Suchergebnisse

The heat wave of August 2003 caused a hecatomb in France. Its extent and consequences (INVS 2003) require analysis in order to understand why such a situation occurred and how to avoid that the same medical disaster will be caused in the future by identical climatic conditions. This natural disaster had no known precedent in France. The heatwave lasted for three weeks in August 2003 and led to 14800 deaths. However, the human toll of this catastrophe cannot be explained solely by the violence of the attack. Any analysis of this dramatic crisis, as for any public health threat, should take into account the agent involved, the population concerned, the specific relation between the agent and the target, and, based upon this, the crisis management needed. The analysis presented in this article, following the described line, shows that the crisis management was far from optimal. Learning from this situation should allow us to do better, next time such a climatic catastrophe occurs. A key factor is promoting adequate citizen response.

This study presents a French programme designed to observe and evaluate psychoactive substance dependence and abuse. Annual surveys lasting 4 weeks are performed with drug users in drug centres. Its usefulness is discussed using examples from the study: potential for antidepressant dependence (amineptine), monitoring benzodiazepine use and consumption associated with maintenance treatments. Flunitrazepam is the most consumed benzodiazepine and often got by deal (29%). There are important differences between buprenorphine consumption in a maintenance treatment context (9/10) and beyond this context (1/10). The main methodology problems encountered are representativeness and validity of data. The limits of the programme and its role in the French health care system are discussed.

<b><i>Purpose:</i></b> The aim of this study was to describe the extent of methylphenidate (MPH) abuse and characterize its patterns by following several cases involving intravenous administration of crushed MPH tablets. <b><i>Methods:</i></b> First, a drug reimbursement database (covering 4 million inhabitants) was explored to assess the magnitude of MPH abuse among the general population, and second, a specific study based on individuals with drug dependence was performed to describe abusers' characteristics (n = 64), patterns of abuse and clinical implications. <b><i>Results:</i></b> From 2005 to 2011, the number of patients who were dispensed MPH at least once increased by 166%. The patients with 'deviant' patterns of MPH consumption were mainly male adults with opiate maintenance treatment reimbursements. MPH abusers had precarious living conditions. Half of them consumed MPH daily by intravenous route and reported amphetamine-like effects (cardiovascular events, weight loss, psychiatric adverse events). <b><i>Conclusion:</i></b> Given the increase of MPH use, it is important to warn the scientific community about possible MPH abuse, especially in individuals with drug dependence. This study has facilitated public health intervention and dissemination of information related to MPH abuse among health care professionals at local and national levels.