[The Challenges of Victimization in the Treatment of Substance Addiction: What Do Clinicians Say About It?] / Les enjeux liés à la victimisation dans le traitement de la dépendance aux substances : qu'en disent les cliniciens en dépendance ?

Literature seems to establish a two-way relationship between psychoactive substance use and the presence of victimization. Indeed, substance can be used by a victim to overcome the different impacts lived because of the criminal acts experienced. On the other side, psychoactive substance use may increase the risks of a person being victim of criminal acts. It is therefore no wonder that an important proportion of people who consult for a problem of consumption/addiction to psychoactive substances have already been victims of criminal acts. Since the clinical profiles of these individuals is severe and complex, it appears important that the clinicians working with this person be aware of the presence of victimization in their life in order to help them. The objective of this project is to document the difficulties and the challenges encountered by the addiction clinicians in their interventions with people having already been victims of criminal acts and to present possible solutions to help improve interventions and promote their recovery. Thirty-two addiction clinicians (N = 9 Men) have taken part in individual meetings of about 60 minutes. Once transcribed in verbatim form, the interviews have been analyzed under a continuous theming method following the steps put forward by Braun and Clarke (2006). The results of the qualitative analysis highlighted the four following aspects: (1) Perception of clinicians regarding the portrait of people consulting in a public intervention center specializing in addiction; (2) Perception of addiction clinicians regarding the possible interactions between substance use and victimization; (3) The stakes of substance abuse intervention with the victims of a criminal act and (4) Suggestions to improve services for people with substance addiction and being criminal act victims. The results put forward the complexity of intervention with people with a problem of consumption/addiction and who were victims of criminal act victims. The results highlight the complexity of the intervention with people with a problem of consumption/addiction and who were victims of criminal acts, as well as the need for training addiction clinicians about victimization.

The early impact of COVID-19 on the incidence, prevalence, and severity of alcohol use and other drugs: A systematic review.

BACKGROUND: The aim of this paper was to examine the early impact of COVID-19 on substance use to assess implications for planning substance use treatment and support systems. METHOD: A systematic review of literature published up to March 2021 was conducted to summarize changes in prevalence, incidence, and severity of substance use associated with COVID-19 and the accompanying public health measures, including lockdown, stay-at-home orders, and social distancing. RESULTS: We identified 53 papers describing changes to substance use at the population level. The majority of papers described changes related to alcohol use and most relied on self-reported measures of consumption during the COVID-19 pandemic, compared with pre-pandemic use. There was less evidence to support changes in non-alcohol substance use. In general, risky pre-pandemic alcohol use, caregiving responsibilities, stress, depression, anxiety, and current treatment for a mental disorder were found to be associated with increased substance use. CONCLUSION: This review provides preliminary data on changes in substance use, indicating that certain segments of the population increased their alcohol use early on in the COVID-19 pandemic and may be at greater risk of harm and in need of additional services. There is a need for additional population-level information on substance use to inform evidence-based rapid responses from a treatment system perspective.

Estimation of Needs for Addiction Services: A Youth Model.

OBJECTIVE: In the field of health care services, resource allocation is increasingly determined based on a population needs model. Although service needs models have been developed for adults with substance use problems, it would seem inappropriate to apply them indiscriminately to young people. METHOD: The method used proposes six steps: (1) targeting the population, (2) estimating the proportion of the population affected by substance misuse and (3) the proportion of youths who should receive services, (4) identifying categories of services, (5) estimating the proportions of youths who should have access to each category of services, and (6) applying the model to real use of services by youths to recalibrate it. RESULTS: Youths ages 12-17 from the Province of Québec were classified within a tiered model comprising four levels of substance use severity. Youths in need of services varied from 38% (weak response) to 95% (high response) for the highest severity cases. Service categories retained are detoxification/intoxication, outpatient, and residential, with each one being subdivided into four categories. The proportion of youths from each tier who should access categories and subcategories of services varied widely. After a pre-experimentation, the model was adjusted. CONCLUSIONS: The model can be applied in different jurisdictions, with the caution of adjusting prevalence to local reality. Further improvement will be based on more accurate information concerning the path of clients through services, better strategies to reach youths in need of services, and increased knowledge of optimal service categories. Models adapted to low- or moderate-income countries, where the health care system has minimal services in the areas of mental health and addiction, should be developed.