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Background: The relationship between sleep disorders and Internet addiction has been little work. Given the importance of these disorders, we felt it appropriate to make a synthesis of available data and to establish causality or accountability between Internet addiction and the onset of sleep disorders., Methods: A literature review was then performed. We selected scientific articles in English and French, published between 1987 and 2016 by consulting the databases Medline, Embase, PsycINFO and Google Scholar. The words used alone or in combination are as follows: addiction, dependence, Internet, behavioral addiction, sleep., Results: A computer screen light inhibits melatonin secretion and acts as a real external desynchronizer circadian rhythm resulting in a withdrawal syndrome or syndrome sleep phase delay when the stress of social awakening is suppressed., Conclusion: We assume here that the specific treatment of addictive disorders have an influence on sleep disorders., (Copyright © 2016. Published by Elsevier Masson SAS.)

Cocaine remains the second most commonly used illicit drug worldwide after cannabis. Observed levels of cocaine use among countries considerably vary. An increased cocaine use is recorded in the general European population. Cocaine addiction is a worldwide public health problem, which has somatic, psychiatric, socio-economic and judicial complications. It is a multifactorial disorder variable in its clinical manifestations and heritable. Compared to the general population, there is a high prevalence of somatic and psychiatric disorders among cocaine-dependent patients. There are predictable dose-related effects of pharmacological action of cocaine and effects which are uncommon, unrelated to dose and occur randomly in this population. The number of patients entering drug treatment for primary cocaine use has been increasing in Europe for several years. However, there is no specific pharmacotherapy with established efficacy for the treatment of cocaine addiction, nor is any medication approved by regulatory authorities for such treatment. Recent controlled clinical studies and laboratory studies have highlighted some very promising medications. The perfect therapeutic platform for abstinence initiation and relapse prevention of cocaine addiction is a combination of pharmacological treatments and behavioral treatments. Targeting somatic and psychiatric comorbidity is another way to use pharmacological treatments in addictions., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Unlabelled: Tobacco use is a commonplace phenomenon in our society. Its use is responsible for more death and disease than any other noninfectious cause. More deaths are caused each year by tobacco use than by all deaths from HIV, illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined. Tobacco remains responsible for greater morbidity than alcohol and all other drugs combined. Tobacco dependence is highly prevalent among drug-dependent patients. Substance abuse patients smoke more and are more vulnerable to the effects of smoking than general populations. Traditional substance abuse therapeutic programs too frequently focus only on treatment of alcohol or other drugs rather than including treatment for tobacco dependence. Currently, there are no official medical recommendations for the treatment of tobacco addiction in illicit polysubstance users., Methods: A comprehensive literature search from a range of electronic databases (PubMed, Embase, PsycInfo, Google Scholar) was conducted for the period from 1988 to September 2012, using the following keywords alone or in combination: tobacco, nicotine, cocaine, cannabis, amphetamines, opiates, substance abuse, substance dependence, addiction, treatment. There were no restrictions on the identification or inclusion of studies in terms of publication status, language and design type., Results: Our literature review will focus on epidemiological, neurobiological, clinical interactions between tobacco, alcohol and other illicit drugs. It will also focus on therapeutic programs in this dual addictive disorder. The aim of this literature review is to make proposals for the treatment of tobacco addiction in polysubstance users entering in specific therapeutic programs., (Copyright © 2013. Published by Elsevier Masson SAS.)

Cocaine is an illicit substance which is the greatest suicide-induced potential. Studies show a link between cocaine dependence and suicide. The prevalence of its use, in the days leading up to a suicide, may vary as between 9.4 and 20% according to the chosen method. The number of suicides is important. The acting out may be present at all stages of the addictive cycle associated with cocaine. On the 12th National Day on Suicide Prevention devoted to addictions and suicide, it was recommended that addictive phenomena should be taken more into account by experts in the subject, and that the risk of suicide should be evaluated by specialists in addiction in order that people presenting a risk be placed in appropriate preventative care in time., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Methamphetamine is the second illicit drug used after cannabis in North America, Asia, Oceania. It also becomes a prominent part of the European drug scene, especially in East European countries such as Czech Republic and Slovakia. Methamphetamine addiction is a serious worldwide public health problem with many consequences and complications. Significant morbidity, including cardiovascular, infectious, pulmonary, dental diseases and other systems complications are associated with methamphetamine acute or chronic use. Cognitive disorders, psychotic and mood disorders have been reported. There is also substantial evidence that methamphetamine has an adverse impact on social relationships. Treatment of methamphetamine complications is primarily supportive and need a multidisciplinary approach. It can serve as a target to initiate a treatment for the addiction problem. The use of behavioral therapies and pharmacological agents are the best therapeutic approach., (Copyright © 2010 Elsevier Masson SAS. All rights reserved.)

According to available information, GHB and its precursors--gamma-butyrolactone (GBL) and 1,4-butanediol (1,4BD)--are used especially in a nightlife scene characterized by the search for amplified sensations through the combination of electronic music, marathon dancing, and substance abuse. Evidence indicates that GHB/GHL is used particularly in some subpopulations and in places, such as in gay nightclubs. Commonly known as Gorliquid ecstasy, it was misused in the 1980s for its bodybuilding effects and in the 1990s as a recreational drug at music venues. In the same period, media coverage of the use of GHB in sexual assault (often referred to as date rape) brought the drug into the spotlight. GHB/GHL addiction is a recognized clinical entity evidenced by severe withdrawal symptoms when the drug is abruptly discontinued after regular or chronic use. There is evidence that negative health and social consequences may occur in recreational and chronic users. Nonfatal overdoses and deaths related to GHB have been reported. These undesirable effects and especially the deaths appear to have prompted campaigns to limit the use of GHB. Clinicians must also be aware of GBL, which is being sold and used as a substitute for GHB.

Introduction: Tobacco is an important source of somatic diseases and causes high mortality. It is associated with cognitive disorders which tend to maintain addictive mechanisms. In the short term, the nicotine contained in tobacco enhances attention and memory., Method: To realize this review, we made a research, we made a research on Medline, Embase, PsycInfo, Google Scholar using the single or combined key-words "tobacco", "nicotine", "addiction", "dependence", "cognitive disorders", "executive function", "memory", "attention", "neuropsychological". We selected English or French articles from 1987 to 2008 by privileging controlled studies., Results: This effect can be observed in smokers (with or without withdrawal symptoms), non-smokers and in patients suffering from cognitive disorders. In the long term, tobacco accelerates dementia processes. It is associated with an increased risk of cognitive deterioration. This deterioration concerns mainly memory and processing speed. These results were reported in prospective studies. They contradict early reports, that suggested smoking could actually be protective against certain central neural system disorders. These early results relayed on case-control studies, which were certainly biased by a "healthy survival effect". Further studies are required to evaluate nicotine's long term effect and its potential efficacy in treating and preventing cognitive disorders or dementia.

Cocaine is more and more used and abused in France. Cocaine dependence is quite serious and is associated with numerous adverse health consequences. No effective pharmacotherapy for cocaine dependence is yet available. Recent advances in neurobiology, brain imaging and some clinical trials suggest that certain medications that modulate GABAergic, dopaminergic, and glutamatergic systems, as well as immunotherapy, show promise in the treatment of cocaine addiction. Recent controlled clinical studies have tested some of these drugs, which act on the various neurobiological circuits modified by cocaine exposure and clinically improve patients' symptoms. Pharmacological agents such as modafinil, GABAergic agents (baclofen, topiramate, tiagabin, and vigabatrin), disulfiram, aripiprazole, N-acetylcysteine and cocaine vaccine seem very promising in the treatment of cocaine dependence. However, this must be confirmed in larger patient populations.

Background: Adolescents and young adults seeing a nurse or physician for any reason should be screened for psychoactive substance use. Several English-language questionnaires are available to screen for and assess harmful use of psychoactive substances among adolescents, but to our knowledge, no such instrument exists in French. The aim of the ADOTECNO study was therefore to develop simple and efficient tools for this purpose., Methods: Two questionnaires widely used in French epidemiologic studies (CRAFFT-ADOSPA to screen for harmful use and POSIT to assess the seriousness of consumption from physical, psychological and social viewpoints) were completed by 1728 secondary and post-secondary school students. Statistical analyses assessed correlations between the questionnaires and calibrated optimal cutoff points for the different tools included in ADOTECNO., Results: Correlations between psychoactive substance consumption, responses to the CRAFFT-ADOSPA questionnaire, and POSIT factor A scores showed that CRAFFT-ADOSPA provided early detection of regular alcohol intoxication and of regular and daily cannabis use. At a score of 2, CRAFFT-ADOSPA detects harmful substance use, and at a score higher than or equal to 3 it demonstrates serious substance use., Conclusion: These findings enabled us to recommend useful cutoff values for the CRAFFT-ADOSPA tools for screening subjects at moderate or high risk of substance abuse. This simple broad screening should be complemented for the subjects found to be at risk by a computer-assisted POSIT to guide practitioners in selecting an approach (educational, school, family, psychological, psychiatric, etc.) to care and management according to the specific types of impairment resulting from substance use.

Introduction: Self-mutilation is direct and deliberate harm to one's body without conscious intent to die. It is observed in both men and women with various psychiatric disorders, but most of those who self-mutilate are women diagnosed with borderline personality disorder. Cocaine addiction is a significant worldwide public health problem, associated with somatic, psychological, psychiatric, socioeconomic and legal complications. Amphetamine use, but not cocaine use, has previously been associated with severe self-injurious behavior., Case: We report here a case of a female patient with recurring self-injurious behavior ("the pleasure of bleeding") induced by cocaine abuse., Discussion: The clinical characteristics of self-mutilation are manifold and there is a lack of agreement about its etiology. The complex behavior associated with cocaine abuse may be one cause of self-mutilation. Dysfunction of the inhibitory brain circuitry caused by drug addiction could explain why this cocaine-addicted patient loses control and self-mutilates during cocaine use.

Objectives: The CAGE questionnaire is considered a useful tool for detecting alcohol problems, especially in clinical populations. Its sensitivity exceeds 75% and its specificity 90%. Our objective was to assess performance of the French version of the CAGE (DETA) in identifying patients who meet the DSM-IV criteria and to discuss its usefulness in hospitals., Methods: Data come from study of hospital morbidity in the Auvergne district of central France in 1998. Alcohol problems were diagnosed by physicians using the DSM-IV alcohol abuse or dependency criteria. For each diagnostic category, we calculated the performance of the CAGE questionnaire at a cut-off of 2 (CAGE 2+) and of 1 (CAGE 1+)., Results: The study included 5,452 patients--48.5% of them men--in acute- and intermediate-care facilities. CAGE 2+ had a sensitivity of 77% and a specificity of 94% among the diagnosed patients. It was more sensitive for patients diagnosed as alcohol-dependent than for alcohol abusers (61% vs 84%), but specificity was identical for both groups (94%). These results are similar to the properties of the English version. For a cut-off of 1 the CAGE had a sensitivity of 88% and a specificity of 87%., Conclusion: The French version of CAGE is a useful screening tool for alcohol abuse and dependance. Its systematic use in hospitals is desirable: a positive response to any item should attract the physician's attention and lead to further investigation.

Introduction: Since the end of the nineteen-nineties, cannabis is not only incriminated in the onset of thromboangiitis obliterans but also in inducing artheromatous lesions in young subjects., Observation: A young, Caucasian, 18 year-old man was referred for cannabis withdrawal in the treatment of arteritis of the left leg., Discussion: Cannabis is by far the illicite psychoactive substance most consumed by the 15-25 year-olds. Data in the literature, notably since the end of the nineteen-nineties, show that cannabis is accused of provoking arterial disease similar to that which is found in Buerger's disease (or thromboangiitis obliterans) in young subjects of whichever sex.

TWO CALCULATION SCHEMES: We estimated the cost of health care related to alcoholism using two different medicoeconomic approaches. PREVALENCE OF ALCOHOLISM: Corresponding costs of alcohol-related conditions can be calculated from the prevalence of alcoholism in hospitalized and ambulatory patients. It is however impossible to calculate the alcohol-related cost, even for heavy drinkers, when alcohol is involved as a risk factor. METHOD ONE: For a 10% prevalence of excessive alcohol intake in the general population, the minimal cost in 1996 would be approximately 14 billion francs ($2.2 billion). For a 15% prevalence, it would reach 16 billion ($2.6 billion). This cost only concerns diseases directly or indirectly related to alcoholism. The estimated hospital cost of diseases directly related to alcoholism, that is alcoholic dependence and psychosis, cirrhosis, and upper airway-digestive cancers, reaches 6 to 6.5 billion francs ($1-$1.03 billion) respectively for a 10 or 15% prevalence. Total costs (hospital and ambulatory costs) are between 6.4 and 6.9 billion francs ($1.02-$1.04 billion). For diseases where alcohol is only a risk factor, the minimal cost varies between 7.5 and 9.5 billion francs ($1.20-$1.51 billion). METHOD TWO: With this method, the minimal total cost is to the order of 20 billion francs ($3.75 billion) with half being hospital costs and half ambulatory costs. This cost only concerns alcohol in overt disease states. Costs related to alcohol as a risk factor are not included in this estimation as there is no known coefficient for attribution. HIGH COST OF ALCOHOLISM: Both of our methods used a minimizing estimation scheme and found total costs to lie in the range of 15 ñ 20 billion francs ($2.38-$3.75 billion). Extrapolating from studies conducted in other countries where social costs amounted to 75% of total costs, it can be considered that alcoholism in France costs more than 80 billion francs ($12.7 billion) a figure exceeding 1% of the GNP.