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Through the Mirror… Considerations Concerning the Pertinence of Structural Diagnosis for Young Drug Addicts
What is the object of the desperate quest of drug addicts? Olievenstein (1983) distinguishes the “real drug addict” from the one who has become a regular user by fortuitous events. According to the author, the “real drug addict’s” split traces back to the stage of the mirror where he had the opportunity to grasp a unified reflexion of himself; afterwards, the mirror broke. Later, the person desperately tries to gain back this feeling of a full existence, and it is the drug, which allows him to temporarily close this hole. Olievenstein’s conception is analysed through the description of four young drug addicts’ evolution, and the theoretical question of the significance of the drug for the drug addict is discussed. The discussion is also fed with some data taken from a retrospective study based on drug-dependent prisoners’ records. By means of a correlational and multidimensional analysis, the possibility to distinguish two profiles of functioning, based on the metaphorical versus the metonymic prevalence in the TAT, is tested. Consequences for psychotherapy are drawn from these considerations.
This qualitative study examined women assuming leadership roles in Oxford Houses, which are communal, democratically run recovery settings for substance use disorder. Semi-structured interviews were conducted with 10 women Oxford House leaders who shared their thoughts and experiences on leadership. Several themes emerged from qualitative data analysis, most notably that stepping up and accepting a leadership role in Oxford House had a positive effect on self-esteem, which is vital to women with a history of substance abuse. Barriers to leadership were also identified such as negative interpersonal relationships with other women. A number of methods mentioned to increase the number of women leaders included: developing workshops, providing positive encouragement, and accessing existing female role models. The implications of this study are discussed.
Sexual Behaviours and Condom Use in a Sample of Brazilian Crack Cocaine Smokers
Crack cocaine smokers exhibit high levels of risky sexual behaviours. The current study examined a cohort of Brazilian crack cocaine smokers (n=304) admitted to an addiction inpatient care unit, assessing the reasons for risky sexual behaviours and their non-use of condom. Using a drug abuse screening test (DAST) and semi-structured questionnaires to collect socio-demographic data and sexual behaviour characteristics, the study showed that nearly half of the sample, mostly men, never used condoms or used condoms inconsistently. The main reasons for not using condoms included steady partner, disruption of sensitivity, and too much sexual arousal. Gender was the most important variable for discriminating non-use of condoms. In men, the number of partners and race were predictors of condom use. In both genders, more severe dependence was associated with higher rates of non-use of condoms and sexual activity in the last 12 months. Condom use is an important issue for the development and implementation ofgender-targeted, culturally appropriate interventions to promote condom use in crack cocaine smokers.
On The Essence of Drunkenness and the Pathway to Addiction: A Phenomenological Contribution
This essay aims to examine the essence of drunkenness in its temporal and spatial dimensions. Despite the interest shown by phenomenological literature in the study of psychopathological consequences of acute and chronic drunkenness, the essential characteristics of drunkenness have not yet been addressed in depth. This essay claims that the temporal essence of drunkenness is the overwhelming, disintegrator of temporality’s condition, which converges to its own extinction in a temporality, thus encompassing a distinct ability of assimilatory magnetization of the temporal dimensions. From the spatial standpoint, the essential manifestation of the condition of drunkenness is increased materiality, expressed by means of compression and exclusivity. At last, we show how the essence of drunkenness gradually leads to instability and decrease in the consciousness’ ability of temporalization, which are both typical of a general condition of addiction.
Use of Dexmedetomidine for the Management of Excited Delirium in a Polysubstance Dependence Trauma Patient
Management of acute delirium in patients with polysubstance dependence remains a challenge due to the overlap in symptoms between the delirium and the withdrawal syndromes from multiple agents. We describe a recent case of a trauma patient after a motor vehicle accident with polysubstance dependence including opioids, benzodiazepines and cocaine. The patient developed acute agitated delirium, requiring mechanical ventilation for respiratory insufficency. His delirium was treated with haloperidol and lorazepam, but to facilitate rapid control and possible prevention of a withdrawal syndrome we used dexmedetomidine in the acute phase. The early use of dexmedetomidine may facilitate a safe and effective treatment modality in agitated delirium as well as a possible preventive measure in controlling any severe withdrawal syndrome.