Identification of Psychoactive Substance Users in Young Adults (16 to 25 Years Old) Visiting the Emergency Department
Condition: Psychiatric Emergency; Drug Use
MeSH terms: Emergencies
Study type: Observational

Summary: 
      Adolescence is a time for great physical and psychological change and it's often at that
      period of life that first use of psychoactive substances occurs. Although addiction is rare
      in teenagers, psychoactive substances abuse can have serious long-term health consequences on
      them. This is therefore a priority for all healthcare providers to identify early use and
      abuse of drugs in the youth's population.

      The addictive process underlies environmental, genetic and individual causes. That is why it
      is somehow possible to identify individuals at risk based on some common sociological,
      cultural and environmental risk factors.

      Due to the acute consequences of psychoactive substances abuses, Emergency Departments are
      main checkpoints for the screening of young drug users. Indeed, one patient out of five
      admitted in an Emergency Department shows a positive blood alcohol concentration regardless
      of the reason for their admission. This rate is twice as high as in the overall population.
      Hence, Emergency Departments are at the front-line for screening, caring, referral and
      transfer of psychoactive substances users. That is why the Emergency Department is the best
      place for this study.

      In 2004, the special consultations of young consumers were founded in order to deal with
      these special cases where dependence is not yet established or installed and care has to be
      adapted to the age. Offering help to this age range represents a real challenge since only
      20% of the teenagers come to visit this special consultations on their own initiative. The
      rest of teenagers are either obliged by their parents or sentenced by a court. The
      investigators assume that the repetition of care offered to the teenagers by repeated
      emergency admissions could trigger their own desire to overcome their drug use disorders and
      visit the Addictionology Department.
    


Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Young people aged 16-25 inclusive, admitted to the Medical and Psychiatric Emergency
        Department (Building N) of the Edouard Herriot Hospital.
      
Biospecimen description: 
      Urinary strips will determine the recent consumptions (from a few days to a few weeks
      according to the products) of seven psychoactive substances (alcohol, tobacco, cannabis,
      ecstasy, amphetamines, cocaine, morphinics). The detection of some substances in urine works
      via measurement of the decomposition products from metabolism: cotinine for tobacco, ethyl
      glucuronide for alcohol, benzoylecgonine for cocaine. Regarding ecstasy, amphetamines,
      cannabis and morphinics, the detection is done directly in urines. There are seven reading
      windows (one for each substance) on the Drug Screen: if a colored strip appears in the
      reading window it means that the detection is negative, otherwise if there is no strip it is
      considered as positive