IMAGES CONSORTIUM MEETINGSt Petersburg, April 25-28, 2010

Should someone do something concerning addiction? The French

GP's Answers

Chantal Mougin CNRS – CERMES3-équipe CESAMES,

ParisCentre de Recherche Médecine, Sciences, Santé, Santé

Mentale et Société

Seven General Practitioners’ (GP’s) Focus Groups in France

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

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?

Two Main Questions :

• Why do people get addicted?

• Should someone do something about it?

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

1 - GP’s can do something and have to do something

(90 lines)

YES, WE CAN!We have to stay by them, to listenThey suffer and we provide supportWe can prescribe substitution treatmentWe can send people to hospitalsWe can help some to stop drinking

2 - GP’s cannot do anything

(72 lines)

NO WAY !It is no use: there is no medical answerThey do not want to changeIt is not our missionWe are not trained for addictionWe need to send addicts to other

professionals

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.

It is their job Addicts are psychotics

4 – Psychiatrists

should take care of addicts (36 lines)

5 – The addict is responsible:it’s no use to try and help him

(26 lines)²

They refuse to be helpedThey have no willWe cannot motivate themThey do not ask for help

6 – Specialized centres for addicts

must take care of them(17 lines)

They know how to deal with addictsThey choose the addicts they accept

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…

8 – Prevention is important(10 lines)

Is it possible ? Is it our mission ?

9 – It is the Casino’s fault(6 lines)

•They should forbid access to addict gamblers

• Instead of what, they encourage gambling, for profit.

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…

11 – Someone should do something

(5 lines)

• provide some kind of structure• convince• take care• be present

But who ?

12 – I don’t know who should…

(4 lines)

I do not have the answer I don’t know

About Physically Abused Women

They are in danger: we have to take care of themWe are responsible to protect them and their

children Social Workers support them

Conclusion

French Physicians need Training in Addictology.