2023-12-15 11:58:01
In the “Patient Support” section, the Galien Prize jury awarded its “favorite” to the Fluid-crack-psy project, dedicated to crack users and led by Professor Florence Vorspan, head of the Ambulatory Addictology unit from the Fernand-Vidal hospital in Paris. Fluid-crack-psy brings together expertise, a capacity for projection and support for entry and maintenance in the care of users with psychiatric pathologies.
Screening, diagnosis, orientation and support network in the psychiatric care of crack users to streamline their journey, Fluid-crack-psy (AP-HP, GHU Nord, Fernand-Widal Hospital, department of psychiatry and addictological medicine), wins the “favorite” of the Galien 2023 prize (“Patient support” section).
The population of crack users has doubled in France over the last ten years. It is estimated today at 43,000, including 13,000 in Paris and its close suburbs. This results in an increase in open scenes of consumption in transport and public spaces, in the influence of drug dealers and in concern for local residents. For crack users, dependence poses a major health problem, exposing them to the risk of overdoses, but also induced psychiatric symptoms. Strong dependence, social disaffiliation, psychiatric symptoms: all these factors combine to make it difficult for these patients to organize themselves with traditional psychiatric and addictological follow-up, justifying specific support.
In this context, the objectives of the Fluid-crack-psy program are:
– to reach out to patients, in particular those furthest from care and the front-line teams who meet them;
– to provide diagnostic and therapeutic expertise;
– to initiate appropriate treatments for psychiatric pathologies;
– to make the link between medico-social and psychiatric monitoring structures.
– to support and retain patients to avoid interruptions in care.
– to support medico-social and psychiatric structures in the reception and specificities of these complex patients.
Made up of a psychiatrist, an educator, a social worker, an advanced practice nurse, a case manager and a general practitioner who is an addictologist, the team also relies on the expertise of the hospital, which includes an addiction care, support and prevention center (Csapa) and carries out hospital withdrawals.
After a year of operation, the network made it possible to meet and begin active treatment for 68 patients, with, for some, real changes in trajectory, while an end of follow-up was noted for 38 other people ( 24 lost to follow-up, 3 deaths, 8 relays, 5 departures from Paris). The patient profile confirms the extreme complexity of the cases and the difficulty of maintaining them in care. The benefits observed for patients seem relevant, because they would not have been able to access care without the Fluid-crack-psy team. This has enabled a reduction in patient suffering and, for some, real changes in trajectory with lasting integration into care.
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