Addictions: equipping professionals in social and medico-social structures

All professionals in the social and medico-social sector must be prepared to support people encountering difficulties related to the consumption of legal or illegal psychoactive substances and/or the use of games (money and chance, video). To this end, the High Authority for Health publishes recommendations to help the professionals of these structures to undertake a process of prevention of addictions and reduction of risks and damages (RdRD). They are available for the disability sector, the elderly, social inclusion and child protection.

HAS has been working for several years on the issue of addictions in establishments and services in the social and medico-social sector (ESSMS). She has already published works for Harm reduction reception and support centers for drug users (Caarud) and Centers for care, support and prevention in addictology (Csapa) with the aim of improving support for people with use disorders regardless of their age, their degree of autonomy or the consumption in question.

In the published recommendations the challenge is to provide guidance to professionals in ESSMS who are not specialized in addictology, who may feel helpless. All of these professionals are – or have been – confronted with the use of psychoactive substances, in particular because the people supported present various risk factors: isolation, precariousness, mistreatment, migratory route, loss of autonomy, etc.

In these recommendations, the HAS details how to undertake an addiction prevention and risk and harm reduction approach within the ESSMS. With one document per sector of activity, this work proposes a common approach – which favors a framework and support for consumption and uses in relation to prohibitions and sanctions – and takes into account the specificities of four specific sectors. These recommendations are broken down into four documents corresponding to the four sectors:

  • The elderly ; support the elderly
  • Handicap ; support people with disabilities by relying on those around them
  • Child protection ; in child protection, preventing the onset of addictive behaviors and supporting young people with drug use disorders
  • Inclusion ; support users in the social inclusion sector by breaking the ban on the consumption of legal products

• Prevention of addictions and reduction of risks and harm (RdRD) in social and medico-social establishments and services (ESSMS) – HAS, 24 January 2023.

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