[Dependence, abuse and misuse of drugs: knowledge and attitudes of private physicians in the Ile-de-France].
BACKGROUND: The rise in drug consumption and poorly adapted prescription practices are currently a growing problem. In the face of this trend, "L'Union Professionnelle des Médecins Libéraux d'Ile-de-France" investigated the awareness and the attitude of physicians towards drug dependency, abuse and misuse. METHODS: One hundred physicians and 50 specialists, randomly selected, were contacted by phone. They were asked to give their own description of dependency, abuse and misuse based on patients' attitudes. They were to describe cases of their patients classifying them according to each category. In the second part of the phone interview, the physicians were to give their view about existing and potential tools to solve these problems. RESULTS: Dependency, abuse and misuse problems were well known and frequent: 94% of physicians have such experience and among those, 60% saw such a patient more than once a week. The population concerned by these problems were generally middle-aged women with chronic disease. Misuse behavior was less easily identified (53% of the physicians described such patients). They generally concerned young men, most often drug addicts. From a global point of view, psychotropes were the most frequently misuse drugs, followed by the pain drugs and nsaids. These types of drugs are used routinely, some of them being sold without prescription. Diseases concerned were essentially psychiatric disorders, sleeping troubles and long lasting pains well classified. To face these problem, physicians recommend a dialogue between medical members and patients as well as a changing in professional (physicians and pharmacists) behavior such as firmness, education and listening. CONCLUSION: Situations evoked during the survey were frequent but non systematically discerned as damageable. As a matter of fact, these observations are only a piece of an "intuitive" estimation of the risk versus benefit of the prescription of the drugs mentioned above. Actual regulation and control tools seem to be somewhat irrelevant to solve the problem.