IMAGES CONSORTIUM MEETING St Petersburg, April 25-28, 2010

1. IMAGES CONSORTIUM MEETING St Petersburg, April 25-28, 2010 Should someone do something concerning addiction? The French GP's Answers Chantal Mougin CNRS – CERMES3-équipe CESAMES, Paris Centre de Recherche Médecine, Sciences, Santé, Santé Mentale et Société

2. From 2008 July to 2010 January Methods: * Gathering GP’s * They watch film extracts * They comment freely, with a guide * Their comments are transcribed * The transcriptions are analysed Seven General Practitioners’ (GP’s) Focus Groups in France

3. We Proposed the following six Questions : • 1 – Try to describe what is happening in this extract and how do the characters behave ? • 2 – What should have occurred before? • 3 – What should occur just afterwards? • 4 – How will the characters be 10 years from now? • 5 – Should this occur in real life? • 6 – Should someone do something concerning that problem?

4. Two Main Questions : • Why do people get addicted? • Should someone do something about it?

5. 12 Items • 1 – GP’s can do something and have to do something 90 lines • 2 – GP’s can do nothing 72 • 3 – The State should vote measures 39 • 4 – Psychiatrists should take care of addicts 36 • 5 – The addict is responsible for his problem 26 • 6 – Specialized centres for addicts must take care of them 17 • 7 – Several professionals should intervene: social workers, organizations… 17 • 8 – Prevention is important 10 • 9 – It is the Casinos fault 6 • 10 – His wife should do something for her alcoholic husband 5 • 11 – Someone should do something 5 • 12 – I don’t know who should… 4

6. 1 - GP’s can do something and have to do something(90 lines) YES, WE CAN! • We have to stay by them, to listen • They suffer and we provide support • We can prescribe substitution treatment • We can send people to hospitals • We can help some to stop drinking

7. 2 - GP’s cannot do anything(72 lines) NO WAY ! • It is no use: there is no medical answer • They do not want to change • It is not our mission • We are not trained for addiction • We need to send addicts to other professionals

8. 3 – The State should vote measures(39 lines) • Laws should protect people • What about Prohibition? • Taxes and rising prices have an impact • Newspapers and internet give encouragments to drink or smoke • Our Training must be improved and our role, reinforced • The Legal System is the answer.

9. 4 – Psychiatrists should take care of addicts(36 lines) • It is their job • Addicts are psychotics

10. 5 – The addict is responsible:it’s no use to try and help him (26 lines)² • They refuse to be helped • They have no will • We cannot motivate them • They do not ask for help

11. 6 – Specialized centres for addicts must take care of them(17 lines) They know how to deal with addicts They choose the addicts they accept

12. 7 – Several Professionals should intervene: Social workers, Organizations… (17 lines) • A multidisciplinary network, together with : • Addicts specialists, the family doctor, the family • The Police, Psychiatrists, GP’s, Dieticians, Associations, Detox Centres…

13. 8 – Prevention is important(10 lines) • Is it possible ? • Is it our mission ?

14. 9 – It is the Casino’s fault(6 lines) • They should forbid access to addict gamblers • Instead of what, they encourage gambling, for profit.

15. 10 – His wife should do something for her alcoholic husband(5 lines) • She abandoned him and it does not help • She accepts his drinking: to be consistent, she should resist and refuse…

16. 11 – Someone should do something(5 lines) • provide some kind of structure • convince • take care • be present • But who ?

17. 12 – I don’t know who should…(4 lines) • I do not have the answer • I don’t know

18. About Physically Abused Women • They are in danger: we have to take care of them • We are responsible to protect them and their children • Social Workers support them

19. Conclusion • French Physicians need Training in Addictology.

20. Merci pour votre attention!27 avril 2010