[Interest of take-home naloxone for opioid overdose].

Over the course of these last decades, we observed a change on opioid use with the marketing of opiate maintenance treatment, an increase of opioids used for pain management and recent concerns have arisen around the use of synthetic opioid. The World Health Organization (WHO) reports around 70,000 people opioid overdose death each year. In France, according to the DRAMES program (fatalities in relation with abuse of licit or illicit drugs) of the French addictovigilance network, most of deaths are related to opioids overdose (especially methadone, following by heroin, buprenorphine and opioid used for pain management).

Proton pump inhibitors prescriptions in France: Main trends from 2006 to 2016 on French health insurance database.

Because national data on proton pump inbibitors (PPIs) consumption in France are scarce and because there is a growing literature on potential adverse drug reaction induced by this pharmacological class, we would like to more describe the main evolution of PPI use and the main characteristics of its users in France. We used a 1/97th representative sample of beneficiaries of the French health insurance called "échantillon généraliste des bénéficiaires" (EGB) to describe PPIs' use over time (duration of use by year) from 2006 to 2016. In 2016, 108,249 patients had at least 1 dispensing of PPI (i.

Doctor shopping of opioid analgesics relative to benzodiazepines: A pharmacoepidemiological study among 11.7 million inhabitants in the French countries.

Background: The abuse of prescription opioids and its subsequent consequences is an important public concern particularly in the USA. The literature on opioid analgesic abuse is scarce.

Objective: We assess the extent and risk of opioid analgesics abuse relative to benzodiazepines (BZD) using the doctor shopping method, taken into account the pharmacological characteristics (dosage, route of administration, extended or immediate release).

Patterns and profiles of methylphenidate use both in children and adults.

Aim: The aim of the present study was to characterize patterns of use of methylphenidate (MPH), a prescription stimulant medication recommended in the treatment of attention deficit hyperactivity disorder (ADHD) and of narcolepsy, in France, both in children and adults, over a 3-year period.

Methods: Using the French General Health Insurance database, limited to two areas covering approximately 4 million individuals, we made up a cohort of incident MPH users between July 2010 and June 2013. Splitting them into distinct age groups (18-24, 25-49 and ≥50 years of age for adults and <6, 6-11 and 12-17 years of age for children), we established the characteristics of these populations at MPH initiation and during follow-up according to the duration of treatment, quantities dispensed and coprescription with central nervous system (CNS) drugs.

Chronic use of proton pump inhibitors, adverse events and potential biological mechanisms: A translational analysis.

Proton pump inhibitors (PPIs) are among the most frequently prescribed drugs. Even if PPI are usually considered as safe, there is a growing concern for a range of adverse effects of chronic PPI therapy often in the absence of appropriate indications. We propose, after a summary of renal, cardiovascular and neurological complications (dementia, chronic kidney disease, myocardial infarction and stroke), an integrative overview of the potential biological mechanisms involved.

Methylphenidate: Gender trends in adult and pediatric populations over a 7year period.

Objective: Methylphenidate (MPH) is a prescription-stimulant medication which is authorized in France for two indications: attention-deficit hyperactivity disorder in children (aged≥6years) and narcolepsy in cases where modafinil is ineffective (for children and adults). MPH use has increased worldwide in the past 2 decades in children and adults. Different pharmacoepidemiological Europeans studies have described MPH patterns of use.

[Surveillance system on drug abuse: Interest of the French national OPPIDUM program of French addictovigilance network].

It is important to assess drug abuse liability in 'real life' using different surveillance systems. OPPIDUM ('Observation of illegal drugs and misuse of psychotropic medications') surveillance system anonymously collects information on drug abuse and dependence observed in patients recruited in specialized care centers dedicated to drug dependence. The aim of this article is to demonstrate the utility of OPPIDUM system using 2015 data.

Immeasurable time bias due to hospitalization in medico-administrative databases: which impact for pharmacoepidemiological studies?

Purpose: Drugs administered to hospitalized patients are not available within almost all health insurance databases. However, this unobservable exposure time bias is very rarely taken into account in pharmacoepidemiology. The objective was to model unobservable periods due to hospitalization and to assess their impact on risk estimates in the context of the association between benzodiazepines and mortality.

[What can we expect from clinical trials in psychiatry?].

Clinical trials in psychiatry allow to build the regulatory dossiers for market authorization but also to document the mechanism of action of new drugs, to build pharmacodynamics models, evaluate the treatment effects, propose prognosis, efficacy or tolerability biomarkers and altogether to assess the impact of drugs for patient, caregiver and society. However, clinical trials have shown some limitations. Number of recent dossiers failed to convince the regulators.

Antidepressant adherence patterns in older patients: use of a clustering method on a prescription database.

According to the World Health Organization, depression will become the second most important cause of disability worldwide by 2020. Our objective was to identify patterns of adherence to antidepressant treatments in older patients using several indicators of adherence and to characterize these patterns in terms of medication exposure. We conducted a retrospective cohort study using the French National Health Insurance reimbursement database.

Long-term use of antipsychotics in community-dwelling dementia patients: prevalence and profile accounting for unobservable time bias because of hospitalization.

The aim of this study was to assess the prevalence of long-term antipsychotic (AP) use in community-dwelling patients with dementia considering hospitalization periods as AP exposure or not. A retrospective study was carried out from 2009 to 2012 on a PACA-Alzheimer cohort (which included 31 963 patients in 2009 and 36 442 in 2012 from 5 million inhabitants). Three groups of patients were identified according to the longest exposure to APs without interruption: nonusers, short-term users (≤3 successive months without discontinuation), and long-term users.

Use of a multi-state model in a claims database: illustration with methadone.

Purpose: In pharmacoepidemiology, one of the main concerns is analysis of drug exposure time. However, in real-life settings, patient's behavior is complex and characterized by drug exposure dynamics. Multi-state models allow assessing the probabilities of various patterns, instead of just continuous use and/or discontinuation.

New methadone formulation in France: results from 5 years of utilization.

Background: In France, methadone has historically been less accessible than buprenorphine. In 2008, a dry formulation (capsule) was introduced into the market, aimed in particular to improve methadone accessibility.

Objective: To describe the impact (prevalence of use, patient profiles and compliance with requirements) of the dry methadone formulation in France.

Example of an investigation of an "emergent" phenomenon in addiction vigilance: the case of methylphenidate.

Abuse of and addiction to medication are a major public health issue which is evolving fast, in particular in countries like France, one of the largest consumers of medication in Europe. As a single source of information is not generally sufficient to measure a phenomenon as difficult to apprehend as medication-related addiction, as can be seen in the case of methylphenidate, it is essential to mobilise all the tools available, here surveillance programmes developed by the French CEIP Addiction vigilance network, such as suspicious prescriptions indicating possible abuse data (OSIAP) or observatory of illegal or misused psychoactive medications (OPPIDUM), as well as the health insurance databases, and health professional sentinel networks. The latest data available on methylphenidate abuse in France suggests a stabilisation of the phenomenon, which emerged in the Provence-Alpes-Côte-d'Azur (PACA) region in southern France.