Du médicament psychoactif à l’addictovigilance dans le Code de la santé publique en France (1990–2017)

Abstract

Addictovigilance in the French Public Health Code, in the section related to poisonous substances, refers to a monitoring system developed since 1990: control of psychoactive substances and products, with medicinal use or not, was completed by a specific system focused on evaluation and information on pharmacodependance in 1999. The French medicines agency (Agence du médicament) created in 1993 was involved in this monitoring system; pharmacodependance evaluation was added by law to the missions of the agencies that followed: the Agence française de sécurité sanitaire des produits de santé missions (AFSSAPS, 1998) and the Agence nationale de sécurité du médicament et des produits de santé (ANSM, 2011). "Addictovigilance" first appears in French Law in 2017 whereas it was used by pharmacodependance centers and AFSSAPS since 2007. Legal definition of addictovigilance in the French Public Health Code testified to public authorities action against addictive behavior whatever products status, legal or not. The visibility of addictovigilance is growing on the Internet as well (ANSM website, web portal for reporting adverse health events).

Combatting the misuse of benzodiazepines and related Z drugs in French general practice: a clinical review

“…These prescription forms are also mandatory for some BZDs and Z drugs (zolpidem). 25,26 In 2011, a pay-for-performance intervention between the Federation of the French GPs and the French Ministry of Health was implemented in order to motivate GPs to improve their practices, but the proportion of patients who continued their BZDs did not decrease. In 2015, the French Ministry of Health decided to decrease the reimbursement of the BZDs from 65% to 15%, but this measure did not reduce the long-term consumption of BZDs (>90% of the French population has supplementary insurance that usually covers the entire copayment).…”

“…28 The actions of the FAN resulted in the withdrawal of flunitrazepam in 2013, 29 and in the mandating of the tamper-resistant prescription form for prescribing and dispensing clonazepam and zolpidem with a 28-day duration limit. 25,26 Deprescribing by GPs and withdrawal of BZDs…”

Nitrous Oxide: What do we Know about its use Disorder Potential? Results of the French Monitoring Centre for Addiction Network Survey and Literature Review

“…The 3 main missions of the CEIP-A network are to collect data and assess the substance use disorder potential of psychoactive drugs, to provide information on the risk of substance use disorder of psychoactive substances, and to carry out research. 20 All health care professionals (regardless of their field of expertise) are required to anonymously report cases of serious drug abuse and dependence associated with the use of substances, drugs, or plants with psychoactive effects. These spontaneous notification reports are key for determining "real-life" drug misuse and abuse.…”

French national addictovigilance follow-up of zolpidem between 2014 and 2020: evolution of drug abuse, misuse and dependence before and after the regulatory change

“…In France, there is a special system coordinated by the ANSM (French Drug Agency) called Addictovigilance, which collects and analyzes cases of abuse or dependence related to the use of psychoactive substances. 1 , 2 It uses (i) notifications of cases of drug dependence or abuse from health professionals (NOTS, for spontaneous notifications in French); in France, health professionals have a regulatory obligation to report cases to their centre 3 and (ii) epidemiological surveillance tools, including OSIAP (Suspect Prescriptions Possibly Indicating Abuse), which is based on the surveillance of falsified prescriptions presented in community pharmacies. 2 , 4 …”