Addiction Rehab: [Integrated Treatment of Cooccurring Mental and Substance Use Disorders in Urban Populations : The Situation in Montréal].

[Integrated treatment of cooccurring mental and substance use disorders in urban populations : the situation in Montréal].

Filed under: Addiction Rehab

Sante Ment Que. 2012; 37(1): 31-46
Dubreucq S, Chanut F, Jutras-Aswad D

The prevalence of patients diagnosed with both a psychiatric and an addiction disorder is considerable. Like many other large urban centers, Montreal harbors many of these socially marginalized individuals. In spite of a wide range of resources for the treatment of each condition taken singly, there has been until recently an alarming dearth of programs aimed at providing integrated treatment models. In recent years, the CHUM has endeavored to implement such a program in order to address the multiple needs of a population often rendered vulnerable in many respects. In this article, the authors address the magnitude of this “dual diagnosis” problem, existing intervention models and the obstacles faced by this population in terms of access to health care ; they describe the steps leading to the establishment of an Addiction Psychiatric Unit at the CHUM and the challenges arising from the creation of a multidisciplinary integrated treatment model in an urban setting.
HubMed – addiction


[Taking care of outreach workers who intervene with marginal youths : Part 2].

Filed under: Addiction Rehab

Sante Ment Que. 2012; 37(1): 13-30
Aubin D, Abdel-Baki A, Baret C, Cadieux C, Glaize A, Hill T, Lafortune D, Létourneau P, Monast D, Tiberghien C

Outreach work with youths in a precarious situation raises emotions and questions in workers while confronting them with their own suffering and fragility. In order to help them help as well as counter the risk of vicarious traumatisation, spaces for talking and exchanging with a third party have been created in various intervention settings. The objective is to allow them to elaborate on what their work makes them feel and thus preserve their stability and their ability to think. Through group or individual clinical discussions, these exchanges favor distancing and allow new perspectives on their work. That is why peer support appeared as an essential element for psychologists and therapists who support not only youths but the workers who help them. The setting up of our outreach meetings-a result of our observation, allows keeping the flame alive without risking being burned. In this article, the issue of marginality in professionals working with homeless youths-as well as our own-is raised. It sometimes translates in the absence of a fixed location for a meeting symbolizing traditional stability, sometimes in the necessary flexibility of a framework to reach this population, sometimes in the openness to otherness and more precisely to a difference that disturbs when anxiety that this disaffiliated being raises, could well be our very self! Is it really marginality or a particular positioning aiming at constructive denunciation of stigmatization, unjust exclusion that youths with mental health and addiction problems sustain that place them at risk of homelessness? Neither missionaries, nor saviors are needed, but only hopeful facilitators working alongside people who want to stand up and take their place in society.
HubMed – addiction


Associations between self-control and dimensions of nicotine dependence: A preliminary report.

Filed under: Addiction Rehab

Addict Behav. 2012 Nov 17; 38(3): 1812-1815
Wilson SJ, Maclean RR

Self-control plays an important role in several health-related behaviors, including cigarette smoking. There is some evidence that individual differences in self-control are negatively associated with overall levels of nicotine dependence but, to our knowledge, finer-grained relationships between these constructs have not been explored. This is an important knowledge gap, as nicotine dependence is thought to be composed of separate dimensions that motivate smoking behavior in relatively unique ways. The goal of this preliminary study was to begin to characterize the potentially nuanced associations between self-control and facets of nicotine dependence using data pooled from two previous studies (n=282). Specifically, we examined the correlation between self-control and the following dimensions of nicotine dependence: compulsion to smoke due to craving and desire to avoid withdrawal symptoms; preference for smoking over other reinforcers; reduced sensitivity to the effects of smoking; consistency of smoking patterns; and smoking behavior that is rigid and immutable. In line with prior research, self-control was negatively correlated with overall levels of dependence. As predicted, however, self-control was differentially associated with distinct dimensions of nicotine dependence. Specifically, self-control was negatively correlated with the compulsion to smoke due to craving and desire to avoid withdrawal symptoms but positively correlated with the consistency of smoking patterns. Given the potential conceptual and clinical importance of such effects, additional research investigating the role(s) that individual differences in self-control play in addiction to cigarettes would be useful.
HubMed – addiction


More Addiction Rehab Information…