Delile Jean-Michel
Comité d'étude et d'information sur les drogues, 24, rue du Parlement Saint-Pierre, 33000 Bordeaux.
Rev Prat. 2005 Jan 15;55(1):51-63.
Cannabis consumption occupies a front place in the field of addictions in France, not only by the levels of consumption but also by the related health harms induced with a growing potentially problematic use of cannabis among young men (14% of those aged 14 to 18 in 2001). Therefore, it is not only an educational problem but also a public health issue. Harmful cannabis use must be systematically researched by history taking on the consumption of tobacco, alcohol and drugs as an integrated part of the patient's social history. The diagnostic of cannabis abuse is made by a clinical evaluation of harmful use, the frequency and quantity of consumption, the search for complications. The practitioner must also evaluate the factors of severity (modalities of consumption and parameters predictive of poor outcome like precocity of first experiences, auto-therapeutic use and the various types of individual and social vulnerability: personality characteristics, psychiatric pathology, family characteristics and social environment). The physician may also be helped by drug screening diagnostic and evaluation instruments like validated autoquestionnaires. Urinary screening can be used especially in public health or forensic medicine fields. Some situational risks must be known while cannabis intoxicated: pregnant women, mentally ill, driving, working. Finally, professionals must know that present situation is very different from what we knew in the seventies and that they have to cope with this fast moving issue.
在法国，大麻消费在成瘾领域占据重要地位，这不仅体现在消费水平上，还体现在随着年轻男性中大麻潜在问题使用的增加所引发的相关健康危害上（2001年，14至18岁人群中有14%使用大麻）。因此，这不仅是一个教育问题，也是一个公共卫生问题。必须通过询问患者烟草、酒精和药物消费情况，将其作为患者社会病史的一个组成部分，系统地研究有害大麻使用情况。大麻滥用的诊断是通过对有害使用情况、消费频率和数量以及并发症的临床评估来进行的。从业者还必须评估严重程度因素（消费方式以及预测不良后果的参数，如首次使用的早熟情况、自我治疗用途以及各种个人和社会脆弱性类型：人格特征、精神病理学、家庭特征和社会环境）。医生也可以借助经过验证的自填式问卷等药物筛查诊断和评估工具。尿液筛查尤其可用于公共卫生或法医学领域。在大麻中毒时，必须了解一些情境风险：孕妇、精神疾病患者、驾驶、工作。最后，专业人员必须知道，当前的情况与我们在七十年代所了解的情况大不相同，他们必须应对这个迅速变化的问题。
