Lesdifficultés de la substitution aux opiacés en médecine générale PDF Download

Author: Lucie Boireau
Publisher:
ISBN:
Category :
Languages : fr
Pages :

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Book Description
Les traitements de substitution peuvent être prescrits par les médecins généralistes depuis quinze ans. Ces traitements ont fait la preuve de leur efficacité en termes de baisse de mortalité et d'insertion sociale, dans un contexte d'augmentation du nombre de consommateurs d'héroïne. Cependant, les chiffres fournis par la CRAM de la Loire pour l'année 2009 révèlent de très grandes disparités dans la prise en charge des patients sous traitement de substitution aux opiacés. Devant ce constat, nous avons fait une étude qualitative par entretiens semi dirigés auprès de douze médecins généralistes de la Loire, afin d'explorer leurs difficultés dans la prescription de ces traitements. Après une double analyse thématique indépendante, il apparait que la première consultation conditionne souvent la suite des soins. L'arrivée d'un patient inconnu entraine une méfiance du médecin qui refuse parfois de recevoir le patient. La méconnaissance des produits, en particulier pour la Méthadone, freine également la prise en charge. Les structures d'accueil des patients toxicomanes sont peu connues mais sont perçues comme des centres de référence pour l'instauration du traitement et pour l'accueil en cas d'urgence. Les modalités de prescription sont bien acceptées, mais les craintes de surconsommation et la peur d'alimenter un trafic sont très présentes. L'absence de consensus concernant la durée du traitement conduit à une incompréhension et à l'assimilation du traitement à une drogue. Pourtant, malgré ces difficultés, les médecins sont très concernés par la toxicomanie et souhaitent que les généralistes aient une place centrale dans la substitution. Améliorer la formation initiale et optimiser le réseau ville-hôpital sont deux possibilités qui pourraient faire évoluer la situation actuelle.

Author: Eduard Levinstein
Publisher:
ISBN:
Category : Drug withdrawal symptoms
Languages : en
Pages : 158

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Author: James A. Inciardi
Publisher: SAGE Publications, Incorporated
ISBN: 9780761904236
Category : Social Science
Languages : en
Pages : 0

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This book presents an historical overview of heroin use in the USA, as well as articles by experts in the field which focus on current developments and emerging trends in prevention, treatment, distribution and consumption. Filling a void in the literature on what is known about the `new' heroin users, this volume also updates the reader on the status of ageing heroin-addicted populations who initiated use of the drug prior to the `age of cocaine'.

Author: Jean-Paul Moatti
Publisher: Psychology Press
ISBN: 9781857285079
Category : AIDS (Disease)
Languages : en
Pages : 296

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Book Description
Major changes in the nature and dynamics of the AIDS epidemic over the last few years are reflected in changing epidemiological trends as well as in the progress made in biomedical research and treatment. AIDS in Europe brings together papers from leading social science researchers to look at the opportunities and challenges these changes bring and the different ways in which they are being responded to in both western and eastern Europe. Papers are organised under three headings: *new challenges for HIV prevention *care of people living with HIV/AIDS in a new therapeutic context *AIDS public policies: from specialisation to normalisation AIDS in Europe provides a comprehensive overview of current social and behavioural research on HIV and AIDS for all health professionals.

Author: Jay Kalra
Publisher: Springer
ISBN: 9783030807436
Category : Technology & Engineering
Languages : en
Pages : 0

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This book is concerned with human factors and ergonomics research and developments in the design and use of systems and devices for effective and safe healthcare delivery. It reports on approaches for improving healthcare devices so that they better fit to people’s, including special population’s needs. It also covers assistive devices aimed at reducing occupational risks of health professionals as well as innovative strategies for error reduction, and more effective training and education methods for healthcare workers and professionals. Equal emphasis is given to digital technologies and to physical, cognitive and organizational aspects, which are considered in an integrated manner, so as to facilitate a systemic approach for improving the quality and safety of healthcare service. The book also includes a special section dedicated to innovative strategies for assisting caregivers’, patients’, and people’s needs during pandemic. Based on papers presented at the AHFE 2021 Conference on Human Factors and Ergonomics in Healthcare and Medical Devices, held virtually on 25–29 July, 2021, from USA, the book offers a timely reference guide to both researchers and healthcare professionals involved in the design of medical systems and managing healthcare settings, as well as to healthcare counselors and global health organizations.

Author: Emily Martin
Publisher: Princeton University Press
ISBN: 0691141061
Category : Medical
Languages : en
Pages : 398

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Book Description
Bipolar Expeditions' is an ethnographic inquiry into mania and depression in their American cultural and historical contexts. The text explores the complex darkness and stigma associated with those deemed 'mad.

Author: Manal Guirguis-Younger
Publisher: University of Ottawa Press
ISBN: 0776621483
Category : Medical
Languages : en
Pages : 331

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"Brings together leading and emerging researchers to advance understanding of the complex relationships between homelessness and health. Covering a wide range of topics from youth homelessness to end-of-life care, contributors outline policy and practice recommendations to respond to this public health crisis."--Back cover.

Author: Paul S. Haber
Publisher: Specialty of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney
ISBN: 1742104894
Category : Medical
Languages : en
Pages : 408

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Book Description
The Australian Guidelines for the Treatment of Alcohol Problems have been periodically developed over the past 25 years. In 1993, the first version of these guidelines, titled: ‘An outline for the management of alcohol problems: Quality assurance in the treatment of drug dependence project’ was published (Mattick & Jarvis 1993). The Australian Government commissioned an update a decade later (Shand et al. 2003) and a further edition in 2009 to integrate the Guidelines with the Australian Guidelines to Reduce Health Risks from Drinking Alcohol (National Health and Medical Research Council, NHMRC 2009; Haber et al., 2009). The present version of the Guidelines was also commissioned by the Commonwealth of Australia to remain current and integrated with the updated NHMRC consumption guidelines (2020). In order to ensure that guidelines remain relevant, the next set of guidelines should be updated in 2025, consistent with NHMRC recommendation that guidelines be updated every five years. These guidelines aim to provide up-to-date, evidence-based information to clinicians on available treatments for people with alcohol problems and are largely directed towards individual clinicians in practice, such as primary care physicians (general practitioners, nursing staff), specialist medical practitioners, psychologists and other counsellors, and other health professionals. Some chapters highlight service or system level issues that impact on clinicians and their patients. These include recommendations concerning Aboriginal and Torres Strait Islander peoples, culturally and linguistically diverse groups, stigma, and discrimination. Elsewhere, organisation capacity is implied, such as medical resources for withdrawal management where recommendations indicate use of medications. As all forms of treatment will not be readily available or suitable for all populations or settings, these guidelines may require interpretation and adaptation.

Author:
Publisher:
ISBN: 9780071623445
Category : Airway (Medicine)
Languages : en
Pages : 588

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"Written by the founders of The Difficult Airway Course: Anesthesia and utilizing an instructive case-based approach, this text/DVD presents all of the leading-edge principles, tools, and procedures of airway assessment and management. The scope of the book encompasses the many airway devices that have been developed since the publication of the first edition, many of which have the potential to markedly enhance airway management. Extensively revised and updated, the second edition of Management of the Difficult and Failed Airway emphasizes how airway management is context-sensitive: included are strategies for treating patients in a range of settings, from prehospital care to the ER, as well as proven techniques for special patient populations. In addition, new chapters have been added to further refresh the book's content and provide you with a solid grasp of the most critical topics in this fast-evolving area. The book's effective organization has been maintained, beginning with the first section's focus on the basic foundations of difficult and failed airway management. The second section reviews must-know airway devices and techniques, while the third part of the text introduces case studies that thoroughly examine the application of these techniques in complex clinical situations. A final section covers the practical considerations, such as difficult airway carts and teaching and simulation in airway management."--Publisher description

Author: Jean-Paul Gaudilliere
Publisher:
ISBN: 9781526149671
Category : History
Languages : en
Pages : 248

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Book Description
This book proposes an encompassing view of the transition from international public health to global health, bringing together historians and anthropologists exploring the relationship between knowledge, practices and policies. Historical and anthropological studies of the governance of health outside Europe and North America leave us with two gaps. The first is a temporal gap between the historiography of international public health through the 1970s and the numerous current anthropological studies of global health. The second gap originates in problems of scale. Macro-inquiries of institutions and politics abound, as do micro-investigations of local configurations. The book interrogates these gaps through an engagement between the disciplines, the harnessing of concepts (circulation, scale, transnationalism) that cross both domains, and the selection of four domains of interventions and globalisation: tuberculosis, mental health, medical genetics and traditional (Asian) medicines.