ABSTRACT
Cannabis is the most consumed illicit substance in France, and its use can lead to dependency. Lille university hospital, le Pari association, offers patients wanting to stop using cannabis a support therapy based on positive feedback led by nurses, as well as symptomatic treatment of anxiety and sleep disorders.
Subject(s)
Ambulatory Care , Marijuana Abuse/nursing , Marijuana Abuse/rehabilitation , Substance Withdrawal Syndrome/nursing , Substance Withdrawal Syndrome/rehabilitation , Adult , Anxiety Disorders/nursing , Anxiety Disorders/psychology , Humans , Male , Marijuana Abuse/psychology , Motivation , Nurse-Patient Relations , Reinforcement, Psychology , Sleep Initiation and Maintenance Disorders/nursing , Sleep Initiation and Maintenance Disorders/psychology , Social Support , Substance Withdrawal Syndrome/psychologySubject(s)
Advanced Practice Nursing , Alcoholism/nursing , Behavior, Addictive/nursing , Nurse's Role , Adolescent , Adult , Alcohol Drinking/adverse effects , Alcohol Drinking/ethnology , Alcoholism/rehabilitation , Ambulatory Care/economics , Ambulatory Care/organization & administration , France , Humans , Practice Patterns, Nurses'ABSTRACT
Advanced nursing practices are procedures enabling nurses to carry out, in a structured and predefined manner, tasks usually entrusted to doctors. Introduced in France by the Berland reports of 2003 and 2006, advanced nursing practices remain under-developed in the fields of psychiatry and addictology. In this context, Lille regional and university hospital has set up an outpatient programme for alcohol withdrawal, a scheme coordinated by a nurse, authorised to modifythe treatment dosage according to the patient's clinical state and who is supported by a network of caregivers during the period of medicalised withdrawal.
Subject(s)
Advanced Practice Nursing , Alcoholism/nursing , Alcoholism/rehabilitation , Outpatient Clinics, Hospital , Cooperative Behavior , France , Hospitals, District , Hospitals, University , Humans , Interdisciplinary CommunicationABSTRACT
AIMS: The inversion of melatonin circadian rhythm secretion in some alcoholics during both intake and acute withdrawal has been widely reported. In the same way, what happens to this inversion when these patients are in long-term withdrawal is not known. To document this abnormality in alcoholics after withdrawal we investigated melatonin secretion observed during chronic alcoholization and after withdrawal. METHODS: We measured the urinary 6-sulfatoxymelatonin (6SM) (6SM/creatinine ratio), main metabolite of the hormone, in two fractions, one diurnal and the other nocturnal, in seven alcohol-dependent patients presenting with this abnormality during alcoholization at two times: in acute withdrawal phase (under benzodiazepines) and 15 days after beginning of withdrawal (free of any psychotropic treatment). RESULTS: Our results show that this reversed rhythm of melatonin secretion as seen by the diurnal excretion of 6SM (6SM/creatinine ratio) persists during acute withdrawal in more than half of the patients and is still present 15 days after withdrawal in three patients. CONCLUSION: It is remarkable that the inversion of the melatonin rhythms gets corrected in four out of seven patients after withdrawal. But, the circadian disorganization of melatonin secretion in three patients could underline a desynchronization in some alcoholic patients and may indicate more widespread circadian temporal structure disturbances in these patients.
