L’efficacité du traitement assisté par diacétylmorphine (héroïne pharmaceutique) à l’étranger

Demaret, Isabelle; Lemaître, André; Ansseau, Marc

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L’efficacité du traitement assisté par diacétylmorphine (héroïne pharmaceutique) à l’étranger

Demaret, Isabelle; Lemaître, André; Ansseau, Marc

2010 • In Revue Médicale de Liège, 65 (12), p. 681-687

Peer reviewed

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https://hdl.handle.net/2268/83731

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21287763

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Keywords :

Heroin-assisted treatment; Efficacy; Addiction; Substitution; Traitement assisté par diacétylmorphine; Efficacité; Assuétude

Abstract :

[en] Before implementing the TADAM project in Belgium (a heroin-assisted treatment trial), our research team studied the trials in other countries. Since 1994, six randomised controlled trials have been developed using the same treatment model of heroin-assisted treatment (HAT). Each trial concluded that HAT had more efficacy than methadone treatment. We analysed those trials in order to find on which levels patients in a HAT treatment are expected to improve. Improvements appeared after at least six months on the level of street heroin use, (physical and mental) health and criminal behaviour. In the longer term, the continuation of treatment had positive but limited effects on the social level. Due to his higher cost, this treatment should remain a second-line treatment for this special target group: severe heroin addicts, using continuously street heroin in spite of a methadone treatment.
[fr] En préalable au projet belge TADAM (un essai clinique de traitement assisté par diacétylmorphine), notre équipe de recherche a étudié les essais cliniques réalisés à l’étranger. Depuis 1994, six études contrôlées randomisées ont été développées sur le même modèle de traitement par diacétylmorphine. Chacune de ces études a conclu à l’efficacité supérieure de ce traitement par rapport au traitement par méthadone. Sur base de ces études, nous avons cherché à définir les principaux effets positifs de ce traitement pour les patients. Les améliorations se sont manifestées après au moins six mois au niveau de la consommation d’héroïne de rue, de la santé (physique et mentale) et du comportement délinquant. A plus long terme, les patients ont montré des améliorations limitées au niveau social. Néanmoins, compte tenu de son coût élevé, ce traitement devrait rester un traitement de deuxième ligne pour le groupe cible spécifique des personnes sévèrement dépendantes de l’héroïne qui continuent à consommer de l’héroïne de rue quotidiennement malgré un traitement par méthadone.

Disciplines :

Public health, health care sciences & services

Author, co-author :

Demaret, Isabelle ; Université de Liège - ULiège > Département des sciences cliniques > Psychiatrie et psychologie médicale

Lemaître, André ; Université de Liège - ULiège > Institut des sciences humaines et sociales > Criminologie

Ansseau, Marc ; Université de Liège - ULiège > Psychiatrie et psychologie médicale

Language :

French

Title :

L’efficacité du traitement assisté par diacétylmorphine (héroïne pharmaceutique) à l’étranger

Alternative titles :

[en] Efficacy of the treatmement assisted by diacetylmorphine (pharmaceutical heroin)

Publication date :

December 2010

Journal title :

Revue Médicale de Liège

ISSN :

0370-629X

eISSN :

2566-1566

Publisher :

Hopital de Baviere, Liège, Belgium

Volume :

Issue :

Pages :

681-687

Peer reviewed :

Peer reviewed

Name of the research project :

Projet TADAM, un projet pilote de traitement assisté par diacétylmorphine

Funders :

Ministre Fédérale des Affaires Sociales et de la Santé Publique

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