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Emergence des traitements de substitution aux opiacés en médecine de ville

Abstract : In the nineteen nineties, the drug addiction treatment world took a change of direction. Until then "drug addiction" was confined to specialised approach, which treated it as the symptom of a disturbance inherent in the individual, psychological in origin. But the AIDS epidemic, which counts drugs addicts among its first victims, led to a reconsideration of how addiction was handled. It was now above all question of fighting the disease and especially halting its spread. The drug addict had to be taken out of his condition as a "sick person " and considered as a responsible partner in his own care. In other words, he had to be made an ally in the fight against the virus. Thus initiatives and schemes started to converge towards what is commonly known as "risk reduction". The drug user became a partner. The last stage of this policy can be seen in the placing on the market of high-dose buprenorphine, prescribed by GPs. Drug users who wish to stop using can see a GP to get a replacement therapy. However, general practitioners are not very familiar with drug users. How do the deal with this new patient group ? This is one of the objectives, to understand how doctors cope with this new, atypical patient group and how they integrate them ? or not ? into their daily routine. Beyond that, there is also the matter of understanding why it has been up to general pratcise to take on this last stage in the "risk reduction" process. In other words, because general practitioners are open to all, they are liable to attract a large number of users looking for a replacement therapy
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Saïd Megherbi. Emergence des traitements de substitution aux opiacés en médecine de ville. Sociologie. Université Paul Verlaine - Metz, 2010. Français. ⟨NNT : 2010METZ018L⟩. ⟨tel-01748681⟩

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