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Research paper thumbnail of A Qualitative Study of Addiction Help-Seeking in People with Different Co-occurring Mental Disorders and Substance Use Problems

International Journal of Mental Health and Addiction, 2017

People with mental disorders (MD) have high rates of substance use problems (SUP) that are undert... more People with mental disorders (MD) have high rates of substance use problems (SUP) that are undertreated and understudied despite their adverse outcomes. The objective of this study is to examine barriers and facilitators that influence help-seeking to addiction treatment from the perspective of people with co-occurring MD and SUP. Forty-three individuals with MD and SUP were selected from the sample (n = 127) of a larger research project. This sub-group participated in semi-structured interviews and completed questionnaires. Interview contents were thematically analyzed using a trajectory approach. Based on participants’ addiction trajectories, two mental health experiences were identified: the “multiple disorders experience” and the “anxiety disorder experience.” The analysis highlighted how participants relate to barriers and facilitators to addiction help-seeking at the individual level (denial/minimization of problematic drug use, fear of being labeled an addict, influence of social networks, and knowledge of addiction services) and health system level (waiting time, costs, relationships with health providers, therapeutic approaches, and availability of psychological support). Interventions should be sensitive to the different experiences of people with MD and SUP. Integrated addiction services and a “no wrong door” approach are suggested.

Research paper thumbnail of The concept of time perspective and its relevance for harm reduction for street youth using psychoactive substances. A narrative literature review

HAL (Le Centre pour la Communication Scientifique Directe), Jun 1, 2019

Research paper thumbnail of Met and unmet needs of homeless individuals at different stages of housing reintegration: A mixed-method investigation

PLOS ONE, Jan 14, 2021

This study aimed to identify and compare major areas of met and unmet needs reported by 455 homel... more This study aimed to identify and compare major areas of met and unmet needs reported by 455 homeless or recently housed individuals recruited from emergency shelters, temporary housing, and permanent housing in Quebec (Canada). Mixed methods, guided by the Maslow framework, were used. Basic needs were the strongest needs category identified, followed by health and social services (an emergent category), and safety; very few participants expressed needs in the higher-order categories of love and belonging, self-esteem, and self-actualization. The only significant differences between the three housing groups occurred in basic needs met, which favored permanent housing residents. Safety was the only category where individuals reported more unmet than met needs. The study results suggested that increased overall access to and continuity of care with family physicians, MD or SUD clinicians and community organizations for social integration should be provided to help better these individuals. Case management, stigma prevention, supported employment programs, peer support and day centers should particularly be more widely implemented as interventions that may promote a higher incidence of met needs in specific needs categories.

Research paper thumbnail of COVID-19: Mental health consequences and strategies put in place to overcome them from the perspective of young adults experiencing social precarity and substance use in Montreal

Research Square (Research Square), Dec 19, 2022

COVID-19, MENTAL HEALTH AND PS USE COVID-19: Mental health consequences and strategies put in pla... more COVID-19, MENTAL HEALTH AND PS USE COVID-19: Mental health consequences and strategies put in place to overcome them from the perspective of young adults experiencing social precarity and substance use in Montreal.

Research paper thumbnail of Prostitution masculine, internet et conduites à risque : l’importance d’une approche globale de réduction des risques

Sciences Sociales Et Sante, Sep 1, 2019

Research paper thumbnail of People with opioid use disorders: A taxonomy of treatment entrants to support the development of a profile‐based approach to care

Drug and Alcohol Review

IntroductionPeople with opioid use disorders (OUD) present with high levels of medical and psycho... more IntroductionPeople with opioid use disorders (OUD) present with high levels of medical and psychosocial vulnerabilities. In recent years, studies have highlighted a shift in demographic and biopsychosocial profiles of people with OUD. In order to support the development of a profile‐based approach to care, this study aims to identify different profiles of people with OUD in a sample of patients admitted to a specialised opioid agonist treatment (OAT) facility.MethodsTwenty‐three categorical variables (demographic, clinical, indicators of health and social precariousness) were retrieved from a sample of 296 patient charts in a large Montréal‐based OAT facility (2017–2019). Descriptive analyses were followed by a three‐step latent class analysis (LCA) to identify different socio‐clinical profiles and examine their association with demographic variables.ResultsThe LCA revealed three socio‐clinical profiles: (i) “polysubstance use with psychiatric, physical and social vulnerabilities” (...

Research paper thumbnail of COVID-19, usages de drogues et réduction des risques

Criminologie (Montreal), 2022

Research paper thumbnail of Young Adults’ Mental Health and Unmet Service Needs in the Context of the COVID-19 Pandemic Across Canada and France

Community Mental Health Journal

While young adults experienced mental health challenges during the COVID-19 pandemic, little is k... more While young adults experienced mental health challenges during the COVID-19 pandemic, little is known about how their mental health needs were subsequently met through access to mental health services (MHS). From October to December 2020, we conducted an online survey of young adults (18-29 years) living in Canada and France to investigate factors associated with unmet MHS needs. Of the 3222 participants expressing a need to access MHS (50.7% of the total sample), 58.2% in Canada and 74.8% in France reported unmet MHS needs. In both countries, those who identified as men and those who lost income due to COVID-19, were more likely to report unmet MHS needs. In Canada, participants from Quebec, those living in rural areas, and those who experienced ethno-racial discrimination had higher odds of reporting such unmet needs. Urgent investments are needed to improve access to MHS for young adults during and after the COVID-19 pandemic.

Research paper thumbnail of Drogues et santé : perspectives de personnes qui consomment par injection à Montréal

Drogues, santé et société, 2021

Introduction. Persons who use drugs by injection (PUDI) face multiple threats to their health and... more Introduction. Persons who use drugs by injection (PUDI) face multiple threats to their health and life in addition to being subject to repression and social marginalization. Methodology. A qualitative study was carried out to understand the links that PWID establish between psychoactive substance use and health, as well as to explore how they perceive their own health. Twenty-six one-on-one interviews and two focus groups were conducted with a total of 30 participants. The study took place in three community harm reduction organizations. The data were analyzed thematically. Results. The participants, for the most part, perceive themselves to be in good health, despite their drug consumption or their medical diagnoses. On the other hand, others consider themselves to be in very poor health mainly because of their symptoms, functional limitations, emotional and psychological problems. While drug use can sometimes be part of a self-destructive dynamic, it can also be a way to cope with life challenges and maintain health, including avoiding very trying opioid withdrawal. It is above all the associated lifestyle, such as the quest for the product, sleep deprivation or the severing of ties with relatives, which are all elements perceived as harmful to health. Thus, one of the central objectives expressed by participants in relation to their health is to be able to better control their drug and alcohol use. Conclusion. The fact that many PWID seem to have a desire to have their drug consumption reduced without necessarily aiming for abstinence may help to direct the health and social programs and services intended for them towards a harm reduction approach.

Research paper thumbnail of La Méthode De La Revue Systématique

Presses de l'Université du Québec eBooks, Aug 26, 2020

Research paper thumbnail of Changes in self-rated physical and mental health and life satisfaction associated with opioid and potentially inappropriate opioid prescribing in primary care older adults

Family Practice

Objective To examine changes in life satisfaction and physical and mental health associated with ... more Objective To examine changes in life satisfaction and physical and mental health associated with opioid and potentially inappropriate opioid prescribing (PIOP) among older adults. Methods Secondary data analysis from the Étude sur la Santé des Aînés (ESA)-Services study. The sample consisted of 945 older adults recruited in primary care with available health survey information linked to administrative medical record data. The exposure of interest was categorized as no prescription, opioid prescription, and PIOP, defined using the Beers criteria. Outcomes were self-rated physical health, mental health, and life satisfaction measured at baseline and at a 3-year follow-up. Generalized estimating equations were used to examine 3-year changes in outcomes as a function of opioid prescribing. Analyses were adjusted for covariates relating to health, psychosocial, and sociodemographic factors as well as duration/frequency of opioid prescribing. Analyses were conducted in the overall sample ...

Research paper thumbnail of Combining the World Café and the Deliberative Democratic Evaluation: A Win-Win Strategy

Journal of participatory research methods, Feb 2, 2023

Research paper thumbnail of Adjustments to Service Organization in Specialized Addiction Services and Clinical Strategies for Better Meeting the Needs of People with a Persistent Substance Use Disorder

International Journal of Mental Health and Addiction

Research paper thumbnail of Social and professional integration, addictive behaviours and time perspectives: personal experiences of young adults involved in a low-threshold employment program in Montreal

HAL (Le Centre pour la Communication Scientifique Directe), Oct 1, 2019

Research paper thumbnail of Improving Harm Reduction Services: A Qualitative Study on the Perspectives of Highly Marginalized Persons Who Inject Drugs in Montreal

Journal of Drug Issues

Harm reduction (HR) is an alternative to the moralization of drug use and a pragmatic public heal... more Harm reduction (HR) is an alternative to the moralization of drug use and a pragmatic public health approach aimed at minimizing harms associated with use. This study sought to gain the perspectives of persons who inject drugs (PWID) on the adequacy of services provided by HR organizations in Montreal. Twenty-two semi-structured interviews and two focus groups were conducted with 30 participants. Some of the key advantages of HR perceived by participants include access to injection equipment, psychosocial support, and reduced social isolation. However, many wanted more opportunities for social insertion and greater value to be placed on their knowledge and life experiences (e.g., experiential knowledge of the street scene, drug use, sex work, or homelessness). This study suggests that PWID who access HR services in Montreal are interested in paid work opportunities in environments that promote power sharing, and activities that are conducted and managed by and for them.

Research paper thumbnail of Group Intervention for Parents of People with Psychotic and Substance Use Disorders: a Qualitative Evaluation of Appropriateness

International Journal of Mental Health and Addiction

Research paper thumbnail of K.Alunni-Menichini. Améliorer la réponse d'urgence offerte aux personnes en situation d'itinérance en contexte d'intoxication : quelles pistes de solution à mettre en place ? Sommet des dépendances, Montréal, Ca

Research paper thumbnail of A systematic review and meta-analysis of the efficacy of the long-term treatment and support of substance use disorders

Social Science & Medicine, 2021

RATIONALE The reconceptualization of substance use disorders (SUD) as a chronic phenomenon calls ... more RATIONALE The reconceptualization of substance use disorders (SUD) as a chronic phenomenon calls for a paradigm shift in service provision, particularly by way of long-term treatment and support. Studies that have evaluated the efficacy of long-term treatment models seem to indicate that they are an improvement on more standard short-term treatments, even though these studies do not take the durations into consideration. OBJECTIVE Measure the efficacy of SUD treatments and support lasting 18 months or more regarding their ability to decrease substance use as compared to shorter treatments. METHODS A meta-analysis based on a systematic literature review was conducted. Eight databases were consulted for peer-reviewed studies. Certain variables were coded as moderators: intervention length, participant characteristics, and treatment characteristics. RESULTS The main results suggest that the people who received a planned long-term treatment or support had a 23.9 % greater chance of abstaining or consuming moderately than did people who received a shorter standard treatment (OR = 1.347 [CI 95 % = 1.087-1.668], p < .006, adjusted OR = 1.460 [CI 95 % = 1.145-1.861]). None of the moderation analyses revealed any variation in the efficacy of the long-term treatments and support. CONCLUSIONS The reconceptualization of the SUD as a chronic disorder among people with this problem leads us to reconsider both the length of the services provided and the paradigms underlying their organization.

Research paper thumbnail of Avoiding the stigma. A qualitative study of socially included women's experiences of drug use and dealing, health services and the police in France

International Journal of Drug Policy, 2021

The figure of drug user and dealer is stigmatized, linked to violence and illness. This is due to... more The figure of drug user and dealer is stigmatized, linked to violence and illness. This is due to a reductionist discourse which implements othering processes generating scapegoat figures in the drug world. All drug users and sellers are assimilated with these spoiled identities in the media or in drug policies, while the reality is much more diverse. This article draws on relational sociology to focus on figures who are the antithesis of stereotypes: socially integrated women who use or sell drugs (WUSD) and are invisible to the health and control enforcement agencies. By seeking to avoid the stigma of the drug user's and dealer's identities, how do socially included WUSD distance themselves from the control enforcement agencies and health institutions? This qualitative research is based on 26 semi-structured interviews conducted with socially included WUSD in France. Participants were recruited using a snowball sampling strategy. It appears that the participants normalized their drug use and integrated it into their professional and personal lives. Some were drug user-dealers and had social supply practices, selling the drugs they used to their friends in order to finance their consumption. None of the participants have ever been in contact with harm reduction and addiction services, both because they do not identify with the users of these services, and because these services are not designed to support this population. With the police, the participants play gender games and show their social inclusion to protect themselves from arrest. In both cases, the stigmatized figure of the drug user and drug seller alienate the participants from the health systems and control enforcement agencies. One of the consequences of the othering process is the invisibility of those who do not want to be identified as "others" by the health and law enforcement services. Rethinking drug policy is essential to reach populations that may need information and support.

Research paper thumbnail of The influence of music on the addictive trajectory: a conceptual framework

Addiction Research & Theory, 2021

Abstract Music is increasingly considered to promote the health and well-being of clinical popula... more Abstract Music is increasingly considered to promote the health and well-being of clinical populations treated in hospital and psychiatric settings. Research shows numerous benefits of music on physical and mental health issues by responding to psychological, emotional, social and physical needs. However, while music’s benefits are largely supported among clinical populations, it appears that marginalized populations remain stigmatized through a lasting emphasis on their difficulties, including their use of music. Nevertheless, music appears as an innovative, accessible and promising tool to address such needs in individuals who experience social inequity regarding their access to health and helping services. Among those are marginalized individuals who suffer psychoactive substance abuse. Though research in this population remains scarce, we observe beneficial and harmful influences of music on psychoactive substance use and on the long-term addictive trajectory. In a more comprehensive manner, this article critically explores the relevance of the music and health conceptual framework developed by Västfjäll et al. to explain the role of music on the addictive trajectory. Accounting for music, individual and contextual factors, the model explains how music alters emotional states positively or negatively, which in turn modulates psychoactive substance use and the different periods encountered through the associated addictive trajectory. Despite some limitations, the model offers insights that can usefully guide and contribute to adapt its use in community interventions and as a harm reduction tool, conditional to the careful consideration of individuals’ needs and interpretation of their musical experiences.

Research paper thumbnail of A Qualitative Study of Addiction Help-Seeking in People with Different Co-occurring Mental Disorders and Substance Use Problems

International Journal of Mental Health and Addiction, 2017

People with mental disorders (MD) have high rates of substance use problems (SUP) that are undert... more People with mental disorders (MD) have high rates of substance use problems (SUP) that are undertreated and understudied despite their adverse outcomes. The objective of this study is to examine barriers and facilitators that influence help-seeking to addiction treatment from the perspective of people with co-occurring MD and SUP. Forty-three individuals with MD and SUP were selected from the sample (n = 127) of a larger research project. This sub-group participated in semi-structured interviews and completed questionnaires. Interview contents were thematically analyzed using a trajectory approach. Based on participants’ addiction trajectories, two mental health experiences were identified: the “multiple disorders experience” and the “anxiety disorder experience.” The analysis highlighted how participants relate to barriers and facilitators to addiction help-seeking at the individual level (denial/minimization of problematic drug use, fear of being labeled an addict, influence of social networks, and knowledge of addiction services) and health system level (waiting time, costs, relationships with health providers, therapeutic approaches, and availability of psychological support). Interventions should be sensitive to the different experiences of people with MD and SUP. Integrated addiction services and a “no wrong door” approach are suggested.

Research paper thumbnail of The concept of time perspective and its relevance for harm reduction for street youth using psychoactive substances. A narrative literature review

HAL (Le Centre pour la Communication Scientifique Directe), Jun 1, 2019

Research paper thumbnail of Met and unmet needs of homeless individuals at different stages of housing reintegration: A mixed-method investigation

PLOS ONE, Jan 14, 2021

This study aimed to identify and compare major areas of met and unmet needs reported by 455 homel... more This study aimed to identify and compare major areas of met and unmet needs reported by 455 homeless or recently housed individuals recruited from emergency shelters, temporary housing, and permanent housing in Quebec (Canada). Mixed methods, guided by the Maslow framework, were used. Basic needs were the strongest needs category identified, followed by health and social services (an emergent category), and safety; very few participants expressed needs in the higher-order categories of love and belonging, self-esteem, and self-actualization. The only significant differences between the three housing groups occurred in basic needs met, which favored permanent housing residents. Safety was the only category where individuals reported more unmet than met needs. The study results suggested that increased overall access to and continuity of care with family physicians, MD or SUD clinicians and community organizations for social integration should be provided to help better these individuals. Case management, stigma prevention, supported employment programs, peer support and day centers should particularly be more widely implemented as interventions that may promote a higher incidence of met needs in specific needs categories.

Research paper thumbnail of COVID-19: Mental health consequences and strategies put in place to overcome them from the perspective of young adults experiencing social precarity and substance use in Montreal

Research Square (Research Square), Dec 19, 2022

COVID-19, MENTAL HEALTH AND PS USE COVID-19: Mental health consequences and strategies put in pla... more COVID-19, MENTAL HEALTH AND PS USE COVID-19: Mental health consequences and strategies put in place to overcome them from the perspective of young adults experiencing social precarity and substance use in Montreal.

Research paper thumbnail of Prostitution masculine, internet et conduites à risque : l’importance d’une approche globale de réduction des risques

Sciences Sociales Et Sante, Sep 1, 2019

Research paper thumbnail of People with opioid use disorders: A taxonomy of treatment entrants to support the development of a profile‐based approach to care

Drug and Alcohol Review

IntroductionPeople with opioid use disorders (OUD) present with high levels of medical and psycho... more IntroductionPeople with opioid use disorders (OUD) present with high levels of medical and psychosocial vulnerabilities. In recent years, studies have highlighted a shift in demographic and biopsychosocial profiles of people with OUD. In order to support the development of a profile‐based approach to care, this study aims to identify different profiles of people with OUD in a sample of patients admitted to a specialised opioid agonist treatment (OAT) facility.MethodsTwenty‐three categorical variables (demographic, clinical, indicators of health and social precariousness) were retrieved from a sample of 296 patient charts in a large Montréal‐based OAT facility (2017–2019). Descriptive analyses were followed by a three‐step latent class analysis (LCA) to identify different socio‐clinical profiles and examine their association with demographic variables.ResultsThe LCA revealed three socio‐clinical profiles: (i) “polysubstance use with psychiatric, physical and social vulnerabilities” (...

Research paper thumbnail of COVID-19, usages de drogues et réduction des risques

Criminologie (Montreal), 2022

Research paper thumbnail of Young Adults’ Mental Health and Unmet Service Needs in the Context of the COVID-19 Pandemic Across Canada and France

Community Mental Health Journal

While young adults experienced mental health challenges during the COVID-19 pandemic, little is k... more While young adults experienced mental health challenges during the COVID-19 pandemic, little is known about how their mental health needs were subsequently met through access to mental health services (MHS). From October to December 2020, we conducted an online survey of young adults (18-29 years) living in Canada and France to investigate factors associated with unmet MHS needs. Of the 3222 participants expressing a need to access MHS (50.7% of the total sample), 58.2% in Canada and 74.8% in France reported unmet MHS needs. In both countries, those who identified as men and those who lost income due to COVID-19, were more likely to report unmet MHS needs. In Canada, participants from Quebec, those living in rural areas, and those who experienced ethno-racial discrimination had higher odds of reporting such unmet needs. Urgent investments are needed to improve access to MHS for young adults during and after the COVID-19 pandemic.

Research paper thumbnail of Drogues et santé : perspectives de personnes qui consomment par injection à Montréal

Drogues, santé et société, 2021

Introduction. Persons who use drugs by injection (PUDI) face multiple threats to their health and... more Introduction. Persons who use drugs by injection (PUDI) face multiple threats to their health and life in addition to being subject to repression and social marginalization. Methodology. A qualitative study was carried out to understand the links that PWID establish between psychoactive substance use and health, as well as to explore how they perceive their own health. Twenty-six one-on-one interviews and two focus groups were conducted with a total of 30 participants. The study took place in three community harm reduction organizations. The data were analyzed thematically. Results. The participants, for the most part, perceive themselves to be in good health, despite their drug consumption or their medical diagnoses. On the other hand, others consider themselves to be in very poor health mainly because of their symptoms, functional limitations, emotional and psychological problems. While drug use can sometimes be part of a self-destructive dynamic, it can also be a way to cope with life challenges and maintain health, including avoiding very trying opioid withdrawal. It is above all the associated lifestyle, such as the quest for the product, sleep deprivation or the severing of ties with relatives, which are all elements perceived as harmful to health. Thus, one of the central objectives expressed by participants in relation to their health is to be able to better control their drug and alcohol use. Conclusion. The fact that many PWID seem to have a desire to have their drug consumption reduced without necessarily aiming for abstinence may help to direct the health and social programs and services intended for them towards a harm reduction approach.

Research paper thumbnail of La Méthode De La Revue Systématique

Presses de l'Université du Québec eBooks, Aug 26, 2020

Research paper thumbnail of Changes in self-rated physical and mental health and life satisfaction associated with opioid and potentially inappropriate opioid prescribing in primary care older adults

Family Practice

Objective To examine changes in life satisfaction and physical and mental health associated with ... more Objective To examine changes in life satisfaction and physical and mental health associated with opioid and potentially inappropriate opioid prescribing (PIOP) among older adults. Methods Secondary data analysis from the Étude sur la Santé des Aînés (ESA)-Services study. The sample consisted of 945 older adults recruited in primary care with available health survey information linked to administrative medical record data. The exposure of interest was categorized as no prescription, opioid prescription, and PIOP, defined using the Beers criteria. Outcomes were self-rated physical health, mental health, and life satisfaction measured at baseline and at a 3-year follow-up. Generalized estimating equations were used to examine 3-year changes in outcomes as a function of opioid prescribing. Analyses were adjusted for covariates relating to health, psychosocial, and sociodemographic factors as well as duration/frequency of opioid prescribing. Analyses were conducted in the overall sample ...

Research paper thumbnail of Combining the World Café and the Deliberative Democratic Evaluation: A Win-Win Strategy

Journal of participatory research methods, Feb 2, 2023

Research paper thumbnail of Adjustments to Service Organization in Specialized Addiction Services and Clinical Strategies for Better Meeting the Needs of People with a Persistent Substance Use Disorder

International Journal of Mental Health and Addiction

Research paper thumbnail of Social and professional integration, addictive behaviours and time perspectives: personal experiences of young adults involved in a low-threshold employment program in Montreal

HAL (Le Centre pour la Communication Scientifique Directe), Oct 1, 2019

Research paper thumbnail of Improving Harm Reduction Services: A Qualitative Study on the Perspectives of Highly Marginalized Persons Who Inject Drugs in Montreal

Journal of Drug Issues

Harm reduction (HR) is an alternative to the moralization of drug use and a pragmatic public heal... more Harm reduction (HR) is an alternative to the moralization of drug use and a pragmatic public health approach aimed at minimizing harms associated with use. This study sought to gain the perspectives of persons who inject drugs (PWID) on the adequacy of services provided by HR organizations in Montreal. Twenty-two semi-structured interviews and two focus groups were conducted with 30 participants. Some of the key advantages of HR perceived by participants include access to injection equipment, psychosocial support, and reduced social isolation. However, many wanted more opportunities for social insertion and greater value to be placed on their knowledge and life experiences (e.g., experiential knowledge of the street scene, drug use, sex work, or homelessness). This study suggests that PWID who access HR services in Montreal are interested in paid work opportunities in environments that promote power sharing, and activities that are conducted and managed by and for them.

Research paper thumbnail of Group Intervention for Parents of People with Psychotic and Substance Use Disorders: a Qualitative Evaluation of Appropriateness

International Journal of Mental Health and Addiction

Research paper thumbnail of K.Alunni-Menichini. Améliorer la réponse d'urgence offerte aux personnes en situation d'itinérance en contexte d'intoxication : quelles pistes de solution à mettre en place ? Sommet des dépendances, Montréal, Ca

Research paper thumbnail of A systematic review and meta-analysis of the efficacy of the long-term treatment and support of substance use disorders

Social Science & Medicine, 2021

RATIONALE The reconceptualization of substance use disorders (SUD) as a chronic phenomenon calls ... more RATIONALE The reconceptualization of substance use disorders (SUD) as a chronic phenomenon calls for a paradigm shift in service provision, particularly by way of long-term treatment and support. Studies that have evaluated the efficacy of long-term treatment models seem to indicate that they are an improvement on more standard short-term treatments, even though these studies do not take the durations into consideration. OBJECTIVE Measure the efficacy of SUD treatments and support lasting 18 months or more regarding their ability to decrease substance use as compared to shorter treatments. METHODS A meta-analysis based on a systematic literature review was conducted. Eight databases were consulted for peer-reviewed studies. Certain variables were coded as moderators: intervention length, participant characteristics, and treatment characteristics. RESULTS The main results suggest that the people who received a planned long-term treatment or support had a 23.9 % greater chance of abstaining or consuming moderately than did people who received a shorter standard treatment (OR = 1.347 [CI 95 % = 1.087-1.668], p < .006, adjusted OR = 1.460 [CI 95 % = 1.145-1.861]). None of the moderation analyses revealed any variation in the efficacy of the long-term treatments and support. CONCLUSIONS The reconceptualization of the SUD as a chronic disorder among people with this problem leads us to reconsider both the length of the services provided and the paradigms underlying their organization.

Research paper thumbnail of Avoiding the stigma. A qualitative study of socially included women's experiences of drug use and dealing, health services and the police in France

International Journal of Drug Policy, 2021

The figure of drug user and dealer is stigmatized, linked to violence and illness. This is due to... more The figure of drug user and dealer is stigmatized, linked to violence and illness. This is due to a reductionist discourse which implements othering processes generating scapegoat figures in the drug world. All drug users and sellers are assimilated with these spoiled identities in the media or in drug policies, while the reality is much more diverse. This article draws on relational sociology to focus on figures who are the antithesis of stereotypes: socially integrated women who use or sell drugs (WUSD) and are invisible to the health and control enforcement agencies. By seeking to avoid the stigma of the drug user's and dealer's identities, how do socially included WUSD distance themselves from the control enforcement agencies and health institutions? This qualitative research is based on 26 semi-structured interviews conducted with socially included WUSD in France. Participants were recruited using a snowball sampling strategy. It appears that the participants normalized their drug use and integrated it into their professional and personal lives. Some were drug user-dealers and had social supply practices, selling the drugs they used to their friends in order to finance their consumption. None of the participants have ever been in contact with harm reduction and addiction services, both because they do not identify with the users of these services, and because these services are not designed to support this population. With the police, the participants play gender games and show their social inclusion to protect themselves from arrest. In both cases, the stigmatized figure of the drug user and drug seller alienate the participants from the health systems and control enforcement agencies. One of the consequences of the othering process is the invisibility of those who do not want to be identified as "others" by the health and law enforcement services. Rethinking drug policy is essential to reach populations that may need information and support.

Research paper thumbnail of The influence of music on the addictive trajectory: a conceptual framework

Addiction Research & Theory, 2021

Abstract Music is increasingly considered to promote the health and well-being of clinical popula... more Abstract Music is increasingly considered to promote the health and well-being of clinical populations treated in hospital and psychiatric settings. Research shows numerous benefits of music on physical and mental health issues by responding to psychological, emotional, social and physical needs. However, while music’s benefits are largely supported among clinical populations, it appears that marginalized populations remain stigmatized through a lasting emphasis on their difficulties, including their use of music. Nevertheless, music appears as an innovative, accessible and promising tool to address such needs in individuals who experience social inequity regarding their access to health and helping services. Among those are marginalized individuals who suffer psychoactive substance abuse. Though research in this population remains scarce, we observe beneficial and harmful influences of music on psychoactive substance use and on the long-term addictive trajectory. In a more comprehensive manner, this article critically explores the relevance of the music and health conceptual framework developed by Västfjäll et al. to explain the role of music on the addictive trajectory. Accounting for music, individual and contextual factors, the model explains how music alters emotional states positively or negatively, which in turn modulates psychoactive substance use and the different periods encountered through the associated addictive trajectory. Despite some limitations, the model offers insights that can usefully guide and contribute to adapt its use in community interventions and as a harm reduction tool, conditional to the careful consideration of individuals’ needs and interpretation of their musical experiences.

Research paper thumbnail of Famille et traitement de la toxicomanie chez les adolescents : étude de cas, par Benoît Gauthier, M. Ps., Karine Bertrand, Ph. D. et Pierre Nolin, Ph. D.

Résumé L’importance d’impliquer la famille dans le traitement de réadaptation en toxicomanie che... more Résumé

L’importance d’impliquer la famille dans le traitement de réadaptation en toxicomanie chez les adolescents fait consensus, mais la nature de son influence demeure peu documentée. Objectifs. Le but de cette étude de cas est de mieux comprendre la contribution de l’implication familiale dans ce processus de réadaptation. Méthode. Des entrevues individuelles semi-structurées ont été menées auprès de deux jeunes en traitement de la toxicomanie, leurs parents et les cliniciens les ayant suivis. Des données quantitatives complémentaires pré et post-traitement sur la gravité des problèmes familiaux et de consommation auprès de deux jeunes ont été recueillies. Résultats. Les récits de ces différents acteurs soulignent les bienfaits d’une implication parentale constante à travers les différentes étapes du traitement.

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Abstract

There is a general consensus as to the importance of involving the family in the rehabilitation treatment of adolescent substance abuse; but there is little documentation as concerns the nature of family influence in this matter. The objective of the present study is to come to a better understanding of how family involvement contributes to the rehabilitation process. The method consists of semi-standardized individual interviews carried out with two youngsters undergoing substance abuse treatment, and with the parents and clinicians monitoring their progress. We have also collected complementary pre- and post-treatment data regarding the seriousness of family difficulties and substance abuse experienced by these two young people. Results. The narratives of these various stakeholders underline the benefits of a constant parental involvement at each stage of the rehabilitation treatment.