P0178 - How to FACE^© polydrug use: Pathways toward an integrative structured care model to facilitate adjustment of cognitions and emotions

Abstract

Background:

Recent developments in the field of polydrug use along with alcoholism provide growing insights into how cognitive, affective, motivational and neurobiological pathways are altered in addictive persons. Few of these insights have as yet been implemented in everyday care.

Aim and Method:

Framed within the multi-site FACE© program (Facilitating Adjustment of Cognitions and Emotions), this paper presents an integrative scientist-practitioner model that aims to translate the above insights into systematized multidisciplinary practice. The pathways from model to structured care are specified using a mixed-method design of bottom-up and top-down approach. Their practice implementation over a three month course is illustrated with case series data in the context of an open-access, first-line addiction centre in the suburban Paris region.

Results:

In as few as seven weeks, dramatic therapeutic improvements come forward. All polydrug patients referred due to long-term treatment refusal, are found to comply with the structured scientist-practitioner model approach. Multidisciplinary practitioner-observed benefits include increased or first-time therapy adherence and drug treatment compliance. Patient self-reported benefits moreover include increased addiction insight and mastery, along with enhanced cognitive-emotional regulation to gain control over addictive craving versus pleasure-seeking behaviours.

Conclusions:

Applying an integrative model that focuses on the cognitive–emotional dynamics at hand in the addictive course with the polydrug using patient, and rigorously implementing related assessment and therapeutic methods manifestly bears immediate and middle-term benefits. Evaluation of longer term benefits is recommended, along with larger scale quantitative outcome analyses. Further research and practice implications are discussed to this respect.