{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T15:42:29Z","timestamp":1771515749201,"version":"3.50.1"},"reference-count":29,"publisher":"EDP Sciences","issue":"10","license":[{"start":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T00:00:00Z","timestamp":1665446400000},"content-version":"vor","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med Sci (Paris)"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:p>La m\u00e9thadone et la bupr\u00e9norphine sont les deux traitements de substitution des opiac\u00e9s autoris\u00e9s en France depuis la fin des ann\u00e9es 1990. Plus r\u00e9cemment, certains pays africains, comme le S\u00e9n\u00e9gal, ont mis en place une nouvelle politique de sant\u00e9 ax\u00e9e sur la r\u00e9duction des risques, en encourageant le recours aux traitements de substitution des opiac\u00e9s. Les objectifs de la substitution sont de r\u00e9duire la morbi-mortalit\u00e9 li\u00e9e \u00e0 la consommation d\u2019h\u00e9ro\u00efne ou d\u2019autres opio\u00efdes de rue, de favoriser l\u2019insertion des usagers de drogue dans le syst\u00e8me de soins, et, plus g\u00e9n\u00e9ralement, de faciliter leur insertion sociale. Cette nouvelle strat\u00e9gie trouve n\u00e9anmoins des limites dans la pratique. Nous rapportons dans cette revue l\u2019exp\u00e9rience du Centre de prise en charge int\u00e9gr\u00e9 des addictions de Dakar, au S\u00e9n\u00e9gal, et proposons une r\u00e9flexion \u00e9thique, tant individuelle que collective, afin d\u2019am\u00e9liorer le traitement de substitution des opiac\u00e9s, notamment en Afrique.<\/jats:p>","DOI":"10.1051\/medsci\/2022125","type":"journal-article","created":{"date-parts":[[2022,10,11]],"date-time":"2022-10-11T08:07:46Z","timestamp":1665475666000},"page":"832-837","source":"Crossref","is-referenced-by-count":1,"title":["Traitement de substitution des usagers d\u00e9pendants des opiac\u00e9s"],"prefix":"10.1051","volume":"38","author":[{"given":"Sader","family":"Gaye","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabelle","family":"Malissin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Macoura","family":"Gadji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mamadou Habib","family":"Thiam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno","family":"M\u00e9garbane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"250","published-online":{"date-parts":[[2022,10,11]]},"reference":[{"key":"R1","doi-asserted-by":"crossref","unstructured":"Richa S, Dirani E, Lucet C, et al. 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