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Self-immolation represents a relatively frequent cause of burn, especially in Tunisia after the revolution, with high costs at the individual and societal level. In this retrospective study, we report epidemiological, clinical and evolutionary characteristics of burns by immolation at the CTB of Tunis over a period of 10 years. The study involved 755 patients over the 10 years. The mean age was 33.38 years with a sex ratio of 4.5:1 (618 M/ 137F). Half of the patients (51%) were single, 2/3 (74.3%) had an unfavourable or medium socioeconomic level, 35.8% were unemployed. The educational level was secondary in 46% of cases and primary in 33.9%. Secondary transfer was noted in 53.6% of cases with agreement in 57.8%. The patients came from all regions of Tunisia with a predominance of those from the Tunis area (37.8%). One third of our patients had a psychiatric history, with the notion of a previous suicide attempt in 5.1% of cases. Alcoholism and/or drug addiction was reported in 17.7% of cases. The act of self-immolation was performed in a public place in 59.2% of cases. TBSA was 41.48%. Burns were deep in 66.2% of cases. Facial involvement was noted in 90% of patients. ABSI was 7.35 and Baux index 78 +/- 50. The average length of stay was 17.64 days. 2/3 of patients (72.1%) required intubation and mechanical ventilation. The mortality rate was 57.2%. [ABSTRACT FROM AUTHOR]

The topic of human rights in the aspect of relations between the state and addicted patients (and in general relations in the sphere of circulation of drugs) remains scantily explored for modern Ukraine, which actualizes further scientific research. The purpose of the article is to determine the authors’ vision of compliance with international human rights standards of the legal anti-drug prohibitions established by the state. To achieve this goal, using the historical-legal, comparative, dialectical, systemic, hermeneutic, sociological methods and legal method of cognition, national and foreign legislation was critically analyzed, international experience in implementing various models of anti-drug policy was studied, and proposals for the draft of a new Criminal Code of Ukraine were formulated. The authors pay special attention to the problems of protecting the rights of drug addicts, legal liability in the field of drug trafficking, legalization of drugs for non-medical needs and compulsory treatment of drug addicts. El tema de los derechos humanos en el aspecto de las relaciones entre el Estado y los pacientes adictos (y en general las relaciones en la esfera de la circulación de drogas) sigue siendo escasamente explorado en la Ucrania moderna, lo que actualiza una mayor investigación científica. El objetivo del artículo es determinar la visión de los autores sobre el cumplimiento de las normas internacionales de derechos humanos de las prohibiciones legales antidroga establecidas por el Estado. Para lograr este objetivo, utilizando los métodos histórico-jurídico, comparativo, dialéctico, sistémico, hermenéutico, sociológico y el método jurídico de cognición, se han analizado críticamente la legislación nacional y extranjera, se ha estudiado la experiencia internacional en la aplicación de diversos modelos de política antidroga y se han formulado propuestas para el proyecto de un nuevo Código Penal de Ucrania. Los autores prestan especial atención a los problemas de la protección de los derechos de los drogodependientes, la responsabilidad jurídica en el ámbito del tráfico de drogas, la legalización de las drogas para necesidades no médicas y el tratamiento obligatorio de los drogodependientes.

Adolescence is a critical stage of life in the triangle of education, family, and peers for young people. During adolescence, young people might need to overcome many hassles and fluctuations. This study aimed to investigate the relationship between the levels of trust in God and some variables such as education levels, mother’s literacy, family unity, drug addiction, having a close friend at the correctional facility, repetitive crime, and experience of running away from home in male juvenile delinquents. This study is an associational research and the population of the study was 500 male adolescents who were in the Ankara Sincan Youth Closed Prison and Correctional Center, Turkey. 389 male adolescents were selected from the research population through purposeful sampling as the sample. In this study, the attitudes of the sample were measured by the Scale of the Image of God. The questions were asked in a closed-ended way, and the data was analyzed by using the SPSS software (version 22). T-Test and ANOVA were utilized to compare the means. The data revealed that the levels of the trust in God of the adolescents differed depending on using addictive substances, repetitive crime, criminal peers, and education level. The male adolescents whose close friends were in prison, those who used drugs, those who were involved in repetitive crimes, and those who had a low education level had a lower level of trust in God than others. It has been deduced that the social environment of adolescents can be consequential in the development of religious perceptions, and that negative life experiences, as well as adverse social conditions, inhibit the development of trust in God.

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Nefopam (Acupan®) is a centrally acting non-opioid analgesic used for the treatment of moderate to severe pain. Similar to a level 1 analgesic in view of the WHO pain classification, it is a 1st or 2nd line drug depending on the intensity of the pain, but due to a significant risk of drug dependence, it should not be used in the context of chronic pain. What can be its interest in general medicine, and under what conditions? [ABSTRACT FROM AUTHOR]

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This article offers a theoretical reflection on drug addiction and the psychological functioning of people with dependence on psychoactive substances. This model is organized around the notion of relationship with an objectdrug, object considered as a substitute for a primary object having been deficient in the transmission of the psychic functions necessary for the economic management of affects, symbolization and subjective appropriation. leaving the subject with functional deficiencies on these different levels. The model is the result of a critical analysis of current models and of qualitative research through interviews with drug addicts and alcoholics. It is supported by extracts from interviews and leads to a reflection on the therapies to be favored with this clinical population. In particular, by emphasizing the transmission of symbolization and containment processes in order to develop the capacities of the ego and to avoid dependence on the institution. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Substance abuse is an important public health issue affecting West Africa; however, there is currently a dearth of literature on the actions needed to address it. The aim of this study was to assess the risks and protective factors of substance abuse in Ghana, West Africa, using the photovoice method. METHODS: this study recruited and trained 10 participants in recovery from substance abuse and undergoing treatment in the greater Accra region of Ghana on the photovoice methodology. Each participant received a disposable camera to take pictures that represented the risk and protective factors pertinent to substance abuse in their communities. They were also given the opportunity to provide narratives of the pictures using pre-identified themes and the different levels of the social-ecological model and participatory action research (PAR). RESULTS: participants identified at the individual level: ignorance; interpersonal level: family and peer pressure; organizational level: lack of regulation; community level: media, availability of drugs, cost of drugs, urbanization, slum communities and cultural factors; and policy level: lack of regulations and their enforcement. Education and beliefs were cited at the individual level; family at the interpersonal level; religion at the organizational level; organizing youth, media and narcotics anonymous at the community level; and nothing at the policy level. CONCLUSION: this is an exploratory study that will add to the limited body of knowledge in the scientific literature with respect to substance abuse in the country and also help develop interventions to address the respective needs of several communities in Ghana.

The Vietnamese government has set the task of creating a prosperous people and a strong, democratic society, a just and civilized country. This task cannot be achieved without a sound domestic policy that includes the fight against anti-social phenomena such as domestic drunkenness, chronic alcoholism, and drug addiction as an essential component, which create the ground for criminogenic behavior. The Objective of the study is to study the basic acts of Vietnamese legislation on the regulation of the prevention of deviant behavior among alcoholics and drug addicts and the resocialization of persons who committed crimes and are in prison, as well as those released from them. The general methodological basis is represented by the dialectical method, which allowed studying the research object in development to establish the corresponding cause-and-effect relationships. The authors used general scientific methods, including analysis and synthesis, induction, and deduction methods, to obtain reliable and scientifically significant results. Attention is drawn to the specific methods of resocialization combined with methadone treatment for drug addicts in the Socialist Republic of Vietnam, the conditions and regime of such treatment, and specific individuals’ responsibilities. In the twenty-first century, there are gradual changes in the worldview of the political leadership and the legal practice of Vietnam concerning people with addictions that can be treated and corrected. This has led to the adoption of evidence-based resocialization methods, particularly the use of methadone substitution therapy for drug addicts. Russian scientists are actively engaged in the problem of resocialization in the context of Russian criminal law issues. This article is the first to raise the issue of the Vietnamese approach, information about which is taken from sources in the Vietnamese language.

Résumé Objectifs Cet article interroge l’automédication, la toxicomanie et leurs effets ambivalents, ce qui justifie de réhabiliter le concept de pharmakon . Plus spécifiquement, il s’intéresse aux façons dont le sujet schizophrène et le sujet mélancolique traitent avec lui leurs problématiques psychiques respectives. Méthode Une fois l’usage des psychotropes replacé dans son contexte culturel, cette recherche procède, dans une perspective psychanalytique, à l’analyse théorico-clinique de situations de patients schizophrènes et mélancoliques à différents stades de la prise en charge psychothérapique. Résultats L’usage de psychotropes permet au sujet schizophrène de substituer au déploiement d’un délire paranoïde la scénarisation d’un fantasme, et au sujet mélancolique de réactualiser un processus de deuil en suspens. À chaque fois, la prise à partie de l’Autre dans le transfert permet à la pulsionnalité de trouver un autre destin. Discussion L’aspect transgressif de l’usage de psychotropes n’a pas la même fonction dans la schizophrénie où le sujet manque surtout d’altérité que dans la mélancolie où le sujet souffre au premier chef d’une culpabilité existentielle. Mais il permet à chaque fois au sujet de se déloger de la place où il semblait figé, ce qui modifie réciproquement sa relation à l’Autre. Conclusions La toxicomanie et l’automédication ont des effets ambivalents, ce dont le sujet témoigne à l’occasion d’une demande de prise en charge. C’est en lui permettant de subjectiver l’impasse psychique sous-jacente qu’il préférera à l’agir, l’inscription dans le langage et dans le collectif. Aims This paper focuses on self-medication, drug addiction, and their ambivalent effects, justifying a return to the concept of the pharmacon. More specifically, it addresses the way in which schizophrenic or melancholic subjects use the pharmacon concept to cope with their respective issues. Methods After placing psychotropic use in its cultural context, this research, in a psychoanalytic perspective, sets out to analyse the situations of schizophrenic or melancholic subjects at different stages in their psychotherapy, from the theoretical and clinical viewpoints. Results The use of psychotropic medication enables schizophrenic subjects to replace paranoid delusion by the staging of fantasy, and enables melancholic subject to reactivate a latent bereavement process. In each instance, the involvement of the Other in the transfer process provides alternative solutions for their drives. Discussion The transgressional aspect of psychotropic drug use does not have the same function in schizophrenia, where the subject mostly lacks otherness, as in melancholia, where the subject mostly suffers from existential guilt. But in each instance it enables the subject to move on from a place where he seemed to be rooted, which modifies his relationship with the Other. Conclusion Drug addiction and self-medication produce ambivalent effects, as evidenced by the patient when he seeks therapy. Once the patient has been made aware of the underlying psychological impasse in which he finds himself, he will come to prefer recourse to language and the collective, rather than to action. [ABSTRACT FROM AUTHOR]

Résumé Un homme de 42 ans, ancien héroïnomane et toxicomane, est traité par buprénorphine haut dosage. En outre, ce patient a contracté une hépatite C pour laquelle du peginterféron alpha-2b et de la ribavirine lui ont été prescrits. Summary A 42-year-old man, a former heroine and drug addict, is treated with high-dose buprenorphine. In addition, this patient has contracted hepatitis C for which peginterferon alfa-2b and ribavirin have been prescribed. [ABSTRACT FROM AUTHOR]

A relação entre Estado e atendimento às demandas dos adolescentes sofreram mudanças históricas, tendo como importante marco a criação do Estatuto da Criança e do Adolescente (ECA). Analisamos, com enfoque qualitativo, como os serviços de saúde mental e drogadição de um município do Estado de São Paulo compreendem a demanda dos adolescentes em situação de vulnerabilidade social. As cinco instituições participantes informaram, por meio de questionários, as características dos serviços oferecidos e sua aproximação com a população atendida. Identificamos a fragmentação entre as ações públicas, havendo ora sobreposição de serviços, ora ausência desses, além do distanciamento das necessidades dos adolescentes, o que impossibilita que essas ações ofereçam elementos para que esse público mantenha uma relação positiva frente aos elementos vulnerabilizantesThe relationship between the State and the demands of the adolescents has historically changed, having as a landmark the establishment of "Child and Adolescent Statute" (ECA). We have analyzed under the scope of qualitative research how mental health services and drug addiction of a city of São Paulo State comprehended the demands of adolescents under social vulnerability. The five participating institutions in this study have reported through questionnaires the characteristics of their services and how they approach the population served. We identified the fragmentation of public actions, with either overlapping of services, sometimes their absence, besides the distance of the needs of adolescents, avoiding public action to raise elements capable of keeping a positive relationship between this public and the elements that turn them vulnerable.

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INTRODUCTION : THE STUDY PURPOSES ARE, ON THE ONE HAND TO ASSESS A PROPORTION OF DRUG ADDICTED PATIENTS WITH A PRISON HISTORY AND TO ESTABLISH A PROFILE OF THEM, AND ON THE OTHER HAND, TO DEFINE POSSIBLE DETERMINANTS OF THEIR STAY IN JAIL. METHOD USED : THIS IS A SURVEY WITH A TRANSVERSE OBSERVATION AIMING AT DESCRIBING THE TOPIC. FORTY DRUG ADDICTED PATIENTS IN A SPECIALISED HOSPITAL UNIT WERE QUESTIONED. LIFE ITEMS WERE REGISTERED DURING A SEMI-STRUCTURED INTERVIEW BASED ON THE ADDICTION SEVERITY INDEX. RESULTS : FORTY PERCENT OF THE INTERVIEWED PEOPLE HAVE HAD A PRISON EXPERIENCE. THERE SEEMS TO BE A HIGHER RATE OF HEPATITIS C AMONG THEM. NO DIFFERENCE ENABLING TO IDENTIFY THE DETERMINANTS OF THE PRISON STAY IS SHOWN. CONCLUSION : THIS SURVEY ENABLES US TO ASSESS THE PSYCHOLOGICAL, MEDICAL AND SOCIAL CONSEQUENCES OF A PRISON EXPERIENCE FOR DRUG ADDICTED PEOPLE. TAKING DRUGS IN A PRISON IS A MAJOR RISK OF TRANSMITTING HEPATITIS C. [ABSTRACT FROM AUTHOR]

Reasons for drug addiction increase in young adults are not fully understood. The study aimed at exploring the relationship between drug addiction and parental attachment, and between the type of attachment and the chosen drug. Method : comparative cross-sectional study carried on a sample of 112 drug abusers and 112 participants with no history of drug abuse. Drug abusers, according ICD-10 classification, were selected among patients receiving care in the hospital from June to December 2010. The second abstinent (primary or secondary) group was selected during the same period among visitors and people accompanying patients in the hospital. The type of parental attachment in both groups was assessed by the questionnaire of Bartholomew and Horowitz (1991). Results : participants with no history of drug abuse had a secure attachment in 64.28 % of cases whereas 96.43 % of addiction' patients had insecure attachment types. Avoiding insecure attachment type was associated with alcohol, tobacco and cannabis abuse, apprehensive insecure attachment type with alcohol and tobacco abuse, insecure preoccupied attachment to almost all drug abuse. Addiction behaviors were strongly correlated with the type of parental attachment. Discussion : results supported the definite influence for addictive choice, of early childhood events, in particular the quality of the child's first interactions with the familyl environment. [ABSTRACT FROM AUTHOR]

Résumé: Les auteurs rapportent une présentation originale de troubles factices du membre supérieur venant compliquer un syndrome des grosses mains chez un patient toxicomane sevré. Il s’agissait d’ulcérations chroniques multiples par automutilations apparues de façon successive. Le patient avouait se mutiler et reporter ses angoisses sur ses mains déformées, dont il ne supportait plus l’aspect. La modification du schéma corporel liée au syndrome des grosses mains, l’existence d’une dépression profonde et de troubles psychotiques associés, expliquaient la récidive quasi immédiate des ulcérations malgré un traitement médicamenteux adapté et un suivi psychiatrique de longue date. [ABSTRACT FROM AUTHOR]

Résumé: Introduction: Les addictions font partie des priorités de santé publique, et depuis 15ans, de nombreuses mesures ont été prises en France dans un objectif de réduction de consommation des substances psychoactives (SPA). Objectif: Nous avons mené une étude descriptive longitudinale de 1998 à 2007 sur une file active de patients consultant en addictologie afin d’analyser les évolutions en fonction des politiques de santé publique. Méthode: Nous avons mené une analyse descriptive transversale et longitudinale des patients ayant consulté pour une dépendance à une ou plusieurs substances psychoactives entre 1998 et 2007 grâce à une base de données informatisée permettant une saisie des données des consultations en temps réel. Résultats: Sept cent cinquante-deux sujets ont été inclus de 1998 à 2007. Les consultations ont beaucoup évolué en dix ans. De même, les profils des consultants ont changé (représentation des âges, motifs de consultations, modes de consommation de SPA). Discussion: Les politiques de santé publique ont clairement un impact sur les profils des patients consultant en addictologie. L’évaluation et le suivi de ces changements sont très importants en complément des systèmes d’évaluation en place (addictovigilance) afin de permettre un ajustement et d’envisager des mesures réglementaires ou thérapeutiques adaptées. [ABSTRACT FROM AUTHOR]

The dental treatments in prison are made by the closest hospital center. After a dental balance sheet at the entrance, the prisoner can ask at any time to be looked after. If the care in prison stay the same that those practised outside, it exists however a lot of specificities in prison environment. The necessity of dental treatment is deteriorate by the beggary, the precariousness or drug addiction. Sometimes acts of violence between prisoners generate wounds or fractures. The ageing of the prison population also goes with its associated pathologies. Finally, according to the establishments of punishment, the conditions are more or less convenient to the initiation or perpetuation of sophisticated treatment plans. Nevertheless, it is essential to treat all prisoners as well as other patients. There should be no barriers to quality care. This is the carer's contribution to enable the prisoners to undertake rehabilitation work and hope to avoid recidivism. If the prison is a place of loss of liberty, it should not be a place of deprivation of dignity. [ABSTRACT FROM AUTHOR]

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In the study of social representations, procedures of data collection called ‘qualitative’ are being used more and more frequently. However, no method of analyzing qualitative material yet exists which is capable of ascertaining the representational dynamic while, at the same time, respecting the conceptual richness of recent developments in the theory of social representations. In this article, which takes the social representation of drug addiction as an example, we illustrate an integrated method for analyzing qualitative data which enables a reading of the discursive realities which corresponds to concepts elaborated in the theory of social representations.

Objective: Retrospective study of the results of confirmatory analysis performed by two laboratories in order to verify the overall performance of the screening tests (calculation of the positive predictive value) and to avaluate the overall performance of roadside tests when they are found positive. Material and Methods: Data collection of GCMS results for four major families of illicit substances, after urine or oral fluid screening tests, or in the case of no available screening data. Results: The illegal substance most frequently encountered in the tested drivers is cannabis, with a prevalence (among the analyzed samples) of 51% at the Lille University Hospital (458 confirmed cases out of 895) and 87% at the IRCGN (679 confirmed cases out of 779). At the Lille University Hospital amphetamines come second, with 6% prevalence among the analyzed samples (57 positives for 895 cases). The opiate family is found in 15 among 108 confirmation analyses at the IRCGN. Cases where the presence of morphine has been demonstrated remain difficult to interpret in regard to the use of street drugs because of confounding factors related to the administration of pain killers or the intake of licit opiates. Conclusion: Urine or oral fluid tests are therefore able to select drivers who have used narcotics before or while driving. Cannabis is the most frequently found substance, which is consistent with available data on consumption patterns in the general population. [ABSTRACT FROM AUTHOR]

Objective: To study alcohol and drug addiction incidence in students exposed to the Dawson College shooting within the 18 months following the event, to identify the precursors of a psychoactive substance addiction development while considering the severity of event exposure, and to examine whether alcohol use, 18 months after the event, is related to any of the various posttraumatic stress disorder (PTSD) symptom groups. Method: The population of this study was comprised of all the Dawson College students at the time of the event. Analyses were conducted with 854 students enrolled in the college at the time of the shooting. Results: Five per cent of women and 7% of men showed, for the first time in their life, a problem with substance addiction following the shooting. In men, young age, lifetime suicidal ideation, and having seen the killer during the shooting are the main precursors of incident accident cases. None of the studied precursors were significant in women. Men and women were also different in terms of PTSD symptoms predicting alcohol use 18 months after the shooting. Conclusion: The study highlights the importance of considering a person's sex when studying their psychoactive substance use following a trauma. [ABSTRACT FROM AUTHOR]

Tabernanthe iboga, or iboga, is a shrub native to equatorial Africa. Its root is commonly taken as a stimulant and hallucinogen. Ibogaine, the principal alcaloid in the plant, is the source of its psychotropic effects. We report the case of a 27-year-old man with a long history of drug addiction who was found dead in 2006, 12 hours after ingesting powdered iboga root as part of a detoxification programme. Ibogaine and ibogamine were identified and quantified in the powder ingested and in the body fluid samples taken at the scene of death and during the autopsy. Methods: Analysis was carried out using GC-MS/MS (electron impact - ion trap) after performing liquid-liquid extraction on the body fluids. Results: The concentrations measured in the post-mortem peripheral blood samples taken at the scene, and in the peripheral blood, urine and gastric juice samples taken during the autopsy were: 0.65, 1.27, 1.71 and 53.5 μg mL-1 for ibogaine; and 0.05, 0.10, 1.12 and 4.34 μg mL-1 for ibogamine. The powder was titrated at 7.2 per cent for ibogaine and 0.6 per cent for ibogamine. Conclusion: The presence of the two molecules in the biological samples was consistent with the recent ingestion of Tabernanthe iboga roots. The combined consumption of other central nervous system depressants (diazepam and methadone), revealed by further toxicological analysis, confirms the hypothesis of death caused by mixed overdose, of which the principal toxin was ibogaine. [ABSTRACT FROM AUTHOR]

This article discusses ethnographic research on the life of drug users and other stigmatized members of the population in urban societies. Technical aspects of the illegal drug market such as the purchase, sale and use of illicit substances is explored. Looking at these aspects in isolation and through the prism of the individuals that engage in them allows for a less biased, and more correct, understanding of the problem and the people involved.

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Abstract: Introduction: Drug-addiction, an universal medico-social problem, starts to spread in Morocco. Even if it appeared a long time ago, one is unaware of the real characteristics of this plague in our country. Objectives: The aim of our work is to study the prevalence of drug-addictions (tobacco, cannabis and alcohol) among students at the University Cadi Ayyad of Marrakech, trying to approach the epidemiological aspect and the impact of this consumption. Patients and methods: Our study is an epidemiologic approach of drug-addiction in the University of Marrakesh. After having prepared a questionnaire allowing the study of toxic consumption (tobacco, cannabis and alcohol) and the evaluation of the depression among consumers; we carried out an investigation near 418 students from Caddi Ayyad University. Results: The analysis of the results obtained makes it possible to establish the following characteristics: 24,6% of the students of our sample were consumers of tobacco, 9,8% were consumers of cannabis and 17,5% were alcohol consumers. Male consumption is prevalent, with 86.4% of smokers, 97.6% of hashish consumers and 86.3% of alcohol consumers. The age of the first consumption of drug coincides with adolescence. The mode of consumption was regular for 100% of smokers, 51.2% of hashish users and for 11% of alcohol consumers. 86.4% of smokers were dependent on tobacco, 76,6% on cannabis and 16,4% on alcohol. 28.1% of the dependent smokers on tobacco presented a moderated to severe depression. It was the same for 35.4% of the cannabis dependent and for 58.3% of those dependent on alcohol. Conclusion: A plan fighting drug-addiction is essential; especially in its preventive shutter, so as to limit this phenomenon and to minimize its repercussions on young population. [ABSTRACT FROM AUTHOR]

Abstract: In France, cannabis is the illicit substance most tested and consumed by the teenagers. In the United States, a therapy appeared particularly effective in this field: MultiDimensional Family Therapy (MDFT), taking as a starting point systemic and cognitive techniques. To validate the effectiveness of this therapeutic method, it seemed paramount to place it in the French framework and context by comparing it with what is usually done in France in the catch in charge problematic consumption of cannabis. Thus, since October 2006, two health care centres of Paris and its suburbs take part in this protocol of research with the prospect to include 150 teenagers, old from 13 to 18 years, presenting a diagnosis of abuse or dependence to the cannabis. This longitudinal study is carried out in partnership with four other European countries and should be completed at the end of 2009. This project, supported by Interdepartmental Mission of Fight against Drugs and Drug-addiction (MILDT), is integrated within the framework of a programme of care and prevention towards the problems of consumption into adolescence. Its objective is double: (1) to validate a therapeutic method in the context European, and more particularly French, effective in the field of the addictions to adolescence; (2) to develop means of evaluation of psychotherapies. [ABSTRACT FROM AUTHOR]

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Abstract: Notion of alcoholic disease goes back to about half a century. Emerged from many other forms of excess in the consumption of substances or activities practices. To treat these disorders, the notion of disease is no longer relevant because considering only dependency on the substance or activity in question, it puts aside the wish and will problems. Yet, they play an important role. Hence, the relevance of the concept of addiction which can grasp of them, provided that is not overlooked the fact that the ability to decide remains unresolved in all addictions whatever the degree of dependence. [Copyright &y& Elsevier]

Abstract: Cannabis remains the most widely used illicit substance throughout the world with approximately 166 million consumers annually. In comparison with the general population, cannabis users have a reduced socioeconomic level, a higher prevalence of unemployment and a lesser overall satisfaction with life. Cannabis use represents a risk factor for physical and mental illness. In vulnerable patients, cannabis worsens certain mental disorders, especially anxiety disorder and suicidal conduct. The relationship between cannabis and schizophrenia is very close. Patients with certain schizophrenia vulnerability who use cannabis increase their risk of developing the disease. Genetic, biological and environmental factors are likely to be implicated in this process. [Copyright &y& Elsevier]

Abstract: The pharmacological treatment of addictions has to be considered in the long term. There are several strategies possible. The withdrawal strategy is linked to post-withdrawal. Withdrawal medications are symptomatic, except for opiates with andrenoceptors. Medications that maintain abstinence are Maltrexone for the opiates, Acamprosate, Maltrexone and Disulfiram for alcohol and Bupropion for tobacco. At present, there is no known medication for cocaine addiction or dependence on cannabis. The substitution strategy is reserved for dependence on opiates and nicotine. Substitute medicines are characterised by a half-life or long lasting action. For opiates, the aim is maintenance in a care framework and an evolution of the personality disorders and for tobacco a progressive detoxification. The risk reduction strategy rests, for opiates, on weaker substitution treatment doses and a more flexible prescription framework, and for tobacco on rapid action substitutes such as gum and spray. The treatment of psychiatric comorbidities which are reinforcement factors of dependence is indispensible. Benzodiazopines should be prescribed with precaution. Second generation antipsychotics should reduce the appetence for certain substances. [Copyright &y& Elsevier]

Abstract: There is an increase in the use of cocaine and crack by the populations of Western Europe and in the demand for treatment. The absence of specific medicinal treatments, and in particular of suitable substitutes for this type of drug addiction, makes their treatment more difficult. Our purpose is to present a focus on cocaine and crack addiction. [Copyright &y& Elsevier]

Abstract: Addiction to drugs is an important public health concern. Describing the frequency of dependence, abuse and use of substances in a country allows a monitoring and helps in the design of an appropriate healthcare system. We will present studies describing the prevalence of use of tobacco, alcohol, and illicit drugs in France, with a comparison to European or International studies. They show a decrease in the use of tobacco and cannabis, while there is an increase in alcohol use in young adults. We also observe that the difference in substances use between females and males is tightening, especially in young people. We have less studies of analytic epidemiology trying to describe risk or protective factors associated with substances’ use in France. Further studies on addicted people''s pathway (from use to abuse and to dependence, as well as from dependence to recovery, with or without medical support) are warranted. [Copyright &y& Elsevier]

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Abstract: Two chronometric studies are described with the goal of outlining a moral representation of doping for children and adolescents. The first study, a moral chronometric task, was proposed to a sample of participants from children to adults. The conclusions indicated that children had a superficial understanding and a lack of internalisation concerning doping. A second study, a moral Stroop task, focalised on adolescence, which is a significant period of risk for doping and drug addiction. The aim of this study was to investigate whether young adolescents displayed an attentional bias to doping words and whether this attentional bias was related to physical self-esteem. Results indicated carry-over effects in young adolescents only for doping words. In addition, a poor physical self-esteem significantly enhanced carry-over effects. Finally, the results emphasise the complexity and at the same time the singularity of the morality of doping in terms of moral judgement. [Copyright &y& Elsevier]

Abstract: Risk-taking behaviours among adolescents have become a clinical reality and are related to a significant mortality and morbidity. Many of these behaviours are ordalique ones and consist in braving death with repetitive and deliberate risk-taking. Adolescents’ll leave their life to chance, fate, supernatural or divine powers in order to know if they must die or not. If subjects survive to fatal situations, they have a deep conviction that they’re protected and they feel therefore invincible. The ordalique behaviour is not equivalent to suicide. It’s a pathological way to restore a serious lack of narcissism and identity deficiencies. The ordalique functioning is a main characteristic of addictions, especially drug addiction. This article presents the construction of the ordalique functioning questionnaire (QFO) and initial validity studies. The QFO is composed of 71 items and four dimensions are evaluated : risk-taking, transgression, positive representation of risk-taking and believes. First dimension refers to the propensity of having dangerous activities (extreme sports, drugs use, risky sexuality, dangerous driving…). Second dimension refers to the subject’s relation to law, rules, prohibition and authorities and his tendency to have transgression behaviours. Third dimension refers to heroic representation of subjects who have risk-taking behaviours. This dimension mainly applies to narcissistic function of risk-taking. Fourth dimension refers to various believes (luck, fate, chance, god…) and the implication of these believes in risk-taking behaviours. In a first study, QFO was administrated to a population of 826 students from several universities of Toulouse. Four hundred and two of them were men and 424 were women. The age ranged from 18 to 37 with a mean of 21,13. The component analysis with varimax rotation allowed to find the four factors of construction. Alpha’s Cronbach are >0.60 for the four factors (from 0.73 to 0.79) and therefore underline the internal consistency of the questionnaire. There’s a good inter-correlation between the factors (from 0.44 to 0.60) except for believes which is not significantly correlated with the other three factors. Each result shows that believes could be an independent dimension. A test-retest study after an interval of 15 days among 80 students indicates excellent temporal reliability (from 0.93 to 1). In a second study, QFO was administrated to 150 subjects (60 drugs addicts, 30 restrictive anorexics, 60 controls). The 60 drugs addicts (30 men and 30 women with a mean age of 27, 28) were in aftercare centers. They have a very strong dependence on drugs and alcohol according to the Addiction Severity Index (ASI, McLellan) and all of them are polyaddicted. The 30 women anorexics (mean age of 19,50) were restrictive type according to the anorexia and bulimia sections of the MINI (Mini International Neuropsychiatric Interview, Sheehan and al.). Twenty anorexics were hospitalized during the research, four anorexics were met in childhood guidance structures and five anorexics were having psychotherapy treatment. The mean weight is 37,12 kg and the mean body mass index (BMI) is 14,67. The 60 controls are composed of 30 men and 30 women with a mean age of 23,55. Thirty eight of them are students and 22 are working people. The controls don’t have any psychiatric troubles listed in DSM-IV (according to the 17 diagnostic sections of the MINI), don’t smoke more than 10 cigarettes per day, don’t suffer from eating disorders and don’t have present problems with drugs or alcohol. Anova analysis and Mann Whitney tests were used to compare means between the three groups. Results of drug addicts are significantly higher than controls on risk-taking (U=0 ; P <0.0000), transgression (U=0 ; P <0.0000), positive representation of risk-taking (U=240 ; P <0.0000) and believes (U=15,5 ; P <.0000). Drug addicts also present results significantly higher than anorexics on risk-taking (U=1 ; P <0.0000), transgression (U=0 ; P <0.0000), positive representation of risk-taking (U=0 ; P <0.0000) and believes (U=11 ; P <0.0000). Anorexics have results significantly lower than controls on risk-taking (U=216,5 ; P <0.0000), transgression (U=288 ; P <0.0000), positive representation of risk-taking (U=217 ; P <0.0000) and believes (U=118 ; P <0.0000). These results underline in drug addicts an important psychic ordalique functioning that we can illustrate for example by the “russian roulette” with overdose, a risky sexuality and the share of syringes despite the threat of VIH. The very important differences between drugs addicts and anorexics indicate that anorexics would have a subjective relation to risk-taking different from drugs addicts. Indeed, unlike drug addicts, anorexics are not aware of the immediate and fatal risk of their behaviour. They don’t have a heroic representation of their risk-taking. They have not other risky activities apart from addiction. Anorexics don’t transgress laws and don’t have delinquent behaviours, they are rather conformist. They have few believes in chance, fate, destiny or god. Their results lower than controls on all dimensions of QFO showed that anorexics avoid sensations seeking and dangerous situations. The seeking of an ideal body is more important than braving death which is not even perceived. So, the subjective relation to risk-taking in anorexics wouldn’t be ordalique but “sacrificial”, that is to say focused on pathological self-control. These differences of functioning (ordalique versus sacrificial) between drug addicts and anorexics must be taken into account for therapeutic care. In this way, our results support the thesis of the existence of two types of addictions : those focused on sensations seeking, impulsivity, dangerous activities and those focused on sensations avoiding, pathological self-control, and no attraction for risk-taking. Moreover, this research shows that addictions could be classified according to a continuum from the more ordalique dependences (drug addiction) to the more accepted and passive ones (tobacco dependence) with at the other extremity the more sacrificial dependences (anorexia). In this second study, the Sensation Seeking Scale (SSS, Zuckerman) was also administrated. Correlations between SSS and QFO (from .70 to .87) indicated a very good concurrent validity. Moreover, there’s a very good inter-correlation between the four dimensions of QFO (from .76 to .90). These results, more satisfactory than in first study, can be due to the population which isn’t a run of the mill population but a pathological one with drugs addicts who have an important ordalique functioning. And notably, believes dimension, central in ordalique behaviours, is here strongly correlated with the three others dimensions of QFO. Therefore our thesis indicated above of an independent dimension can be excluded. In conclusion, QFO appears to be a promising tool for research in psychopathology. [Copyright &y& Elsevier]

Abstract: Emotion processing is supposed to play an important role in psychological dysfunctions in alcohol and drug dependency disorders (DD), as well as in personality disorders (PD). The model of “Emotional Openness” (“Ouverture émotionnelle”) provides a multidimensional framework to analyze problematic patterns of emotion processing. Within this framework, it is suggested that drug- and alcohol-dependent patients as well as borderline and antisocial patients show reduced a) “cognitive/conceptual representation” of affective states; b) “emotion regulation”; and c) “expression and communication of emotion”; but d) increased “awareness of body internal indicators” of affectivity; and e) appropriate psychological treatment is supposed to improve these patterns. Drug-dependent patients with PD comorbidity (in particular borderline or antisocial) are supposed to present even stronger deficits in (a) and (b). The hypotheses are tested with the 36-item DOE questionnaire (“Dimensions of Openness to Emotional experiences”, trait version; ), assessing six main dimensions of emotion processing as represented by the subject (French and Italian version). The instrument presents satisfying reliability coefficients (mean alphas of the scales in two recent studies (N =251; N =435) vary between 0.74 and 0.82) and good factorial validity (6-factor PCA solutions with varimax rotation solutions in the two samples are highly coherent; the mean of Tucker''s congruence coefficients is 0.93). Results of two clinical studies are presented, comparing N =71 patients (21 drug-dependent without personality disorder; 30 drug-dependent with borderline or antisocial personality; 20 dependent in-patients receiving psychological therapy) with normal control subjects (N =51 matched; N =50 reference group), including one pre-post treatment comparison. Results confirm marked deficits of DD patients concerning “conceptual representation” and “emotion regulation”, as well as a reduction of “communication/expression of emotion” but an increased “awareness of body internal indicators” of affectivity. Differences of patients with a double diagnosis correspond to effect sizes of d=–1.33 for cognitive/conceptual representation of emotions and d=–1.25 for emotion regulation; differences in emotion communication and expression are also significant but less important d=–0.44. Awareness of body internal emotion indicators is increased (d=+0.27) but does not differ significantly from the control group. As supposed, patients with a double diagnosis (DD and PD) described significantly stronger deficits in conceptual representation and emotion regulation than the patients with dependency disorder only. In the second study, a group of DD patients receiving multi-component treatment, including individual and group therapeutic intervention, according to the client-centered approach, and working on emotion processing, showed marked differences from the reference group at the beginning of the treatment (d=–0.91 for cognitive/conceptual representation, d=–0.82 for emotion regulation and d=+0.46 for awareness of bodily internal indicators). As supposed, pre-post comparisons indicate improvement with change effect sizes of d=0.99 for conceptual representation, d=0.97 for emotion regulation, as well as d=0.88 for emotion communication and expression. Furthermore, the changes following treatment are highly significant and substantial, except for the awareness of internal bodily indicators, which only slightly decreased. Patients “normalize” their emotion processing following treatment, describing increased conceptual representation and emotion regulation, as well as emotion communication and expression. Results underline the importance of dysfunctional modes of emotion processing in both pathologies, and underline the validity of applying the model and the DOE instrument. They are discussed with reference to the model of alexithymia. [Copyright &y& Elsevier]

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Abstract: In recent years, the incidence of systemic infections due to Candida increased, but the incidence of spondylodiscitis remained low, and epidural involvement during such infection was seldom reported. The purpose of this study was to report the cases of 2 young male heroin addicts who developed spondylodiscitis due to Candida sp., with epidural involvement. In one case, a microbiological diagnosis was obtained after biopsy. In the other case, the diagnosis was based on serological data and Candida antigenemia. In both cases, an oral fluconazole based therapy was administered at first (because of a poor peripheral venous system), but proved to be inefficient. A secondary therapy by liposomal amphotericin B proved efficient allowing a favourable evolution. This pathology raised a number of problems concerning diagnosis and treatment. The clinical data was non-specific the paraclinical diagnosis required MRI, and biopsy. When microbiological assessment is negative, serology and the antigenemia can be useful. The treatment pattern suggested for the management of bone and joint infections is: intravenous amphotericine B for 2–3 weeks, followed by oral administration of fluconazole or voriconazole for 6–12 month. Surgical treatment is recommended only to patients ay risk of neurological disorders or severe epidural abscess. [Copyright &y& Elsevier]