From the fight against alcoholism to 'addictology': shifting the paradigm gives rise to the 'Addictions Management Policy' in France

摘要

This issue's News and Notes describes an ambitious new strategy to combat addiction in France. It involves a major reorganization to implement a workable hospital pathway dedicated to addictions care with specialized units, departments and a university discipline: 'addictology'. Thus, within 5 years every university hospital should have its own university addictology unit. This new health care organization is a concrete manifestation of a conceptual change which shifted social and medical orientation from 'the fight against alcoholism' to the implementation of addictology in the primary care and hospital settings and at the university level, and to recognize addiction as a disease, and not as a 'vice'. Of course, the majority of harmful use does not correspond in the strict sense of the term with an addiction conceived of as a 'brain disease'. However, the concept of 'early detection and brief intervention' is fully consistent with this model and the shift from a moral model to a medical model is a major step in public health policy. This editorial analyses the historical elements of this change and its implications.