In the past few years, there has been a considerable amount of evidence that cannabis use can cause structural and functional brain abnormalities.Structural imaging studies of cannabis users have revealed reduced prefrontal cortex volumes and white matter damage that may be involved with impulsivity.Objectives: To Determine the level of dependence on cannabis among cannabis users consulting the detoxification center of Sfax, Tunisia To assess in addition the impact of cannabis on impulsivity and motor control.

This is a cross-sectional, descriptive and analytical study that was conducted over a period of 13 months between September 15, 2020 and October 1, 2021 among cannabis users consulting the detoxification center of Sfax, Tunisia.A short form of the Barratt Impulsiveness Scale (the BIS-15) and a Cannabis Abuse Screening Test (CAST) were used to assess impulsivity and to determine cannabis abuse.Results: Thirty Eight cannabis users agreed to participate in this study. The distribution of CAST scores showed that 36 users (94.7%) had problematic cannabis use at the time of the study. The mean BIS 15 score was 38.2. In our sample, The level of impulsivity was highest in people with a high level of cannabis dependence. A higher level of impulsivity was found in younger subjects. However, a greater level of impulsivity was found in subjects with a lower socio-economic level. Concerning employment status, unemployment was significantly correlated with a higher level of impulsivity.

Impulsivity is often associated with a variety of problematic behaviors such as aggressive behavior, smoking, drug abuse, pathological gambling or compulsive buying.

A higher frequency of cannabis use and earlier age of onset use have been shown to be associated with the highest rates of impulsivity.

Therefore, cannabis addiction represents a real public health problem, both because of the serious complications and heavy repercussions that it causes.

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In recent years, there has been a rise in misuse of low-cost prescription pills across Middle Eastern and North African (MENA) countries. In Algeria, Tunisia and Morocco, for example, the consumption of prescription medications has dramatically increased, particularly amongst young and marginalized groups. Drugs such as clonazepam and pregabalin are extremely popular in these regions, as they are relatively inexpensive and perceived as safe. With the migration of MENA citizens to Europe, it is likely that mental health services will come across substance use disorders related to these medications.

The authors aim to analyse prescription medication misuse reports from MENA countries, specifically pregabalin and clonazepam, and review the pharmacological, neurobiological and social factors that contribute to their potential for abuse.

Narrative review of articles referenced on PubMed and Google Scholar.

Pregabalin and clonazepam are widely used in psychiatry and neurology. Pregabalin is an alpha 2 omega ligand with supposed GABA-mimetic properties. Anecdotal reports suggest that pregabalin, used recreationally in amounts up to 3-20 times the therapeutic doses, possesses both sedative and psychedelic effects. Experimenters are mainly individuals with a history of recreational polydrug use, who are aware that pregabalin is not included in standard drug monitoring tests, with this molecule being used in some instances as a legal substitute of common illegal drugs. Clonazepam is a benzodiazepine that combines high potency and a long duration of action and is said to cause euphoria at doses over 8mg. It is very popular and affordable, placing consistently in the top three of benzodiazepines sales across the globe. Clonazepam has potential for tolerance build up and severe withdrawal symptoms. These medications are frequently used together and in combination with other substances such as alcohol and opiates, increasing the risk for respiratory failure and death.

Prescription medications such as pregabalin and clonazepam are extremely accessible, inexpensive and highly addictive substances, whose abuse is well disseminated across MENA countries. With migratory flows from this region, the prevalence of misuse of these drugs in Europe is expected to increase. Therefore, physicians should be aware of their potential for abuse and carefully evaluate patients’ previous history before prescribing these medications.

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Obsessive-compulsive disorder (OCD) is characterised by intrusive thoughts and repetitive behaviours that considerably impact general functioning. Recent evidence links the endocannabinoid system to OCD neurobiology, and several case reports describe significant improvement after using dronabinol (synthetic tetrahydrocannabinol) in patients with severe OCD. Nevertheless, to what extent this new information can change our perspective on pharmacological treatment in OCD is unclear.

We present the case of a patient with obsessive-compulsive symptoms triggered after increased long-term cannabis use. Our purpose is to emphasise the necessity of continuous research and a better understanding of the correlation between OCD and cannabis derivates before formulating treatment recommendations.

We used psychiatric assessments to evaluate the patient’s symptoms and evolution over time and exclude other possible causes that could have triggered the disorder.

Our patient is a 37-year-old man who has been frequently brought to the hospital by the police in the last 11 years for psycho-motor agitation after cannabis use. This year, he came to the hospital by himself, complaining about intrusive thoughts that required motor and mental repetitions to reduce anxiety. His obsessions were mainly about the need for symmetry and exactness and his checking compulsions about his mother’s health. The symptoms required more than half a day and caused functional impairment. A detailed history did not outline any obsessive-compulsive symptoms before the previous year. The patient denies using new drugs, and we did not identify other medical conditions that could better explain the symptoms. However, he admits to increasing the doses and frequency of cannabis use during the last year. After two weeks of cannabis abstinence and Sertraline treatment, his symptomatology improved significantly, with a reduction of more than 50% in the time spent daily on mental and motor compulsions, reduced anxiety, and a noticeable increase in overall functionality. In addition, the Yale-Brown Obsessive Compulsive Scale result decreased from 35 on the first day to 17 on discharge.

Recent studies support the use of cannabis derivates for treating OCD symptoms. However, this case report outlines that prolonged cannabis use could also trigger OCD. Therefore, further studies are necessary to identify not only the potential benefits but also the potential risks of using cannabinoids as a pharmacological intervention.

Nicolini H et.al.CannabisUseInPeopleWithOC.FrontPsychiatry.2021May10; 12:664228.doi:10.3389/fpsyt.2021.664228.PMID:34040556;PMCID:PMC8141625

KayserR.R. et.al.TheEndocannabinoidSystem:ANewTreatmentTargetforOCD? CannabisandCannabinoidResearch.Jun2019.7787.doi10.1089/can.2018.0049

GoodmanWK et.al.1989.YBOCS:Archives of General Psychiatry,1006–1011.doi10.1001/archpsyc.1989.01810110048007

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What defines any addiction, including alcohol dependence? Other than the accepted definitions from WHO, ICD or DSM, addiction is characterized by constant returns to alcohol consumption. Whether called relapse or lapse (slip), the truth is that patients - once abstinence is initiated - return to drinking in a matter of months (50% within 3 months, 65% within 6 months and 80% within 1 year). So why are we looking for total abstinence when treating patients with alcohol dependence, when the results are so poor? Should we look at this complex and intricated problem with monochrome lenses? Black or white? Couldn’t a more moderate approach present with better results? I think that a more reasonable response to this problem could be controlled drinking. Not just as an intermediate goal when seeking life long abstinence, but as a stand-alone indication, as an ultimate treatment goal. Are we looking to get healthy patients, with good social lives and satisfying quality of lives patients or are we just looking to obtain abstinence? Sure, alcohol should be forbidden to those with severe co-morbidities related to alcohol consumption (who could only worsen) should the consumption persist, but should all patients fall under the same category? Should total lifetime abstinence and relapse prevention remain the gold standard when treating this burden, even with emerging pharmacotherapy? Although additional pharmacotherapy for alcohol dependence exists, physicians may be reluctant to prescribe them, therefore they are severely underutilized. We should break barriers and rethink the way we treat this pathology, from medication to end-goals.

Raise awareness in the way we currently treat alcohol dependence among physicians, showing that a more considerate and moderate approach could be more beneficial, rather than a lifetime abstinence goal.

Relevant papers were selected for review from literature, from both sides of the treatment approach spectrum

Although controlled drinking is accepted by a wide selection of physicians specializing in alcohol dependency treatment and studies have shown that pharmacotherapy for alcohol dependence works, current treatment guidelines (including EMA) still recommend total abstinence as an ultimate goal.

The presentation is not intended to draw definitive conclusions, just raise awareness regarding the way we view and treat alcohol dependence.

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Poly use of psychoactive substances (tobacco, alcohol and cannabis) is a major health issue, especially among younger children, mainly adolescents and students. The prevalence of addictive behaviour in Tunisia is clearly increasing. This development attracts the attention of the scholarly society from the point of view of the effects and consequences on the short or long term. Since this is still a taboo subject given the socio-cultural and religious constraints, there are still difficulties in conducting epidemiological investigations on this subject.

In this context, we conducted this study with the Tunisian student population during the academic year 2020/2021. The objectives of this work were: To determine the prevalence of the use of the three psychoactive substances (tobacco, alcohol and cannabis) and to evaluate school performance as associated factors of substance use.

We proceeded to a descriptive and analytical cross-sectional study conducted with a sample of the Tunisian student population during the 2020/2021 academic year (from November 2020 to February 2021).

We included in the analysis 772 students. The average age of the study population was 23.29 3.25. Alcohol was the most reported substance in 35.8% of participants. The prevalence of tobacco use was 32.1% and that of cannabis use was 14.4%. Academic achievement was assessed by the notion of repetition, from which we noted that 81.3% of respondents did not experience repetition. Repetition was statistically significantly associated with the use of all three substances (p < 10-3). The concept of repetition increased the risk of smoking by 2.616 (95% IC95 [1,724-3,969]). The concept of repetition increased the risk of consumption by 2.33 (IC95%[1,522-3,578]). The notion of repetition multiplies the risk of cannabis use by 2,250 (IC95%[1,369-3,699]).

The relationship between the use of psychoactive substances and low academic performance has been explained from different medical and psychological perspectives. It is crucial to recommend the development of support cells in academic institutions as well as to strengthen psychological management especially for people who have experienced a drop in school because they would be people at risk of developing a substance use.

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Psychotropic drugs are sometimes taken outside of any medical context and can be diverted or even trafficked. This phenomenon affects more adolescents and young adults, more specifically those who are already struggling with other consumption problems. This vulnerable population is thus exposed to several negative health and social repercussions.

The objective of our work is to determine the sociodemographic characteristics of the patients, the main drugs used, the dose, the route of administration, the mode of obtaining the drug and the intentionality of the use.

It is a retrospective study spread over 1 year on a series of patients who were hospitalized in the service of addictology at the psychiatric hospital Ar-razi of Salé. The data collection was carried out from the medical files and an exploitation form.

A total of 141 patients were hospitalized during this period of which 53 37.5 had a diverted use of medication. Our sample is characterized by a predominance of female patients (90%) with a median age of 33 years. The most misused drugs were benzodiazepines (85.7%), analgesics (11.7%), hypnotics (9.4%) and antihistamines (1.9%). Misuse is related to exceeding doses (up to 40 times the maximum dose of the AMM) and duration of treatment, to use or obtaining drugs without a prescription 79.2 , to the route of administration and to drug addiction. 11.3 of patients were dependent on a single drug; 88.7% of patients had a co-addiction: tobacco 86.8%, cannabis 77.3%, alcohol 58.5%, cocaine 34.5%, solvents 15 , heroin 1.8% or a history of addiction. Hospitalization was only related to drug misuse in 11.3% of cases. The effects sought: anxiolysis 58.5%, euphoria 30.2%, analgesic 5.7%, disinhibition 3.8%, increased performance 1.9%

The misuse of psychotropic drugs is a well-known public health problem. However, this phenomenon remains unknown and neglected in Morocco.

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Addiction is a chronic disorder resulting in physical, psychological, and/or social harm following the repetitive, compulsive consumption of a substance. In Morocco, there are few data on female addictive behavior, apart from those concerning the prevalence of consumption of products based on surveys of the general population.

Report the current epidemiological, clinical, and therapeutic peculiarities of female addiction according to a heuristic approach (based on proven scientific evidence).

A questionnaire was distributed to patients followed at the addiction center in Tetouane and the Ar-razi psychiatric hospital in Tangier. We also carried out a systematic review of the literature, focusing on about ten articles. The main search engines are PubMed, Medline, Science Direct.

The substance use disorder concerns cannabis in 68% of cases, tobacco in 52.1% of cases, alcohol in 40.33% of cases, benzodiazepines in 33.61%, cocaine in 15.96%, opioids (7.5%), and inhalants (1.6%). 73.8% of residents have psychiatric comorbidities, of which 42.9% suffer from depression, 13.40% from bipolar disorder, 10% from generalized anxiety disorder, 4, 20% have panic disorder, 1.7% have social anxiety, 0.8% have post traumatic stress syndrome and 0.8% have bulimia. 58.8% of patients had a personality disorder, 36.1% attempted suicide, 16% suffered physical violence, and 20.20% of patients were victims of rape.

International literature shows the growing interest in gender issues in the field of addictions (whether they involve the consumption of legal or illegal products or behaviors such as gambling, food, purchases, sexuality, etc.), apart from those concerning the prevalence of consumption of general population survey products, shows the growing interest in gender issues in the field of addictions. This problem has been recognized as being of crucial importance and has been posed as a priority objective

Minimum levels of consumption among women tend to obscure the impact of gender relations on female addicts. Through this research, we hope to identify the differences between male and female addictions. The overdetermination of certain forms of psychiatric suffering and/or certain living conditions makes women more vulnerable to the problematic use of psychotropic drugs. On the other hand, women have to gain from being able to benefit from specific responses within the framework of front-line or support and care systems.

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Alcohol use disorder is a real public health problem in the world, it consists of a pathological mode of consumption which is characterized by a loss of control and craving. Depressive disorder and alcohol use disorder are among the most frequent mental pathologies and are often associated.

The links between these two disorders can be of several types: Alcohol Induced Depressive Disorders, Primary Depressive Disorders and Secondary Alcohol Dependence. They can also have two-way relationships or be favored by common factors.

The objective of our work is to analyze the causal links between alcohol use disorder and depression.

provide an update via two clinical vignettes and a review of the literature the relationship between alcohol use disorder and depression

The causal relationships between alcohol dependence and psychiatric disorders can be of several types which are not mutually exclusive: primary alcohol dependence, secondary psychiatric disorders, induced by alcohol. This is the case for the majority of depressive disorders encountered in alcohol-dependent patients; primary psychiatric disorders and secondary alcohol dependence; alcohol dependence and anxiety and/or depressive disorders are favored by common factors, in particular personality disorders, encountered in approximately 40% of alcohol-dependent patients. Whatever the direction of causation, alcohol dependence and psychiatric disorders worsen each other over time.Depression and alcohol use disorder are among the most frequent mental pathologies and are often associated.The optimal management of patients with dual diagnosis is so-called “integrated” management, simultaneously combining alcohol and psychiatric therapeutic approaches.

Alcohol consumption impairs the prognosis of depression, increases the risk of suicide, impairs social functioning and increases recourse to the healthcare system.The optimal management of patients with dual diagnosis is so-called “integrated” management. Psychotherapeutic (individual and systemic), drug and psychosocial approaches would be necessary to maximize therapeutic success.

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Cannabis is an illicit substance whose use is very common among the patients we see daily in hospitals. Its use is not simply a “recreational” desire, but above all an attempt at self-medication in order to manage emotions that have become too painful. However, even if cannabis reduces the symptomatology in the moment, it worsens most psychiatric pathologies.

The purpose of this study is to assess the experiences of cannabis users’ families.

The survey was carried out among the families of patients hospitalized at the Arrazi Hospital in Salé and those followed in consultation and who use cannabis. The collection of information is done with the help of an exploitation form.

34.6% of the participating families put bad company as the cause of consumption, followed by family problems, psychiatric problems come in 3rd position with a percentage of 19.2%. Cannabis use is considered as a disease in 52.8% of the families participating in the study. 58.5% of the families distinguish between good and bad cannabis use and define bad use by the use of large quantities of cannabis in 34.2% of the cases. The majority of the participating families (86.8%) saw cannabis as aggravating their loved one’s mental illness.

The understanding of the perceptions of the families towards the use of cannabis by their close relatives as well as the correction of the false perceptions will help to establish better prevention programs and better patient care especially with the family therapy which showed its utility in the management of the patients having disorders related to the use of cannabis.

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Montenegro is a country in Southeastern Europe. Podgorica, the capital and largest city covers 30 % of its total population of 621 000 and around 80 % of patients enrolled in buprenorphine treatment.

Buprenorphine was registered in Montenegro in May 2017.

Buprenorphine is an opioid partial agonist. It’s a safe and an effective option for the treatment of opioid addiction. Buprenorphine may be abusable. Its abuse potential, however, is lower in comparison with that of opioid full agonists.

Benefits of buprenorphine treatment:

Suppress symptoms of opioid withdrawal. Reduce illicit opioid use. Help patients stay in treatment.

Buprenorphine maintenance keeps the person stable while they make positive changes in their lives.

Health problems are reduced or avoided, especially those related to injecting, such as HIV, hepatitis B and hepatitis C viruses, skin infections and vein problems.

Crime behavior reduction

Clinical study.

We followed the patients who were enrolled in the buprenorphine substitution treatment for a period of five years, to be more precise in the period from May 2017 August 2022.

In May of 2017 only 33 patients were enrolled in program, the number of patients were gradually increased to 193 patients in December of 2017. Until the December of 2018 the number of patients was increased to 203. In December of 2019 numbers of patients were increased to 291. At the end of 2020 numbers of patients were 348. In December of 2021 numbers of patients were increased to384 and in August of 2022 numbers of patient were 426.

Health problems are reduced or avoided.

Crime behavior was reduced for 65% over five year’s period.

A total of 124 new cases of HCV infection were discovered from the beginning of study to the end of July of 2022.

Doses are required only once a day.

For most adults with opioid use disorder, maintenance therapy with buprenorphine is the most effective treatment approach.

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In mental health settings, there is no place more social than where people smoke tobacco, patients and healthcare professionals alike much as many social activities in other settings even nowadays.

Yet mental illness is associated with higher levels of social anxiety. Those who suffer are doing their coping and may appear to be doing better than the others but in fact may need special attention for smoking cessation because they are still smoking more than other patient populations.

To reflect on tobacco smoking and social anxiety.

Pubmed search using terms: tobacco and smoking and social anxiety/ social anxiety disorder

Social anxiety:

1. 1. Is associated with higher smoking initiation and progression to dependence

2. 2. is more frequent in smokers

3. 3. is used as a coping mechanism for distress caused by social interactions and may alleviate negative affect and thus serve as negative reinforcement

4. 4. may be associated with higher nicotine dependence

5. 5. has not been definitely associated with heavier smoking

6. 6. may differ in its effects according to gender

7. 7. may be associated with less quit attempts

8. 8. may hinder success in quitting smoking and may be associated with higher rates of relapse

Identifying and treating social anxiety may lead to better outcomes in smoking cessation in a sub-group of patients who present elevated social anxiety with or without social anxiety disorder.

Patients with mental illness, especially serious mental illness, will likely present with higher levels of social anxiety which may represent a significant factor contributing to an increased difficulty in quitting tobacco smoking in this patient population.

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The intentional use of drugs before or during sexual intercourse (chemsex) is a phenomenon of special importance in the MSM (men who have sex with men) population due to its impact on mental, physical and sexual health. Sexual health issues related to chemsex practice have been described such as difficulties in achieving sober sex, erectile dysfunction or problems with sexual desire.Objectives: The objective of this study was to understand the sexual motivations for chemsex practice o a group participantes of a sexual health program for chemsex users in two Drug Substace Use Disorder Clinics in Madrid.

Qualitative research approach. We analyze an anonymous survey with chemsex users with open answer questions about the motivations for chemsex practice. Data analysis was based on thematic analysis of content.

Different qualitative studies have examined the motivations for engaging in chemsex. The participants identified two main raisons: pleasure and losing inhibitions. We analyed the inhibitions described by participants: difficulties with arousal, ejaculation, social interaction in sexual context, difficulties in situations that require intimacy, sexual practices that make them feel guilt/shame (for example BDSM) problems with “erotic” self-esteem: rejection of non-normative bodies or towards non- normative gender expression perceived as undesirable.

Understanding the sexual motivations for engaging in chemsex seems necessary to develop and multidisciplinary approach. Mental health proffesionals should consider sexual counselling and sexual therapy for chemsex users in their treatment.

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The emergence of new psychoactive substances (NPS) has had a substantial impact worldwide. NPS mimic the effect of “existing” drugs and are specifically manufactured so that the new substances fall out of regulatory frameworks. Although the structural changes might be minimal, NPS often have marked differences in potency and subsequent harm.

The population of the Azores archipelago has been particularly affected by the rapid growing and changing nature of this phenomenon, mainly caused by the introduction and spread of the “newly” synthetic cathinones as a inexpensive and easily available street drug.

Before any educational, public health and socioeconomic policy changes be proposed to accurately tackle the problem, the basic step of knowing how these substances have been affecting their users, specially their neuropsychiatric effects, must be taken.

This project aims to characterize the neuropsychiatric side effects caused by the acute intoxication of NPS with a psychostimulant profile, namely synthetic cathinones.

Description of the neuropsychiatric symptoms of intoxicated users of stimulant NPS that present to non-governmental organizations specialized in addictions and also to the psychiatry emergency department in Sao Miguel - Azores.

Review of the forensic records of the deaths by suicide in 2021 in Sao Miguel, looking for evidence of recent abuse of NPS or previous history of “NPS use disorder”.

Non-systematic review of the recent and relevant scientific literature on this topic.

The desired effects are increased energy, mood enhancement, euphoria, mental clarity, improved concentration, improved sociability, increased talkativeness, empathy inducing effects, amplification of sound and colour and prosexual effects. Nevertheless, in the case of intoxication, the frequent neuropsychiatric side effects tend to be agitation, agressiveness, irritability, altered consciousness, brief psychosis with paranoid delusion, visual and auditive hallucinations, transient mania, enhanced sensorial experiences, headaches, dizzyness, seizures, confusion and amnesia. Usually, the acjute intoxication period tend to be followed by a “crash” with depression, craving, anxiety, panic, suicidal ideation and behaviours. A third of the deaths by suicides in Sao Miguel Island in 2021, 7 out of 21, were in stimulant NPS active or recent users.

Review of the neuropsychiatric effects of New Psychoactive Substances with a psychostimulant profile. Further studies of this population of synthetic cathinone users in the Azores are due, namely studying their socioeconomic background, looking for risk and protective factors, and also the long-term side effects.

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Addiction Liaison Pychiatric Units are frequently requested by other medical services due to the high prevalence of medical pathologies in substance use disorders. We intend to know patient’s characteristics in order to improve the approach.

To describe patient characteristics of all medical request to the Addiction Liaison Pyshicatric Unit from January 2010 to December 2022.

Study data will be obtained from all patients that were referred to the Addiction Liaison Psychiatric Unit to assess addictive disorders and withdrawal symptoms related to drugs during 12 years in Hospital del Mar (Barcelona, Spain). Demographics and clinical data (substance use, medical comorbidity and dual diagnosis) were obtained.

The results will be presented as soon as all data is obtained. We will explore COVID-19 pandemic implications.

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The rapid development of civilization is accompanied by many changes affecting human functioning. Technological development, wide access to positive stimuli and the neglect of emotional control and self-awareness in the learning process make it difficult for individuals to control their behavior. Such a loss of control is associated with the development of addictions. Therapists, doctors and researchers more and more often encounter cases of compulsive behavior focused on a specific activity - apart from gambling or playing computer or internet games, more and more often the subjects of preoccupation are compulsive shopping, sexual activities and work (workaholism).

The aim of the research was to try to define the mediating role of depression in the relationship between addiction to shopping and work and loneliness, understood in terms of general loneliness among Polish women.

The study was conducted among 556 women. The research was carried out with the use of the diagnostic survey method, using the questionnaire technique: the De Jong Gierveld Loneliness Scale, the Purchasing Behavior Scale, the Work Addiction Risk Test, Beck Depression Inventory and a questionnaire of our authorship.

Depressiveness is a mediator in the relationship between the feeling of loneliness and the degree of addiction to shopping (β = -0.0246, z = -2.03, p = 0.043) and in the relationship between the feeling of loneliness and the degree of addiction to work (β = -0.0722, z = -4.002, p < 0.001). The direct impact of the feeling of loneliness on the degree of addiction to shopping (p = 0.237) and work (p = 0.576) is statistically insignificant.

In the mediation model adopted, it was shown that depressiveness plays the role of a mediator between the feeling of loneliness and the degree of addiction to shopping and work. The increase in the level of depression increased the degree of addiction to shopping and work. The mediator’s participation lowered the level of the feeling of loneliness. Loneliness was not a significant predictor of addiction to shopping and work. There is a need to include activities aimed at identifying psychological factors influencing the occurrence of addictions to shopping and work among women. It seems important to be able to use psychological help when needed. It is also necessary to take institutional preventive measures to prevent the occurrence of behavioral addictions among women.

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“Rust is one of the cruellest games on Steam, and that’s what makes it so compelling.” (PC Gamer) Rust is a multiplayer-only survival video game. It’s full release was in 2018. The average age of a player is between 17 and 40 years. However, one must question the age group that enters the game and continues to play. This presentation will focus on adolescence, gaming addiction, insomnia, and the developing brain.

Rust is a game of round-the-clock survival in the wilderness whereby players must manage the basic essence of human need to “stay alive”. However, it requires a player to be present for a consistent duration of time, or risk “dying”. What does this mean for an adolescent, entering their final two years of school? What is their focus? How does this potentially affect the development of the young mind, still vulnerable to an immediate (real) world moulding a brain from adolescence to young adulthood?

Questions regarding adolescent epigenetics, insomnia and addiction erupt in mental health when Rust and other international multiplayer survival games capture and imprison the mind of our youth.

The WHO added “gaming disorder” to the 2018 International Classification of Diseases. But the APA manual, the DSM-5, did not. The University of New Mexico suggests that 6-15% of all gamers exhibit signs and symptoms consistent of addiction. In an article published in February 2019 BioPsychoSocial Medicine states: ‘Across studies, the presence of International Gaming Disorder (IGCD had a negative effect on sleep and schoolwork in minors … Brain imaging studies indicate that impaired cognitive control in minors with IGD is associated with abnormal function in the prefrontal cortex and striatum.’

Today we ask: of the 83.5% of online gamers and 3.9% of youth reporting problematic behaviour are we Rusted beyond Repair?

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An opioid analgesic exposes you to a risk of problematic use, due to the terrain (vulnerability), its emotional state, the presence of pain and the environment and thus the opioid itself. The risk of developing an opioid use disorder when taking prescription opioids is approximately 3% (over 2 years),

Recognize the method of prescription of opioids, as well as the elements to be sought by doctors during the interrogation and after each prescription of opioids

a descriptive and analytical study, based on a hetero-questionnaire completed by doctors, numbering 120 doctors who were consulted over a period of one year. the study was carried out via Google Forms.

75% of doctors are general practitioners. 90% of our doctors have a period of practice less than 10 years, and the lower half of 4 years, Almost all doctors prescribe opioid analgesics for pain of severe intensity, often of rheumatic origin 50%, neoplastic, post-operative or for a migraine or neuralgia. 9% of physicians think opioid painkillers have a high risk of addiction, almost 20% think opioid painkillers do not even have a risk of addiction, and the majority think the risk is low to moderatedoctors limit the duration of prescription 80%, sensitize their patients in 75%, half prescribe a low dose but the majority abruptly stop treatment. 70% of doctors limit the duration of prescription in less than 02 weeks, but 15% do not limit not prescribing opioids

The dose-efficacy-tolerance relationship is very variable from one patient to another, it is important to adapt the dosage gradually according to the intensity of the pain with monitoring of possible tolerance. Stopping should be done gradually to avoid a withdrawal syndromeThe prescription must systematically be accompanied by information to the patient about the treatment and its discontinuation, and monitoring of these risks even when it is prescribed in compliance with the conditions of the marketing authorization.

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According to domestic and foreign studies, in the last decade there has been an increase in the number of HIV-infected patients suffering from alcoholic disease. Under the influence of alcohol, the risk of infection and transmission of HIV infection increases, the course of the disease worsens. There is a syndemia between alcohol abuse and HIV infection. This requires new approaches to the tactics of managing patients of a narcological hospital with HIV infection.

To identify the prevalence of HIV infection in patients of the substance use treatment facility suffering from alcohol disease of the second stage.

The authors analyzed 446 medical histories of patients suffering from alcoholic disease who underwent inpatient treatment in 2009-2021. For data processing, a statistical method for calculating relative indicators used.

The study showed that a significant proportion of patients with HIV infection were patients of working age 40-59 years. At the same time, since 2009, there has been an increase in HIV-infected patients from the total number of hospital patients. So, if in 2009 they were 1.2%, then in 2021 they were already 7.2%. Most HIV-infected patients of the narcological hospital are single or divorced. The study notes that abuse is common among patients with HIV infection as a means of combating depression. According to 2019 data, 39.0% of hospital patients suffer from depression. The authors show that alcohol affects the increase in risky forms of sexual relations, or risky situations with unprotected sex. In addition, with alcohol abuse, the viral load increases, and therefore the likelihood of transmitting HIV infection to a partner with unprotected sex increases.

Alcohol abuse is a causative factor in HIV infection. Early detection of people with harmful alcohol consumption and referral to a psychiatrist will increase adherence to antiretroviral therapy, as well as reduce the rate of HIV infection

None Declared

Voluntary poisoning with neurotoxic products in order to achieve euphoria is common especially among young people. Neurological complications are quite likely and can be serious and irreversible.

We aim to describe the peripheral neuropathies secondary to N-Hexane intoxication in a Tunisian population.

A retrospective descriptive study was carried out in our department of neurology in the NationalInstitute of Neurology of Tunis including patients diagnosed with N-Hexane neuropathy. All patientshad a history of a N-Hexane exposure. The diagnosis was confirmed after excluding other etiologiesthrough appropriate investigations. Clinical and para-clinical data as well as follow-up were assessed.

We selected 38 patients with a mean age of 22.7 years [14-36]. Among them, 37 were glue-sniffer and 1 had a voluntary toxic exposure to paint. An associated cannabis consumption was found in 6 patients. All of them had a low socio-economic background and 17 were unemployed. Time to onset of neurological signs ranged from 5 months to 11 years. The clinical exam showed a quadriparesis (15,7%), a paraparesis (58%), sensory involvement (55,2%) amyotrophy (40%) and abolished tendon reflexes in lower limbs (81,5%). Swallowing disorder and optic neuritis were found in one case. The electroneuromyogram revealed an axono-demyelinating sensory-motor polyneuropathy (PN) in 16 cases and a demyelinating motor PN in 9 cases. Vitamin therapy, motor rehabilitation and psychotherapy sessions have been indicated. Only 6 patients showed slight clinical improvement after withdrawal. The rest of our patients did not quit; 84% of them became bedridden.

Glue-sniffer related neuropathy is very common in our country especially in adolescents and young adults with low socio-economic background. The neurological outcome is serious and usually irreversible if exposure is persistent.

None Declared

Substance-induced psychosis (SIP) is the name given to a psychosis that starts in the context of substance abuse, but persists for days and weeks with no substance use. There is growing recognition that individuals with substance-induced psychosis are more likely to develop a schizophrenia spectrum disorder. Early onset of substance-induced psychosis and cannabis use are predictors of conversion. Nevertheless, more evidence is needed to identify other factors.

The objective of this study was to analyze the progression of substance-induced psychosis to several mental disorders, by reporting a case of a cocaine user, and identifying the factors that promote the progression.

We report the case of a 55 years old male, with long-term consumption of endovenous cocaine and heroin, who has experienced various episodes of substance-induced psychosis in the past.

In 2017, he presented haptic and visual hallucinations oriented as parasite delusion during rehab hospitalization. The symptoms disappear after a few days of risperidone treatment and absence of consumption. Consuming cocaine and heroin ev in previous days.In October 2018 and July 2021 the patient was hospitalized in Dual Pathology for similar episodes oriented as substance-induced psychosis.

In the current episode, the patient was hospitalized in the Dual Pathology Unit due to a psychotic episode described as parasite infestation delusion and prejudice delusion against his family. The last consumption of heroin and cocaine was 3 months ago.

This case report exemplifies the temporal relationship between substance use and the development of psychotic illness. Suggesting substance-induced psychosis as an indicator for the future development of a severe mental disorder. For this reason, more evidence is needed to identify other factors that promote the progression to severe mental disorders and stablish a higher risk group

None Declared