**Medscape Editions**
**Jean-Bernard Gervais**
**August 4, 2025**
**PARIS** — How can addiction research be encouraged? The Association of Young Psychiatrists and Young Addiction Specialists (AJPJA), in collaboration with the French Federation of Psychiatry Students (AFFEP), sought to answer this question by organizing a research project competition during a session at the Albatros Congress held in Paris on June 11. Modeled after the television show “The Voice,” three judges (Anne Borgne, Tristan Hammonière, and Romain Icick) evaluated five addiction research projects.
The presenters had five minutes to convince the jury and the audience of the relevance of their ideas. One project stood out and won the approval of both the jury and the audience: it was the work of Claire Frougier, a nurse-addiction specialist working in the prison environment at the Tulle detention center and the Uzerche remand center. She developed a motivational interview focused on the use of long-acting buprenorphine (LAB).
**Challenges in Prison Settings**
“Every day, we face polyconsumption, dual pathologies, precariousness, medication dispensing difficulties, and especially prison overcrowding. These conditions lead to significant consequences: the misuse of opioid agonist treatments (OAT) is twice as high in prison as outside (24% versus 12%). Stigmatization leads to extortion, violence, and sometimes suicide, although few quantitative studies exist on this subject,” Claire Frougier introduces. Additionally, when patients are asked about their perception of substitution treatment, more than half find it burdensome to have to go to the infirmary daily to collect their treatment due to strict prison regulations, she notes. It is also reported that about half of the patients receive doses lower than their needs, leading to withdrawal symptoms. “This can be attributed to the caution of some doctors, who hesitate to increase buprenorphine doses due to frequent diversion risks.”
**Introducing Long-Acting Buprenorphine**
To address the issues faced by inmates and ease the workload of healthcare providers in prisons, where daily OAT administration “takes up 100 minutes per month per patient,” Claire Frougier proposed LAB to her patients. “During my thesis, I worked at the Uzerche detention center and the Tulle remand center. At Uzerche, out of about twenty patients surveyed, 40% misused their buprenorphine. In our facility, patients inhale or sniff, without using injections. I proposed long-acting buprenorphine, but more than 50% refused due to fear of injections and lack of knowledge about the treatment.”
**Overcoming Resistance with Motivational Interviews**
To overcome inmates’ reluctance towards LAB, Claire Frougier designed a patient-centered motivational interview specific to the prison environment. Its goal is to make the patient reflect on their situation, engage in a caregiver-patient discussion, and personalize the presentation of LAB. “I will present a clinical vignette of one of my patients at the Tulle remand center. Mr. L, 31 years old, is a polyconsumer who takes his buprenorphine in a bong like his heroin, up to nine times a day. Initially, he refused LAB due to negative perceptions of injection and his complicated past. After completing my motivational questionnaire, we identified his specific issues: stigmatization, withdrawal syndrome, and buprenorphine use similar to heroin, creating a sense of failure. A few weeks later, he agreed to switch to LAB. Today, he receives monthly injections and feels well, even saying it’s the first time he hasn’t felt any withdrawal under substitution treatment,” Claire Frougier details.
**Positive Outcomes and Future Prospects**
The questionnaire was resubmitted to this patient three months after adopting LAB. “The inmate no longer experiences withdrawal syndrome or stigmatization, and he no longer visits the infirmary daily to collect his pills. He is very satisfied with his treatment. This questionnaire improves the caregiver-patient relationship by creating mutual trust and broadening the discussion to the experiences of inmates under substitution treatment, who live in an even more complex environment than outside,” Claire Frougier observes. Following this success, she proposed her questionnaire in different prisons. Currently, it is used in four facilities. “The goal is to gather enough data to evaluate the questionnaire’s interest for both caregivers and the patients concerned,” she concludes.
This article was originally published on Univadis.fr, a member of the Medscape network.
**Source:** [https://francais.medscape.com/s/voirarticle/3613089](https://francais.medscape.com/s/voirarticle/3613089)