Abstracts
Résumé
Dans le but d’identifier les pistes d’amélioration requises pour mieux répondre aux besoins des personnes qui présentent à la fois une consommation de substances psychoactives et un traumatisme craniocérébral, une revue narrative concernant les modalités de dépistage, d’évaluation, d’intervention et d’organisation de services a été réalisée. De plus, une consultation menée auprès d’usagers et d’intervenants concernés par la problématique a permis d’identifier les difficultés rencontrées sur le terrain et les pistes d’amélioration souhaitées.
Constats : La présence simultanée des deux problématiques semble multiplier les obstacles au rétablissement. Peu d’études permettent d’identifier un modèle d’intervention précis. Les études répertoriées ciblent, entre autres, les comportements de consommation, l’intégration sociale ou l’engagement en traitement, ce qui rend difficile le cumul de preuves pour une intervention en particulier. Néanmoins, plusieurs directives favorisant une meilleure réponse aux besoins de cette clientèle ont été publiées au cours des dernières années.
Conclusion : À la lumière de ces travaux, des recommandations orientées vers une meilleure sensibilisation de la clientèle et des professionnels exposés à cette double condition, l’adaptation du processus de dépistage, d’évaluation et le traitement des comportements de consommation de cette clientèle ainsi que l’ajustement de l’organisation des services sont proposées.
Mots-clés :
- traumatisme craniocérébral,
- lésion cérébrale,
- consommation,
- troubles d’utilisation de substances psychoactives,
- organisation de services,
- intervention
Abstract
To better meet the needs of people with both psychoactive substance use and traumatic brain injury, a narrative literature review about screening, evaluation, intervention and service organization has been carried out. In addition, consultation with users and stakeholders concerned by the problematic identified the challenges encountered in the field and the desired avenues for improvement.
Findings: The simultaneous presence of the two problems appears to increase barriers to recovery or limit the impacts of the usual treatment or rehabilitation process. Few studies can identify a specific intervention model. Indeed, the studies listed target, among other things, consumer behaviours, social integration or commitment to treatment, which makes it difficult to accumulate evidence for a particular intervention. Nevertheless, several guidelines favouring a better response to the needs of this clientele have been published in recent years.
Conclusion: Recommendations aimed at raising awareness among clients and professionals exposed to this dual condition, promoting adaptation of the screening, evaluation and treatment for substance use of this clientele as well as supporting that adjustment of the organization of services is proposed.
Keywords:
- brain injury,
- psychoactive substances use,
- substances use disorders,
- services organization,
- treatment
Resumen
Con el objetivo de identificar las mejoras necesarias para responder más eficazmente a las necesidades de las personas que presentan simultáneamente un consumo de sustancias psicoactivas y un traumatismo cráneo cerebral, se ha llevado a cabo una revisión narrativa sobre las modalidades de detección, evaluación, intervención y organización de servicios. Además, una consulta realizada entre usuarios y personas intervinientes preocupadas por la problemática permitió identificar las dificultades que se encuentran en el terreno y las pistas de mejoramiento deseadas.
Constataciones: La presencia simultánea de dos problemáticas parece multiplicar los obstáculos para el restablecimiento. Pocos son los estudios que permiten identificar un modelo de intervención precisa. Los que fueron registrados se centran, entre otras cosas, en los comportamientos de consumo, en la integración social o en el compromiso con el tratamiento, lo que hace difícil acumular pruebas para una intervención en particular. Sin embargo, se han publicado en los últimos años numerosas directivas que favorecen respuestas más adecuadas para las necesidades de esta clientela.
Conclusión: A la luz de estos trabajos, se proponen recomendaciones orientadas hacia una mejor sensibilización de la clientela y de los profesionales expuestos a esta doble condición, a la adaptación del proceso de detección, evaluación y tratamiento de los comportamientos de consumo de estas personas y al ajuste de la organización de los servicios que se proponen.
Palabras clave:
- traumatismo cráneo cerebral,
- lesión cerebral,
- consumo,
- problemas de uso de sustancias psicoactivas,
- organización de servicios,
- intervención
Appendices
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