Les addictions restent associées à la notion stigmatisante de produits illicites, tandis que le trouble de l’usage des médicaments est banalisé voire ignoré. L’histoire nous montre que le statut de drogue attribué à un produit est avant tout une question d’époque, d’écosystèmes et surtout de représentations. Les addictions médicamenteuses sont devenues un enjeu de santé publique, leur émergence renforce la nécessité de considérer l’usage plus que le produit.

The term addiction is too often associated with illicit drugs, and their stigmatizing consequences, while prescribed drug use disorder remains underestimated, trivialized or even ignored. The purpose of this communication was to reconsider the position of prescribed drugs amongst addictive behaviors in France. The identification of these addictions is limited by various factors that require our attention. History shows us that a product's status (illicit drug versus medication) is primarily a question of epoque (accessibility, utility) and/or ecosystem (regulation, law: licit, illicit), the addictive risk attributed to a substance depends on representations and still too often on false beliefs (example of GHB: gamma-hydroxybutyrate). However, some drugs (benzodiazepines, opiates and opioids) are among the most consumed products in France, after tobacco and alcohol, far ahead of illicit products. The emergence of this still poorly identified public health problem, reinforces the need to consider the addictive behavior rather than the product. Whatever the substance, similar neurocircuits are involved in the development of the addictive behavior through the repeated use of the substance by a vulnerable subject. The repeated use of a drug is facilitated by its availability. However, prescription medication use disorder is currently an underestimated problem, little detected, undervalued and therefore poorly treated, despite numerous neuropsychiatric, somatic, economic and social consequences as occurring in the United States with the opioid crisis.