Description:
<jats:title>ABSTRACT</jats:title><jats:p><jats:bold>Aims </jats:bold> To evaluate the associations between methadone and high‐dose buprenorphine maintenance treatment and illicit drug use and injection among drug users in France.</jats:p><jats:p><jats:bold>Design </jats:bold> A cross‐sectional study. Data were gathered using a questionnaire administered containing closed‐ended questions.</jats:p><jats:p><jats:bold>Setting </jats:bold> Drug dependence clinics (DDC) and general practitioners’ (GPs) offices in three French cities.</jats:p><jats:p><jats:bold>Participants </jats:bold> Drug users undergoing maintenance treatment with methadone (<jats:italic>n</jats:italic> = 197) and buprenorphine (<jats:italic>n</jats:italic> = 142).</jats:p><jats:p><jats:bold>Measurements </jats:bold> Interviews covered the use of illicit drugs (heroin, cocaine or crack) and injection practices (illicit drugs and/or substitution drugs) during the last month, current treatment modalities, socio‐demographic and health characteristics. Bivariate analysis and multivariate logistic regressions were conducted.</jats:p><jats:p><jats:bold>Findings </jats:bold> Overall, 35.4% of respondents (34.5% in the methadone group, 36.6% in the buprenorphine group, <jats:italic>P</jats:italic>= 0.69) had used at least one illicit drug, 25.7% reported having injected drugs and 15.3% had injected the substitution drug. Injection was more common among buprenorphine‐maintained individuals (40.1%) than among users on methadone (15.2%) (<jats:italic>P <</jats:italic> 0.01). Multivariate analyses indicate that the type of substitution drug (buprenorphine versus methadone) was not associated with illicit drug use (OR = 1.1; 95% CI = 0.7–1.8). In the buprenorphine group, injection was related independently to social situation, as measured by housing (unstable versus stable housing, OR = 4.3; 95% CI = 1.6–11.5), but this was not the case in the methadone group. The risk of injection increased with buprenorphine dosage (high/low dosage OR = 6.2; 95% CI = 2.0–19.7), but this association was not observed in the methadone group.</jats:p><jats:p><jats:bold>Conclusion </jats:bold> Further studies comparing the benefits of these two types of treatment should be carried out, taking outcomes such as physical health, mental health and social functioning into consideration.</jats:p>