The RECAMS Study Group included the following physicians and pharmacists: Jacquiez (Agen), de Goer/Badin (Aiton), Baranski/Condette (Albi), Gonzales/Hermant (Amiens), Aubry (Bar-le-Duc), Campagne (Bayonne), Serhani (Beauvais), Claude (Belfort), Miner-Vini (Besançon), Lavigne (Béziers), Anys (Blois), Michel/Taleb (Bois d'Arcy), Fortuit (Bonneville), Bordes (Bourges), Saccardy (Brest), Dauver (Caen), Millot/Bony (Cahors), Krack-Fournerie Petit/Cannard/Rudoni/Vaillant (Dijon), Vella (Draguignan), Vanrenterghem/Mestdagh (Dunkerque), de Beaurepaire/Lansalot/Decoux/Lebouc/Jung/David (Fresnes), Leport (Gradignan), Lamiraud (Guéret), Hannequin (Laon), Variot (Le Havre), Serre (Le Mans), Wajsbrot (Le Pontet), Martin-Dupond (Limoges), Archer/Bollengier (Loos-lès-Lille), Undrelner (Luynes), Beaupere (Lyon), Galinier Pujol/Scotto difacano/Ripper/Barruet (Marseille), Heysch de la Borde (Montauban), Millet (Montbéliard), Harambat/Palluel (Mont de Marsan), Vogt/Kacem (Mulhouse), Lambert/Colas (Nancy), Marzo/Heulin (Nanterre), Robert (Nantes), Laffranchi/Rouvre (Nice), Caer/Robert (Nîmes), Seltz (Osny), Villeneuve (Pau), Rémy (Perpignan), Stephant/Kerjean (Ploemeur), Morin (Rennes), Léger/Pesquet (Rouen), Carrière/Aubry (Saint Brieuc), Defayolle/Straub/Viallon/Ollien (Saint-Etienne), Senninger (Sarreguemines), Le Guhennec (Toulon), Laurencin/Haoui/Crochet/Albardier (Toulouse), Panetta (Troyes), Dombret (Valence), Gojon/Guillard (Villefranche-sur-Saône), Meroueh (Villeneuve-lès-Maguelone), and Levasseur/Marzo/Certon (Villepinte).
Maintenance therapy and 3-year outcome of opioid-dependent prisoners: a prospective study in France (2003–06)
Article first published online: 29 APR 2009
© 2009 The Authors. Journal compilation © 2009 Society for the Study of Addiction
Volume 104, Issue 7, pages 1233–1240, July 2009
How to Cite
Marzo, J.-N., Rotily, M., Meroueh, F., Varastet, M., Hunault, C., Obradovic, I. and Zin, A. (2009), Maintenance therapy and 3-year outcome of opioid-dependent prisoners: a prospective study in France (2003–06). Addiction, 104: 1233–1240. doi: 10.1111/j.1360-0443.2009.02558.x
- Issue published online: 4 JUN 2009
- Article first published online: 29 APR 2009
- Submitted 19 February 2008; initial review completed 8 July 2008; final version accepted 3 February 2009
- cohort study;
- opioid addiction;
Aims To describe the profile of imprisoned opioid-dependent patients, prescriptions of maintenance therapy at imprisonment and 3-year outcome in terms of re-incarceration and mortality.
Design Prospective, observational study (France, 2003–06).
Setting Health units of 47 remand prisons.
Participants A total of 507 opioid-dependent patients included within the first week of imprisonment between June 2003 and September 2004, inclusive.
Measurements Physicians collected socio-demographic data, penal history, history of addiction, maintenance therapy and psychoactive agent use, general health status and comorbidities. Prescriptions at imprisonment were recorded by the prison pharmacist. Re-incarceration data were retrieved from the National Register of Inmates, survival data and causes of death from the National Registers of vital status and death causes.
Findings Prison maintenance therapy was delivered at imprisonment to 394/507 (77.7%) patients. These patients had poorer health status, heavier opioid use and prison history and were less socially integrated than the remaining 113 patients. Over 3 years, 238/478 patients were re-incarcerated [51.3 re-incarcerations per 100 patient-years, 95% confidence interval (CI) 46.4–56.2]. Factors associated independently with re-incarceration were prior imprisonment and benzodiazepine use. After adjustment for confounders, maintenance therapy was not associated with a reduced rate of re-incarceration (adjusted relative risk 1.28, 95% CI 0.89–1.85). The all-cause mortality rate was eight per 1000 patient-years (n = 10, 95% CI 4–13).
Conclusions Prescription of maintenance therapy has increased sharply in French prisons since its introduction in the mid-1990s. However, the risk of re-imprisonment or death remains high among opioid-dependent prisoners. Substantial efforts are needed to implement more effective preventive policies.