In France, the number of opioid, amphetamine, cocaine and other intravenous drug users in danger is estimated at 280,000. With respect to opioid users, the role played by general practitioners in prevention and care seems to be disparate and lacking in structure. The “Baromètre Santé Médecins Généralistes” study carried out by the INPES in 1998, 2003 and 2009, makes it possible to trace the development of these practices. The broadening of the scope of prescriptions for opioid substitution therapy has gone hand-in-hand with an increase in the number of opioid users treated by general practitioners. Monitoring of dependent opioid users is most often done by male doctors, based in towns with less than 20,000 inhabitants, with large patient groups from varying social backgrounds (at least 10 % have universal medical coverage - the CMU). Prescribing practices have developed in two directions : the diversification of heroin substitution strategies and with it renewed focus on methadone treatments, while high-dose buprenorphine is the most widely prescribed treatment. These trends show the discrepancy between public authority clinical recommendations and actual practice.