear Doctor Letters: for example information about ketamine and buprenorphine have been disseminated. • Alert in Public Health • Internet: http://www.centres-pharmacodependance.net • Internet: http://afssaps.sante.fr/htm/10/ pharma/indpharm.htm Acknowledgements : we thank AFSSAPS, MILDT (Mission Interministérielle de Lutte contre la Drogue et la Toxicomanie) for their financial support E-mail : chantal.gatignol@afssaps.sante.fr