2023-10-26 17:04:27
Widely consumed even if risks are proven from the first drink, alcohol remains a taboo subject in medical practices. However, its consumption should be discussed with all patients, health authorities believe.
Substance psychoactive « the most consumed in France », alcohol is also the most taboo. To be convinced of this, one only has to look at the battles between alcohol lobbies and addictologists as soon as a public health action is considered to prevent its devastation, or a criticism is expressed on the representation of this substance. . To take only recent examples, the video showing Emmanuel Macron drinking a “dry” beer on the sidelines of a rugby match shocked addictologists; As for the latest campaign by the Ministry of Health aimed at young people, it aroused heavy mockery while other campaigns aimed at the entire population were canceled shortly before their launch.
However, alcohol deserves to become « a health issue for all »estimates the High Authority for Health (HAS), which is releasing this Thursday a set of tools intended for health professionals, to help them undertake a « systematic, early and regular identification of all » consumers, and not just those whose consumption is considered problematic. « All consumption must be able to be questioned », estimates the HAS. Including, therefore, so-called “lower risk” consumption (maximum 2 glasses per day, not every day).
Paradox
And for good reason: almost everyone drinks and alcohol is considered a product as festive as it is heritage, even though it carries risks for the person drinking as well as for those around them. « whatever the terms of use”, insists the HAS. It is consumed by 87% of those over 18 and 77% of young people aged 17 (nearly half of whom binge drink). This is therefore a risky substance for the individual and for society… but which everyone appreciates. An article published in the magazine Addiction in 2011 clearly illustrated this paradox of our relationship with alcohol: the authors questioned 48 experts on the risks and benefits of several addictive substances. Alcohol was first in terms of harm, both health and social, slightly ahead of heroin but well ahead of tobacco or ecstasy, for example; but it was also well ahead of the substances that the same experts wanted to be able to consume themselves, and to see consumed by their fellow citizens…
Talking about the effects sought in alcohol consumption and the risks associated with its use remains difficult.
Problem, underlines the HAS: in our society, alcohol is everywhere… except in the singular conversation between the caregiver and his patient! « Talking about the effects sought in alcohol consumption and the risks associated with its use remains difficult », estimates the HAS. However, he is « the leading cause of hospitalization, the second cause of preventable mortality after tobacco, the second cause of preventable cancer »its consumption during pregnancy leads to « neurodevelopmental disorders » in 0.5 to 1% of live births, and « he is involved in 30 % of fatal road accidents as well as in 30 % of cases of violence (physical, psychological or sexual) », insist the Sages. And « contrary to popular belief, the majority of harm caused by alcohol affects people who do not suffer from alcohol addiction ». Yet, « many professionals believe that alcohol is only a legitimate issue in the later stages of alcohol use disorder ».
Systematic screening for all
The HAS went a little beyond the referral to the General Directorate of Health, which asked it in 2019 to issue recommendations for the management of « people with consumption beyond the new lower-risk alcohol consumption benchmarks ». Far from focusing on large consumers, HAS is in fact pleading for « systematic, early, regular identification of all uses and support for each person », and publishes a guide intended for all primary care professionals, from the dentist to the medico-social worker including the general practitioner, the pharmacist, the pediatrician… The HAS also reminds that the professional can rely on a whole network of competent partners. This is the advantage of a country that consumes a lot of alcohol: if the network of bars and other drinking establishments is very tight, that of the structures welcoming patients who abuse this product is too!
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