[Characteristics of cannabis users in a French family practice]. / Caractéristiques des usagers de cannabis dans un cabinet de médecine générale en France.

AIM: Cannabis use, as well as the prevalence of cannabis use disorder, are not known among the population attending general practices in France. 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 18-65 in a general practice during three months from June to August 2014. 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? or answering yes to the question: do you smoke cannabis in the first 5minutes after awakening? or CUDIT score≥8 points. RESULTS: Two hundred and fifty-eight questionnaires were analyzed. Cannabis use in the past six months was found in 54 subjects (21%). Subjective feeling of cannabis dependence was endorsed by 18 subjects (6.9%). Cannabis use in the first 5minutes after awakening was found in five subjects (1.9%) and 23 (8.9%) had a CUDIT score≥8 points. 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.

[State of addiction care by general practitioners in north Paris]. / État de la prise en charge addictologique par les généralistes dans le nord de Paris.

BACKGROUND: General practitioners (GPs) are fully concerned with the care of patients suffering from addiction and must have the support of a specialized network. The aim of the study was to evaluate the prevalence of the addict follow-up care by GPs, their use of addictological care facilities and their needs in communicating with specialists. METHODS: Private and salaried GPs working in the 9th, 10th, 18th and 19th districts of Paris were contacted by phone, and a questionnaire was sent to those who agreed to respond. RESULTS: One hundred and thirty-eight GPs responded (median age 57 years, 38.4% women, 54% in private practice). In total, 78.9% received at least one patient weekly for alcohol dependence, 38.1% received at least one patient monthly for opiates and 40.2% for cannabis. They managed ambulatory alcohol (46.8%) and tobacco (65.0%) withdrawal schemes. Among GPs, 86.1% worked with the support of an addictological care facility structure, 69.6% reported lack of specialists for at least one product and 75.4% for at least one specific situation. CONCLUSION: The majority of GPs in north Paris providing care for patients with substance use disorder, worked with addictological care facilities structures. However, they noticed a lack of specialists with whom to communicate. Optimizations are proposed to facilitate interaction.

[Alcohol withdrawal delirium: What's new for an old disease?] / Delirium tremens : quoi de neuf pour une vieille maladie ?

The management of alcohol withdrawal syndrome is a frequent work in both community medicine and hospital wards. One of the most severe complications of alcohol withdrawal is Delirium Tremens (DT). The purpose of this development is to update knowledge on this complication in terms of diagnosis, evaluation and therapeutic approaches. It also proposes a reflection on the trajectory of care during and after DT.