The Clinique du Château de Garches receives patients having difficulties with cannabis for severance and evaluation of the associated psychological troubles.

Cannabis consumption is a public health issue, at the age of 17, 20% of adolescents take cannabis more than 10 times in a year; 15 % take cannabis several times a week.

There are consequently several types of consumers: occasional, regular and addicts.

Schematically, we can define two types of users: on one hand those who have a « normal » social life and for whom cannabis consumption has little or no incidence on social behaviour, and on the other hand, those for whom consumption clearly alters social behaviour and psychic functioning.  Many studies show that repeated used of cannabis may lead to real psychiatric disorders in fragile and pre-disposed subjects.

The consequences of drug addiction depend on the drug, the quantity taken and its quality but also on the user: his personality and his antecedents.

Cannabis may therefore trigger off an acute psychological state with delirium and hallucinations; regular and prolonged usage often leads to a state of indifference, loss of sense of reality and motivation.

Hospitalisation is advised when day treatment is found to be insufficient, or if a break from the environment in which consumption is made is necessary or in the case of a psychiatric accident.

Severance implies medical treatment that takes into account all the psychological problems of the patient globally.

The therapeutic project must be defined prior to admission at the clinic (either by the patient’s psychiatrist or at the time of the pre-admission consultation).  This project includes the hospitalisation objectives plus the care contract between the patient and the medical team. Severance often necessitates putting in place medicinal treatment to attenuate the symptoms generated by complete stoppage of the drug and facilitates abstinence long term.

The objectives of hospitalisation are multiple:

• Complete stoppage of the use of cannabis.
• Psychiatric evaluation during severance in order to spot a possible emerging pathology, eventually requiring setting up specific treatment.
• Getting away from an environment favouring consumption of drugs and allowing formulation of new projects.

The daily discussions with the psychiatrist (7 psychiatrists for 44 patients) and the therapeutic activities (psychomotricity, relaxation, art-therapy, patient meetings on psychiatric pathologies etc.) are directed towards the same objectives thanks to daily concerting between the different parties involved. The patients’ families are informed and involved in the care if the patients so wish.

Hospitalisation is undertaken in coordination with the patient’s psychiatrist if the patient is already under treatment. If this is not the case, the clinic’s doctor may suggest that the patient continues to be followed-up in order to maintain abstinence once discharged from the clinic.