Mortality Associated With Time in and Out of Buprenorphine Treatment in French Office-Based General Practice: A 7-Year Cohort Study

Ann Fam Med. 2017 Jul;15(4):355-358. doi: 10.1370/afm.2098.

Abstract

In France, most cases of opioid use disorder are treated with buprenorphine by general practitioners in private practice. Using reimbursement data of a representative sample of the French population, Echantillon Généraliste des Bénéficiaires, we investigated mortality during periods when patients were in and out of treatment in a cohort of 713 new users of buprenorphine having a mean (SD) follow-up of 4.5 (1.5) years. The mortality rate was 0.63 per 100 person-years (95% CI, 0.40-0.85) overall. In a multivariate Cox regression model, compared with being in treatment, being out of treatment was associated with a markedly increased risk of death (hazard ratio = 29.04; 95% CI, 10.04-83.99). Buprenorphine appears to be a strong protective factor against mortality.

Keywords: ambulatory care; buprenorphine; cohort studies; mortality; opioid maintenance treatment; opioid-related disorders; primary care; private practice.

MeSH terms

  • Adult
  • Buprenorphine / therapeutic use*
  • Cohort Studies
  • Female
  • France / epidemiology
  • General Practice
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Opiate Substitution Treatment*
  • Opioid-Related Disorders / drug therapy*
  • Opioid-Related Disorders / mortality*
  • Proportional Hazards Models
  • Young Adult

Substances

  • Buprenorphine