[What's new in addiction medicine in 2021 ?] / Addictions.

Addiction medicine is influenced by societal changes and the environment has an impact on addictive behaviors and how they are experienced. The COVID-19 pandemic has had an impact on addictive behaviors, some of which could be favorable, and others highlight vulnerabilities to be considered by clinicians. Recent legislative changes open possibilities to limit the negative impact of electronic lotteries. In a context favorable to a better acceptance of people of LGBTQIA+ diversity, research and training in addiction medicine also have a role to play. In view of advances in understanding the harmful effects of alcohol, it is necessary to adapt the perception of the risk, in order not to provoke the incomprehension in the population.

La médecine des addictions est liée aux enjeux sociétaux actuels, et l'environnement joue un rôle important sur les comportements addictifs et comment ils sont vécus. La pandémie de Covid-19 a eu un impact sur les comportements addictifs, dont certains pourraient être positifs et d'autres mettent en lumière des vulnérabilités à prendre en compte en clinique. Les récents changements législatifs ouvrent des possibilités pour limiter l'impact négatif des loteries électroniques. Dans le contexte favorable à une meilleure acceptation des personnes issues de la diversité LGBTQIA+ (lesbienne, gay, bisexuel·le, transgenre, queer, intersexe et asexuel·le ou aromantique), la recherche et la formation en médecine des addictions ont aussi un rôle à jouer. Au vu des avancées dans la connaissance des effets nocifs de l'alcool, il est nécessaire d'adapter la perception du risque, afin de ne pas susciter l'incompréhension de la population.

A New Swiss Federal Act on Gambling: From Missed Opportunities towards a Public Health Approach?

In January 2019, a new Swiss Federal Act on Gambling (Loi federal de jeux d'argent: LJAr) entered into force following a vote by the Swiss electorate. Intended to modernize and harmonize previous law and open the market for online casinos; the new regulations have highlighted the need for a comprehensive monitoring system. The present article outlines work undertaken by experts within the field to identify and elaborate the first steps towards developing such a monitoring system. This work includes the mapping of institutional actors and draft conceptualization of an impact model, including structural (i.e., prevention and intervention-based components), process (means), and outcomes (effect) indicators. Initial estimations of effective access to indicators and their perceived priority for data gathering are also described. Subsequent steps necessary for implementation of this public health approach for gambling are considered including grey areas for future action.

Gambling and problem gambling in Switzerland.

AIMS: To provide an overview of gambling and problem gambling in Switzerland, including historical aspects, past and current legislation and policies, treatment options and the research base. METHODS: A literature search was conducted on two databases (PubMed and PsycINFO), and official government and statistical reports selected from the official websites of four sources (Federal Office of Justice; Federal Gambling Board; Federal Office of Statistics; Swiss Lottery and Betting Board). RESULTS: After a history of banning or partial banning, Swiss gambling became regulated at the beginning of the 20th century through successive laws. The current system is characterized by important differences in the law and policies for casinos and lotteries, and contradictions in the regulation of these two areas are still under debate in order to develop new legislation. Gambling is widespread in Switzerland, and the prevalence of problem gambling in this country was comparable to that in other European countries in 2014. Most gambling treatment facilities are integrated into mental health treatment services that have out-patient programmes, and treatment for problem gambling is covered by a universal compulsory Swiss health insurance system. The availability of public funding for gambling research is still limited. CONCLUSIONS: Switzerland needs to develop a more coherent regulatory and prevention policy approach to gambling, overcoming conflicts in the current dual system of federal and cantonal regulation. Recent efforts to enhance funding for gambling research are promising, and could lead to a more systematic analysis of the efficacy of prevention and treatment programmes.