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      What Differs between Patients under Methadone and under Buprenorphine for Opioid Use Disorder (OUD) in Daily Clinical Practice in France? A Short Report

      brief-report

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          Abstract

          (1) Background: Opioid use disorder (OUD) is a complex condition that can require long-term treatment. Pharmacological therapy for OUD involves treatment with opioid agonists (OMT) tailored to individual profiles. The aim of our study in daily clinical practice was to compare the profiles of patients treated with methadone (MTD) and those using buprenorphine (BHD or BHD-naloxone-NX). (2) Methods: A cross-sectional multicentre study explored the psychological, somatic and social profiles of patients with Opioid Use Disorder (OUD) following Opioid Maintenance Treatment (BHD, BHD/NX, or MTD). Descriptive and comparative analyses were performed (3) Results: 257 patients were included, a majority were men using heroin. 68% (178) were on MTD, 32% (79) were on BHD. Patients with MTD were significantly more likely to report socio-affective damage, and more likely to be younger and not to report oral or sublingual use as the main route for heroin or non-medical opioids (4) Conclusions: In daily clinical practice, regarding OUD damage, only socio-affective damage was significantly more prevalent among patients on MTD than among those on BHD in the multivariate model. Age and route of administration also differed, and our results could raise the issue of the type of OMT prescribed in case of non-medical use of prescribed opioids. These hypothesis should be confirmed in larger studies.

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          The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire

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            DSM-5 criteria for substance use disorders: recommendations and rationale.

            Since DSM-IV was published in 1994, its approach to substance use disorders has come under scrutiny. Strengths were identified (notably, reliability and validity of dependence), but concerns have also arisen. The DSM-5 Substance-Related Disorders Work Group considered these issues and recommended revisions for DSM-5. General concerns included whether to retain the division into two main disorders (dependence and abuse), whether substance use disorder criteria should be added or removed, and whether an appropriate substance use disorder severity indicator could be identified. Specific issues included possible addition of withdrawal syndromes for several substances, alignment of nicotine criteria with those for other substances, addition of biomarkers, and inclusion of nonsubstance, behavioral addictions.This article presents the major issues and evidence considered by the work group, which included literature reviews and extensive new data analyses. The work group recommendations for DSM-5 revisions included combining abuse and dependence criteria into a single substance use disorder based on consistent findings from over 200,000 study participants, dropping legal problems and adding craving as criteria, adding cannabis and caffeine withdrawal syndromes, aligning tobacco use disorder criteria with other substance use disorders, and moving gambling disorders to the chapter formerly reserved for substance-related disorders. The proposed changes overcome many problems, while further studies will be needed to address issues for which less data were available.
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              The Lie/Bet Questionnaire for screening pathological gamblers.

              A 2-item questionnaire was derived from 10 DSM-IV criteria for pathological gambling. Subjects were 362 men, 191 classified as pathological gamblers and 171 as nonproblem-gambling controls. The two items were significant in sensitivity and negative predictive value and significant in specificity and positive predictive value.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                03 February 2021
                February 2021
                : 18
                : 4
                : 1425
                Affiliations
                [1 ]INSERM UMR 1246, SPHERE, Methods in Patient-Centered Outcomes and Health Research, Nantes and Tours Universities, 44000 Nantes, France; morgane.guillou@ 123456chu-brest.fr (M.G.-L.); gaelle.bouju@ 123456chu-nantes.fr (G.C.-B.); edouard.laforgue@ 123456chu-nantes.fr (E.L.); jean-benoit.hardouin@ 123456univ-nantes.fr (J.B.H.); caroline.vigneau@ 123456chu-nantes.fr (C.V.-V.)
                [2 ]EA 7479 SPURBO, Universite Bretagne Occidentale, 29200 Brest, France; antoine.dany@ 123456univ-brest.fr
                [3 ]HUGOPSY Network, 35000 Rennes, France
                [4 ]CHU Nantes, Addictology and Psychiatry Department, Nantes University Hospital, 44000 Nantes, France; juliette.leboucher@ 123456chu-nantes.fr
                [5 ]CHU Nantes, Pharmacology Department, Nantes University Hospital, 44000 Nantes, France
                Author notes
                Author information
                https://orcid.org/0000-0002-2238-8005
                https://orcid.org/0000-0002-7400-1212
                https://orcid.org/0000-0001-8664-623X
                https://orcid.org/0000-0003-0722-7243
                Article
                ijerph-18-01425
                10.3390/ijerph18041425
                7913704
                33546494
                f158fef2-32b2-4daf-b173-d6380783af65
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 05 January 2021
                : 01 February 2021
                Categories
                Brief Report

                Public health
                opiate medication treatment,buprenorphine,methadone,daily clinical practice
                Public health
                opiate medication treatment, buprenorphine, methadone, daily clinical practice

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