LImpasse Héloïse : Suivi de Hôpital de jour et de Lettre à Willy (French Edition)

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The report highlights the opioid crisis as a complex public health issue that requires a comprehensive approach across all sectors, including health, social services, and law enforcement. Strong health information systems are also needed, particularly data and research. Preventing problematic opioid use requires a combination of policies that ensure more information is provided to patients and health care practitioners, while providing access to appropriate pain management treatment for patients.

A public health approach to problematic opioid use must incorporate socio-economic considerations e. Addiction, December , Vol. However, no study has assessed the validity of this threshold using event-level data. This study aimed to determine the optimal thresholds for the detection of five acute alcohol-related consequences hangover, blackout, risky sex, fights and injury using data from two event-level studies.

DESIGN: An event-level study to assess the ability to use the number of drinks consumed to discriminate between nights with and without consequences using the area under the receiver operating characteristic AUROC curve. Optimal thresholds were determined using the Youden Index based on sensitivity and specificity. Separate thresholds were estimated for gender and age groups versus Adolescents tended to experience consequences more often and at slightly lower drinking levels than did adults.

For all consequences but injuries, the optimal thresholds were one to two drinks lower for women than for men. Data were collected from a national survey conducted in harm reduction facilities in five phases between and Standardized questionnaires collected information on demographics, substance use, and route of administration, as well as lifetime and past-month injection.

Descriptive and multilevel models were applied to account for the hierarchical structure of the data. Prevalence of lifetime and past-month injection remained stable over time, while the prevalence of daily injection increased significantly. Mean age at first injection only appeared to increase for data collected after Gender differences in mean age at first injection decreased over time, suggesting the development of converging patterns of initiation independent of sex.

After controlling for covariates, early initiation of injection was unrelated to daily injection or material sharing, and associated with the number of recently injected substances. Early initiation is likely a predictor of injected polysubstance use. Findings are relevant to the planning, implementation, and evaluation of prevention programs. Addiction, February , Vol. CU was based on frequency of past-year use. CUD was associated with all mental health symptoms across most ages [e. Interactions with sex show stronger associations for females than males in young adulthood [e.

Findings were not moderated by early-onset CU. Although previous research has demonstrated differential age-related risk relationships, it is difficult to estimate the magnitude of selection bias attributable to premature mortality based on existing cohort studies, the average age of which is greater than 50 years. The objective of our study was to assess the distribution of mortality-related harms and benefits from alcohol among adults ages 20 and older in comparison with the distribution among those older than age We also determined the proportion of net deaths and YPLLs occurring in each age group, overall and by cause of death.

Overall, The 30 country fact sheets for EU Member States, Norway and Switzerland present data on consumption, harm and policy implementation for the year , aiming to give guidance to national decision-makers for further priority-setting in the field of alcohol and public health. Besides trends in alcohol consumption, each fact sheet features a section on alcohol consumption and alcohol-attributable harm, with special attention to young people, and a section on the implementation of key alcohol control policies, including the three WHO "best buys" - price increase, limits on availability and bans on advertising of alcohol.

This allows for a quick overview of important subsets of alcohol policy measures that will support countries to assess their own progress towards reducing the burden of noncommunicable diseases and their key risk factors. The fact sheets also present, for the first time, an individual overview of the composite indicator scores of the 10 areas of action to reduce the harmful use of alcohol.

British Medical Journal, 20 September , Vol. Alcohol, actually ethanol C2H5OH , is a psychoactive molecule ingested by 2. Any alcohol consumption confers health risks, including for a range of cancers, and any possible cardiovascular benefits are smaller than was previously understood. Alcohol harms users through intoxication, organ toxicity, and addiction, which cause an estimated 2.

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In a recent systematic review and meta-analysis the Global Burden of Disease Alcohol Collaborators concluded that the "the level of alcohol consumption that minimised harm across health outcomes was zero. Because such measures threaten commercial interests they are challenging to adopt, and ineffectual policy responses often prevail. Broadening how we think about alcohol policies based on clear recognition that alcohol is a drug could have important benefits for public health. Two potentially relevant dimensions for classifying cannabis use typologies are medical versus recreational cannabis use and the co-use of cannabis and alcohol.

Here we compare alcohol use and related problems between cannabis users with and without medical cannabis recommendations. Method: Data come from a larger general population study in Washington State conducted between January and October The primary exposure was having a medical recommendation for cannabis. Results: Compared with those without medical cannabis recommendations, cannabis users with medical cannabis recommendations had 0. Future studies should examine nonhealth reasons regarding how medical and nonmedical users use cannabis differently.

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However, very few studies assess alcohol use in older people. Here, a self-reported questionnaire was administered to all individuals aged 70 years or more who visited a social centre for older people in western France. Thus, a significant proportion of subjects aged 70 years or over consumed more alcohol than is recommended in current guidelines. The participants also reported that they rarely discussed alcohol consumption with their general practitioners. Alcohol use should be assessed regularly. District nurses and members of the primary care team should recommend strategies to help older people reduce their alcohol consumption.

Psychotropes, , Vol. On the other hand, psychologically, the relation to the product would not be significant. Subjects would be confounded in social identifications or unconscious addictive identifications. Therapeutic work would even consist in getting out of these identifications to deal with the obligatory passage of the relationship of any subject with the feeling of lack and the anatomical difference of the sexes.

Eighty percent of acute intoxications admitted in emergency departments concern patients with alcohol addiction. Care protocols validated in all of emergency departments are necessary for prevention of alcohol withdrawal syndrome. Risky uses require ultra-brief interventions, situations of abuse light use disorders require brief interventions and situations of dependence moderate to severe use disorders require motivational interviews to promote the emergence of a process of change. The key word for alcohol intervention in emergencies is: empathy.

Search addictive comorbidities tobacco and cannabis and psychiatric comorbidities depression and suicidal risk must be systematic. The coordination between emergency departments and addictology departments is essential. In the emergency department, the goal is to optimise patient care path for all addictive behaviors. Journal of Illicit Economies and Development, , Vol.

Yet, the fragmentation of the drug policy arena and the complex SDGs task still question whether this will be the way negotiated forward. Drawing on concepts of policy entrepreneurship and idea diffusion, this paper takes stock of the recent dynamics through which the idea of drug and development policy coherence has developed and gained traction. Recognizing the role of knowledge in the construction of alternative policy ideas' acceptability, this paper focuses on knowledge activities and existing platforms where a development-oriented framework for illicit drug-related challenges is promoted and defined.

It asks whether the conditions are gathered for that idea to be translated into concrete categories of policy interventions beyond the UNGASS and SDGs moments of opportunity. STAM N. Addiction, March , Vol. Additionally, to identify opportunities to improve the accuracy and consistency of heroin-related death reporting by examining variability in the attribution, death certification, classification and coding of heroin-related death cases. Differences in the number of deaths reported as well as the classification and coding assigned to the identified heroin-related death cases were investigated by cross-referencing these data sets and examining the assigned ICD codes.

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Additional missed heroin-related death cases occurred as a result of late initial registration of these deaths to the Registry of Births, Deaths and Marriages, and where these cases were then not assessed by the ABS for classification and coding purposes. The objective of this report is to provide an updated analysis of the post-mortem toxicology practices of drug-related deaths DRD in Europe and to discuss the effect of these practices on the monitoring of DRDs. It is based on the results of a project that consisted of two components: a scoping study and a mapping survey.

The scoping study analysed the international and national guidance relating to the post-mortem investigation of suspected DRD cases. The mapping survey was conducted in and in 54 forensic toxicology laboratories in Europe. It looked at their technical equipment, analytical strategies and standards for post-mortem investigations, their technical coverage of typical drugs of abuse with special reference to NPS, their reporting standards and potential hindrances to their daily work.

The study showed that the analytical strategies, standards for post-mortem investigations and methods used across Europe still vary. The report highlights the consequences of the different practices for monitoring DRD. It presents suggestions for improving the completeness and comparability of forensic toxicological data available on DRD cases.

This issue has grown in intensity and importance with the increased recognition of the public health implications related to the escalation of the legalization of cannabis and cannabinoid products. This selective overview and commentary attempt to succinctly convey what is known about one potential consequence of cannabis use, the development of cannabis use disorder CUD.

Such knowledge may help guide a reasonable and objective public health perspective on the potential impact of cannabis use and CUD. Current scientific data and clinical observation strongly support the contention that cannabis use, like the use of other substances such as alcohol, opioids, stimulants, and tobacco, can develop into a use disorder addiction with important clinical consequences.

Treatment seeking for CUD comprises a substantial proportion of all substance use treatment admissions, yet treatment response rates show much room for improvement. Changing cannabis policies related to its therapeutic and recreational use are likely to impact the development of CUD and its course; however, definitive data on such effects are not yet available.

Clearly, the development of more effective prevention and treatment strategies is needed for those vulnerable to developing a CUD and for those with a CUD. FRON M. ENGLISH: Several authors have noted the frequent association between excessive sport and the consumption of psychoactive substances or the presence of an eating disorder, however no study has compared these two types of patients with respect to their sport. The objective of this study was to study the prevalence of antecedents of intensive sports practice defined as more than 8 hours per week and to characterise sports practice, in patients hospitalised in the university addiction service of the University Hospital Centre of Nantes.

The study was proposed to two types of patients psychoactive substance use disorders: "SPA" group and eating disorder: "TCA" group , and the data collection was through a self-questionnaire. Antecedents of intensive sports were significantly more common in the TCA group The frequency found in the SPA group was also similar to that found in other studies. The sporting habits were not significantly different from one group to another, however. On the other hand, it could be said that sporting practice caused more damage in the TCA group, even if this feeling was subjective.

These sites are effective in reducing opioid overdose mortality and other harms associated with opioid use, such as HIV infection, and increasing drug treatment entry. Various U. This purpose of this study is to assess what types of arguments resonate with the public in support of and opposition to legalizing safe consumption sites to combat the opioid epidemic. Methods: A public opinion survey of U. The survey examined the public's perception of the strength of common arguments offered in support of and opposition to legalizing safe consumption sites.

Arguments were identified through a detailed scan of news media coverage, public reports, and advocacy materials. Results: The national sample of U. The most highly rated opposing arguments were that public funds were better spent on addiction treatment, and that sites were allowing illegal activity and encouraging people to use drugs. The highest rated arguments supporting legalization were that safe consumption sites were a better alternative than arresting people for using drugs, they would reduce HIV and hepatitis C by encouraging safe injection practices, and that they would lower emergency department admission and hospitalization costs.

Conclusion: Legalization of this evidence-based harm reduction approach in U. Psychiatry Research, March , Vol. This study assessed the participation bias for a confidential non-anonymous adolescent survey among middle-school adolescents from north-eastern France mean age Because of these possible strong participation biases the construction of adolescent cohorts and the results interpretation should be made with prudence.

Factors reducing the participation rate were: male gender, non-European immigrant, single parent, low parents' education and manual-worker family. They further included low academic performance, school dropout ideation, cannabis and other illicit drugs use, sexual abuse and suicidal ideation in bivariate analysis. These findings help understand participation risk patterns in adolescent studies. While the impact of adolescent cannabis use on the development of psychosis has been investigated in depth, little is known about the impact of cannabis use on mood and suicidality in young adulthood.

Objective: To provide a summary estimate of the extent to which cannabis use during adolescence is associated with the risk of developing subsequent major depression, anxiety, and suicidal behavior. Data Extraction and Synthesis: Study quality was assessed using the Research Triangle Institute item bank on risk of bias and precision of observational studies. Two reviewers conducted all review stages independently. Selected data were pooled using random-effects meta-analysis. Main Outcomes and Measures: The studies assessing cannabis use and depression at different points from adolescence to young adulthood and reporting the corresponding OR were included.

In the studies selected, depression was diagnosed according to the third or fourth editions of Diagnostic and Statistical Manual of Mental Disorders or by using scales with predetermined cutoff points. Results: After screening articles, articles were selected for full-text review, 35 were selected for further review, and 11 studies comprising 23 individuals were included in the quantitative analysis. The OR of developing depression for cannabis users in young adulthood compared with nonusers was 1. The pooled OR for anxiety was not statistically significant: 1.

The pooled OR for suicidal ideation was 1. Conclusions and Relevance: Although individual-level risk remains moderate to low and results from this study should be confirmed in future adequately powered prospective studies, the high prevalence of adolescents consuming cannabis generates a large number of young people who could develop depression and suicidality attributable to cannabis. This is an important public health problem and concern, which should be properly addressed by health care policy.

Key Points: Question: Is adolescent cannabis consumption associated with risk of depression, anxiety, and suicidality in young adulthood? Findings: In this systematic review and meta-analysis of 11 studies and 23? There was no association with anxiety. Meaning: Preadolescents and adolescents should avoid using cannabis as use is associated with a significant increased risk of developing depression or suicidality in young adulthood; these findings should inform public health policy and governments to apply preventive strategies to reduce the use of cannabis among youth.

Drug and Alcohol Dependence, January , Vol. There is little evidence on the extent to which the Stoptober program has an impact on smoking-related outcomes at national levels. We aimed to measure the magnitude and timing of the associations of the Dutch Stoptober program with searching for smoking cessation on the internet. Methods: An interrupted time series analysis was used on Google search queries. Data were seasonally adjusted and analyzed using autoregressive integrated moving average ARIMA modelling.

To examine the magnitude and timing of the program, nine potential intervention periods around early October were analyzed simultaneously, with control for national tobacco control policies. Parallel analyses were made of Belgium as a control group. A smaller, non-significant increase was observed in the two weeks before the challenge.


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No substantial increases were found in the Belgian control group. Conclusions: In the Netherlands, the Stoptober program was associated with a substantial short-term increase in information seeking for smoking cessation. This suggests that Stoptober may be able to affect smoking-related outcomes in national populations at large.

Highlights: The temporary smoking abstinence campaign Stoptober seems a promising intervention. The effect of Stoptober was measured using online search data on smoking cessation. Stoptober was associated with increases in information seeking for smoking cessation. The increases in information seeking were as large as those around New Year. Abstinence campaigns like Stoptober could have a large reach in national populations.

LEA T. Flux is an online prospective observational study of drug use among Australian GBM. We used principal components factor analysis to generate two attitudinal scales assessing "drug use for social and sexual enhancement" and "perceptions of drug risk. Stronger endorsement of drug use for social and sexual engagement and lower perceptions of drug risk were found among men who were more socially engaged with other gay men and reported regular drug use and drug use for sex.

In multivariate analyses, all three scales were associated with recent drug use any use in the previous six months , but only the drug use for social and sexual enhancement scale was associated with regular at least monthly use. CD ; p. Lancet Psychiatry The , December , Vol. Methods - Data were collected through a telephone survey with random sampling conducted between January and July among 9, adults aged living in metropolitan France. Results and conclusion - In , Daily smoking rate was Daily smoking rate among adults has significantly decreased between and Furthermore, the stability of social inequalities observed in is confirmed in However, they remain pronounced: disadvantaged individuals unemployed, no or low education level, low income are more likely to be smokers than others.

LEON C. This finding has led the public authorities to inscribe suicide prevention as part of an overall strategy of mental health promotion and prevention of mental disorders, to set quantified targets for reduction of the number of suicide and suicide attempts. The aim of this work is to present an update of the prevalence of suicidal behavior in metropolitan France in , to identify the populations concerned and to observe changes since The variables of interest in the study were 12 month suicidal thoughts, lifetime and 12 months suicide attempts.

Results - In , 4. Monitoring of the indicators over the years did not show a clear trend in suicidal behaviors since 's. Being a woman, having financial difficulties, being single, divorced or widowed, being inactive professionally and declaring traumatic events are all associated with suicidal behaviors. Discussion - Our results confirm the importance of initiating a suicide prevention policy targeted at high-risk individuals and early intervention before the suicidal crisis, with identification and early care for the psychologically distressed.

Furthermore, multidisciplinary and intersectorial care health, social, medico-social should be implemented, especially for vulnerable populations. Few surveys, however, query use. Research on "bath salt" use is needed, especially in high-risk populations, to inform prevention and harm reduction efforts. Lifetime use of 22 different synthetic cathinones was queried, and agreement with four statements about "bath salts" was also assessed. Prevalence and correlates of self-reported "bath salt" use was examined as well as correlates of beliefs about "bath salts.

One school of thought is that addictive behavior is learned and is not the result of a pathologic neurologic pathway. This article summarizes support for the learning model. Results: The interviews indicated that control measures differ across chains in comprehensiveness and degree of implementation, survey results showed corresponding differences across the chains. This effect may be amplified by a set of measures e. Nevertheless, the expectation is that this effect can only be attained when complemented by external government enforcement efforts.

Le cannabidiol CBD est l'un des principes actifs du cannabis. Mais, que sait-on au juste des effets du CBD, quels sont les produits vendus en Suisse et que recherchent ceux qui les utilisent? Cannabidiol CBD is one of the naturally occurring cannabinoids found in cannabis plants.

Un article de Wikipédia, l'encyclopédie libre.

It is a carbon terpenophenolic compound which is formed following decarboxylation from a cannabidiolic acid precursor, although it can also be produced synthetically. In experimental models of abuse liability, CBD appears to have little effect on conditioned place preference or intracranial self-stimulation.

In humans, CBD exhibits no effects indicative of any abuse or dependence potential. There is also preliminary evidence that CBD may be a useful treatment for a number of other medical conditions. There is unsanctioned medical use of CBD based products with oils, supplements, gums, and high concentration extracts available online for the treatment of many ailments. CBD is generally well tolerated with a good safety profile.

Reported adverse effects may be as a result of drug-drug interactions between CBD and patients' existing medications. Several countries have modified their national controls to accommodate CBD as a medicinal product. To date, there is no evidence of recreational use of CBD or any public health-related problems associated with the use of pure CBD. D'ailleurs, Dobaja et collab. LOWE D. This is particularly important as there are strong motives in these individuals to seek short-term reward e.

Nonetheless, data to support the beneficial effects of cannabis use in psychiatric populations are limited, and potential harms in patients with psychotic and mood disorders have been increasingly documented. This article reviews the effects of cannabis in people with mental illness. Then, we provide a reconciliation of the addiction vulnerability and allostatic hypotheses to explain co-morbidity addiction in mentally ill cannabis users, as well as to further aid in developing a rational framework for the assessment and treatment of problematic cannabis use in these patients.

Forensic Science International, May , Vol. While smoked cannabis use is often associated with significant changes in heart rate and cardiac output, amongst other physiological changes, it has been rarely considered in the forensic literature as a significant contributory or causal factor in sudden unexpected death. A review of case reports of admissions to hospitals for cardiovascular events was undertaken together with a review of epidemiological studies, and case reports of sudden death attributed, at least in part, to use of this drug. These publications show that use of cannabis is not without its risks of occasional serious medical emergencies and sudden death, with reports of at least 35 persons presenting with significant cardiovascular emergencies who had recently smoked a cannabis preparation.

At least 13 deaths from a cardiovascular mechanism have been reported from use of this drug which is very likely to be an under-estimate of the true incidence of its contribution to sudden death. In addition, many cases of stroke and vascular arteritis have also been reported with the latter often involving a limb amputation. While it is a drug with widespread usage among the community with relatively few deaths when faced with a circumstance of very recent use within a few hours , a positive blood concentration of THC and a possible cardiac-related or cerebrovascular cause of death this drug should be considered, at least, a contributory cause of death in cases of sudden or unexpected death.

Highlights: Smoking cannabis has been associated with acute myocardial infarction. Some deaths have been attributed to smoked cannabis. Thrombus formation and stroke has been associated with use of cannabis. Acute use of cannabis should be considered as contributory to death in some cases. British Medical Journal, 18 October , Vol. Ian Hamilton, a lecturer in addiction at the University of York, has welcomed the announcement by the UK home secretary, Sajid Javid, that specialist doctors in England, Wales, and Scotland will be able to prescribe cannabis based products for medicinal use from 1 November.

But he warned that patients could face lengthy waits for treatment because of the "considerable" demand that the move could create. British Medical Journal, 10 November , Vol. Nigel Hawkes reports. Who can prescribe? Only specialists, and they will be expected to get approval from the chair of their hospital's drug and therapeutics committee, or the medical director, on a named patient basis.

GPs cannot prescribe. What indications are included?


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NHS England lists just two: children with rare forms of epilepsy and adults with nausea or vomiting caused by chemotherapy. CD ; 40 p. What is Crohn's disease? Crohn's disease is a long-term condition that results in inflammation of the gastrointestinal tract, occurring anywhere from the mouth to the anus. Common symptoms include fever, diarrhoea, abdominal pain and weight loss. Crohn's disease is characterized by periods of relapse when people are actively experiencing symptoms and periods of remission when the symptoms stop.

What are Cannabis and Cannabinoids? Cannabis is a widely used drug which acts on the endocannabinoid system. Cannabis contains multiple components called cannabinoids. The use of cannabis and cannabis oil containing specific cannabinoids produces mental and physical effects such as altered sensory perception and euphoria when consumed. Some cannabinoids, such as cannabidiol, do not have a psychoactive effect. Cannabis and cannabidiol have some anti-inflammatory properties that might help people with Crohn's disease. What did the researchers investigate? The researchers studied whether cannabis is better than placebo e.

What did the researchers find? The researchers extensively searched the literature up to 17 October and found three studies 93 participants that met the inclusion criteria. One ongoing study was also identified. All of the studies were small in size and had some quality issues. One small study 21 participants compared eight weeks of treatment with cannabis cigarettes containing mg of Delta9-tetrahydrocannabinol THC to placebo cigarettes containing cannabis with the THC removed in participants with active Crohn's disease who had failed at least one medical treatment. Although no difference in clinical remission rates was observed, more participants in the cannabis group had improvement in their Crohn's disease symptoms than participants in the placebo group.

More side effects were observed in the cannabis cigarette group compared to placebo. These side effects were considered to be mild in nature and included sleepiness, nausea, difficulty with concentration, memory loss, confusion and dizziness. Participants in the cannabis cigarette group reported improvements in pain, appetite and satisfaction with treatment. One small study 22 participants compared cannabis oil 10 mg of cannabidiol twice daily to placebo oil i.

No difference in clinical remission rates was observed. There was no difference in serious side effects. Serious side effects included worsening Crohn's disease in one participant in each group. Positive differences in quality of life and the Crohn's disease activity index were observed. Conclusions: The effects of cannabis and cannabis oil on Crohn's disease are uncertain. No firm conclusions regarding the benefits and harms e. The effects of cannabis and cannabis oil in people with Crohn's disease in remission have not been investigated.

Further studies with larger numbers of participants are required to assess the potential benefits and harms of cannabis in Crohn's disease. Future studies should assess the effects of cannabis in people with active and inactive Crohn's disease. Different doses of cannabis and formulations e. CD ; 39 p. What is ulcerative colitis? Ulcerative colitis is a chronic, long-term illness that causes inflammation of the colon and rectum.

Symptoms may include diarrhea, rectal bleeding, passage of mucus, and abdominal pain. It is characterized by periods of acute flares when people experience symptoms as well as periods of remission when symptoms stop. What are cannabis and cannabinoids? Cannabis is a widely used recreational drug that has multiple effects on the body via the endocannabinoid system.

Cannabis contains multiple sub-ingredients called cannabinoids. Cannabis and cannabis oil containing specific cannabinoids can cause cognitive changes such as feelings of euphoria and altered sensory perception. However, some cannabinoids, such as cannabidiol, do not have a psychoactive effect. Cannabis and some cannabinoids have been shown to decrease inflammation in animal and laboratory models which suggests it may help people with ulcerative colitis. For example, cannabidiol is one such cannabinoid that has shown anti-inflammatory activity in mice.

The researchers evaluated whether cannabis or cannabis oil cannabidiol was better than placebo e. The researchers searched the medical literature extensively up to 2 January Two studies including 92 adult participants with ulcerative colitis were included. Both studies assessed cannabis therapy in participants who had active ulcerative colitis.

No studies that assessed cannabis therapy in participants with ulcerative colitis in remission were identified. One study 60 participants compared 10 weeks of treatment with capsules containing cannabis oil with up to 4. The starting dose of cannabidiol was 50 mg twice daily which was increased, if tolerated, to a target of mg twice daily. The other study 32 participants compared 8 weeks of treatment with two cannabis cigarettes per day containing 0.

The study comparing cannabis oil capsules to placebo found no difference in remission rates at 10 weeks. The study also showed higher self reported quality of life scores in cannabis oil participants compared to placebo participants. More side-effects were observed in the cannabis oil participants compared to the placebo participants.

These side effects were considered to be mild or moderate in severity. Common reported side effects include dizziness, disturbance in attention, headache, nausea and fatigue. No patients in the cannabis oil group had any serious side effects. Serious side effects in the placebo group included worsening ulcerative colitis and one complicated pregnancy. C-reactive protein and fecal calprotectin levels both measures of inflammation in the body were similar in both groups. No serious side effects were reported. This study did not report on remission rates. Conclusions: The effects of cannabis and cannabis oil on ulcerative colitis are uncertain, thus no firm conclusions regarding the effectiveness and safety of cannabis or cannabis oil in adults with active ulcerative colitis can be drawn.

There is no evidence for cannabis or cannabis oil use for maintenance of remission in ulcerative colitis. Further studies with a larger number of participants are required to assess the effects of cannabis in people with active and inactive ulcerative colitis. Different doses of cannabis and routes of administration should be investigated.

Lastly, follow-up is needed to assess the long term safety outcomes of frequent cannabis use. Our results showed a direct relationship between the shape of the samples acorn or ingot and the presence of foreign elements, adulterants and microbiological contamination. Foreign elements were found in Adulterants were more frequently detected in ingot than in acorn samples. Microbiological contamination was higher in acorn samples. Most hashish samples Illegal street vending of hashish constitutes a public health issue.

L'usage du cannabis augmente le risque par trois environ de transition vers un trouble psychotique. SAAL C. Contemporary Drug Problems, December , Vol. In doing so, the article employs the concept of liminality whereby individuals and spaces occupy a position at both ends of a threshold to explore how community behaviors and norms relate to issues of space, harm, and drug policy. The article contextualizes the position of cannabis use within the fieldwork site, exploring a series of competing contradictions that divided participants between the rhetoric and reality of drug prohibition.

Drug prohibition suggests cannabis use to be dangerous, which prompted concern. However, the lived reality of prohibition for residents sat in stark juxtaposition: The drug was used commonly and publicly, was effectively decriminalized, and its use reluctantly accommodated. This malaise placed residents within what is described here as the liminality of drug prohibition, in which notions of the licit and illicit became blurred and whereby the illegality of cannabis augmented anxieties yet simultaneously proved a barrier to addressing them.

In conclusion, the current study provides further evidence of prohibitionist drug policy proliferating rather than mitigating drug-related harms. Capture-recapture methods have been used in biology and ecology for more than years. However, it is only recently that these methods have become popular in the social and medical sciences to estimate the size of elusive populations such as illegal immigrants, illicit drug users, or people with a drinking problem.

It has contributions from more than 40 researchers, and is divided into eight parts, including topics such as ratio regression models, capture-recapture meta-analysis, extensions of single and multiple source models, latent variable models and Bayesian approaches. The book is suitable for everyone who is interested in applying capture-recapture methods in the social and medical sciences. Furthermore, it is also of interest to those working with capture-recapture methods in biology and ecology, as there are some important developments covered in the book that also apply to these classical application areas.

We wanted to describe the characteristics of current cannabis users, estimate cannabis use disorder and self-rating of cannabis dependence, and describe medical conditions associated with cannabis use in a general practice in Paris. Methods: An anonymous questionnaire was proposed to every patient aged in a general practice during three months from June to August Cannabis use in the last six months was recorded and cannabis use disorder was assessed according to three different means: answering yes to the question: do you feel like you are dependent on cannabis?

Results: Two hundred and fifty-eight questionnaires were analyzed. Subjective feeling of cannabis dependence was endorsed by 18 subjects 6. Cannabis use in the first 5 minutes after awakening was found in five subjects 1. Cannabis smokers had more often addictive and psychiatric associated medical conditions.

Conclusion: General practitioners could ask about cannabis use and self-rated cannabis use disorder because it is frequent and patients with cannabis use disorder deserve specific care. ENGLISH: Introduction - The aim of this study was to describe the distribution of mental and physical illnesses associated with suicide from death certificates.

These deaths represented 1. Suicide in people aged 25 years or less accounted for a moderate part of all the suicides 5. Conclusion - Despite the limitations of death certificates to report comorbidities, this work allowed exploring information provided by certifying physicians over 15 years. It will be interesting to continue this work with further investigation using medico-administrative bases of the national health data system, in order to identify possible health conditions diagnosed during lifetime and try reducing the biases of medical certification of comorbidities that may have contributed to suicide.

PHAN O. Based on ongoing research in Colombia, this policy paper explores the capacity of communities to organise and resist - as a manifestation of cultural and social capital - in the context of illicit economies. Acknowledging how resistance reflects the experiences of communities and responds to their different needs, the paper offers relevant insights for policy that can inform drug policy formulation in Colombia and similar contexts. Tobacco Control, January , Vol.

Self-reported use of smoking cessation assistance was assessed among smokers who had ever tried to quit and former smokers. Changes in use of each type of assistance were assessed using logistic regression. The question of whether the availability of e-cigarettes will displace other methods, and the impact of such a displacement, should be closely evaluated.

Addictive Behaviors, March , Vol. Increases in risk of cocaine use were seen across nearly all sociodemographic subgroups while increases in CocUD were observed among women, those in the oldest age group, Whites, individuals with the lowest incomes and highest education, and those residing in urban areas. Increases in coca cultivation in Colombia in recent years together with increases in the purity of cocaine entering the U. The results of this study support the continued monitoring of cocaine use and CocUD in the U.

Narrowing of the gender gap in cocaine use was observed. Narrowing of race-ethnic differences were observed. Risk differences lower among those with lowest relative to highest education. MOSS S. Addiction, April , Vol. We examined 1 trends, 2 effect modification by sex and age, 3 associations of marijuana use with deviant behaviors and risk preferences and 4 differences by sex, age and year. There were no significant sex or age differences in the decline of marijuana use over time.

BECK T. This review syntheses published research on the antecedents, behaviours and consequences associated with chemsex behaviours among men who have sex with men MSM. Results were synthesised using a narrative approach and conceptualised using a behavioural analysis framework. Results: The search identified publications, of which 38 were included in the final synthesis. There were wide variations in chemsex prevalence estimates due to the heterogeneous sampling in the studies.

There were wide ranging prevalence estimates on injecting drugs for sexual purposes and the sharing of injecting equipment with some evidence of unsafe injecting practices. Participants were more likely to engage in condomless anal intercourse than men who do not engage in chemsex. This may increase the risk of transmission for HIV and other sexually transmitted infections. Conclusion: A minority of MSM appear to engage in chemsex behaviours but they are at risk of this negatively impacting on their health and well-being. Further research is required to examine high risk chemsex behaviours, impact of chemsex on psycho-social well-being and if chemsex influences uptake of PrEP, PEP and sexual health screening.

Drugs and Alcohol Today, , Vol. Recognising that participants in chemsex are social actors, the authors diverge from the prominent "pathology paradigm" used in public health. The authors explored the definitions of pleasure and the role of stimulants, sexual activity, smartphones and partners in chemsex pleasures. Findings: Chemsex pleasures encompass multiple dimensions that go far beyond bodily pleasures, such as love or romantic relationships, socializing with significant others and sexual discovery through disinhibition.

Narratives of pleasure were also, simultaneously, stories of suffering and distress. This dissonance can pose challenges to the participants in chemsex, their entourages and care providers. Practical implications: Given that the focus of care for gay men and other MSM is on risk behaviors, the findings of this paper help nurture discussions where pleasure is integrated into a new, value-neutral framework of care that incorporates chemsex pleasures.

Findings: The term chemsex has a definition and a purpose that promotes culturally competent care for a marginalized group of vulnerable people. Practical implications: The findings can be used to develop a sense of community and support amongst men who have sex with men in a chemsex setting, and to provide some background and context for professionals working in this field. In this program, participants can develop their freedom of thought their needs, their objectives and their methods of care. The evaluation retains criteria of success that are more appropriate for the objectives of reducing health-related harm in association with alcohol dependence.

The impact of the program on participants, as well as on caregivers, encourages us to expand this approach to all addictive behaviors. What clinicians should know about NPS , , ENGLISH: Cocaine is the second most abused illicit drug after cannabis in France, which has recently passed into the group of the top five European countries for cocaine consumption. Cocaine is spreading rapidly, resulting in a doubling of the proportion of experimenters in a decade and a strong diversification of user profiles. The number of current users of cocaine is estimated at ,, eight times less than for cannabis 3.

This increase in the demand and visibility of cocaine corresponds to a dynamic of significant supply, like the peak of production worldwide in More available and purer, cocaine is the subject of modalities of multiple traffic and in constant renewal. This article reviews the situation of cocaine and current trends, using all the data produced since the s: government statistical sources arrests, requests for treatment, etc.

The combination of these sources provides an updated synthesis of the cocaine market in France, highlighting the challenges faced by public authorities in the absence of drug treatment for cocaine addiction or substitution. Exemple sur le site de Bordeaux, en Gironde. The approaches identified as promising involve putting in place a tobacco prevention program throughout the entire school years incorporated in the school program.

Several studies showed that early initiation to psychoactive substances is a strong predictor of addiction. METHOD: This study was based on a cluster randomized trial comparing three groups: two intervention groups and a control group. The present paper describes the school children 1st year in six secondary schools included in the trial. It studies the national representativity of this population, the comparability between the control and intervention groups and the items link to tobacco initiation.

RESULTS: When considering tobacco behavior in , the included population was representative of the school children in 1st year of secondary school in France with The groups were comparable except for four items family and friends smoking, only child, sensitive urban areas. With this knowledge on factors linked to smoking behaviors this population can be included in the trial analysis. Le commerce illicite, en particulier de produits du tabac, a pris une ampleur importante dans certains quartiers de Paris et de sa proche banlieue.

ENGLISH: Tobacco, alcohol and foods that are high in fat, salt and sugar generate much of the global burden of noncommunicable diseases. We therefore need a better understanding of how these products are promoted. The promotion of tobacco products through sporting events has largely disappeared over the last two decades, but advertising and sponsorship continues by companies selling alcohol, unhealthy food and sugar-sweetened beverage.

The sponsorship of sporting events such as the Olympic Games, the men's FIFA World Cup and the men's European Football Championships in , has received some attention in recent years in the public health literature. Meanwhile, British football and the English Premier League have become global events with which transnational companies are keen to be associated, to promote their brands to international markets. Despite its reach, the English Premier League marketing and sponsorship portfolio has received very little scrutiny from public health advocates.

We call for policy-makers and the public health community to formulate an approach to the sponsorship of sporting events, one that accounts for public health concerns. It is unknown to what extent community pharmacists implement the policy to prevent overdose in patients receiving such treatment. Interpretative Phenomenology Analysis was used to analyse the data. Results: While participants felt their role to be essential in providing the service, they did not feel part of an integrated system.

Conclusion: Participants reported large differences in how 'opioid substitution therapy' services are provided in community pharmacy. Lack of knowledge among some pharmacists and lack of support in providing the service resulted in some patients at high risk not having their risks acted upon. In Australia and the Netherlands, cannabis use is understood and legislated within a harm-minimisation framework. In Australia it is illegal to purchase or consume cannabis. Cannabis use in the Netherlands is illegal, except in licensed coffee shops where the sale and consumption of small amounts 5 g are permitted.

Methods: Secondary school aged children in Victoria, Australia and the Netherlands were surveyed using the same culturally adapted questionnaire, designed to measure community rates of substance use and risk factors. Youth cannabis use and predictors of use were compared between the two countries. Results: Similar levels of cannabis use in the last month were reported in Australia and the Netherlands 4.

Common predictors of use were found in both the Australian and Netherlands sample. Conclusions: The findings suggest that interventions that effectively target similar risk factors to reduce or prevent cannabis use may have applications cross-nationally. Highlights: Cannabis use is common and controversial with adolescents. Australia and the Netherlands have different cannabis policies. Similar levels of use and risk factors were identified in each country.

Cannabis prevention strategies could have similar applications in both countries. Such recognition has been crucial to advances in tobacco control and is known as tobacco exceptionalism. Paradoxically, this idea may now limit progress in global health by obscuring how hard won lessons may apply to other commercial sectors that damage people's health. Tobacco is produced by a highly concentrated and globalized industry, whose behavior over many decades has been shown to have transgressed the most basic ethical responsibilities towards human life in pursuit of profit.

Tobacco companies' internal documents constitute an unusually strong form of evidence on their internal machinations. These show that the tobacco companies continue to understand very well that their business interests are compromised by public health policies, and for this reason continue to oppose them strongly.

Journal of Substance Use, March , Vol. Despite acknowledgement that this is a key clinical and public health issue, little is known about the demographic profile of those most at-risk for abuse of heroin, cocaine and methamphetamine and where users obtain these drugs. Participants included 72, eligible non-institutionalized civilians over age A comparison of abusers of heroin, cocaine and methamphetamine was done using Chi-square analysis. Logistic regression was performed to examine the effect of key variables on drug abuse.

Results: Of the 51, survey respondents, reported abuse of heroin, 1, of cocaine, and of methamphetamine. A significant number of male respondents reported heroin abuse Logistic regression highlighted significant predictors of abuse including: male gender, age years, non-Hispanic white ethnicity, unemployment and no health insurance coverage. The majority of respondents identifying as abusers of heroin, cocaine and methamphetamine reported obtained prescription drugs from non-pharmaceutical sources, such as buying them from a friend or relative or getting them for free, stealing from a doctor and purchasing from drug dealers.

Conclusion: As the instance of heroin, cocaine and methamphetamine abuse rises, tailored preventative measures and response efforts are critical. These findings indicate key demographic predictors of abuse and where the drugs are primarily obtained, informing current public health and clinical strategies and guiding combative policy development. It is essential to ensure the consistency of within-subject diagnostic findings throughout countries, languages and cultures. To date, agreement analyses between different SUD diagnostic systems have largely been based in high-income countries and clinical samples rather than general population samples.

Among cannabis users, 9. Very low endorsement rates were observed for new ICD feature for harmful use 'harm to others'. Minimal variation in clinical features was observed across diagnostic systems. Diagnostic validity of self-reported 'harm to others' is questionable. ENGLISH: This article provides a state of knowledge, proposes preventive measures and summarizes the role of occupational health services. With regard to addictive behaviour, work is a factor in protecting the use of psychoactive substances, but work itself can generate this type of consumption.

Measures to prevent the risk of addictive behaviour must be developed in the workplace. Il s'adresse aux professionnel. Current levels of opioid-related morbidity and mortality in the United States are staggering. Data for indicate that there were more than 47, opioid-involved overdose deaths, and one in eight adults now reports having had a family member or close friend die from opioids.

Increasing the availability and reducing the costs of approved medications for those with an opioid use disorder OUD is imperative; however, jurisdictions addressing OUDs and overdose may wish to consider additional interventions. Two interventions that are implemented in some other countries but not in the United States are heroin-assisted treatment HAT; sometimes referred to as supervised injectable heroin treatment and supervised consumption sites SCSs; sometimes referred to as overdose prevention sites. Given the severity of the opioid crisis, there is urgency to evaluate tools that might reduce its impact and save lives.

In this mixed-methods report, the authors assess evidence on and arguments made about HAT and SCSs and examine some of the issues associated with implementing them in the United States. Survey data based on self-reports on alcohol consumption are useful to monitor and identify drinking patterns among different population groups. This study aims to update key indicators of alcohol levels of consumption and drinking patterns among the French adult population. Methods - The Health Barometer is a random telephone cross-sectional survey among a sample of 25, persons aged years-old living in metropolitan France and speaking French.

Survey methodology relies on random digit dialing of landline and cellular phone numbers. Data collection was carried out between January and July The response rate was Men were consistently more likely than women to drink alcohol, all the more since drinking frequency increased. Drinking pattern also differed between age groups: frequency of alcohol drinking tended to increase with age, whereas mean quantity per drinking day tended to decrease.

Conclusion - In , alcohol consumption was common and remained stable compared to previous years. Among young adults under 25 years-old , recent trends show a stability of heavy episodic drinking, following a decade of increases, especially regular drunkenness. The repetition of Health Barometer surveys and surveys dedicated to adolescents are necessary to monitor alcohol consumption and to describe associated drinking patterns.

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