title: [The four stages of drug addiction (based on clinical experience with 5,000 drug addicts)].
abstract: A medical practitioner has been inquiring on the subject for eighteen years, and confronting the discrepancy between the facts observed and the social and psychiatric approach of the plague. His study of adolescent toxicomania was proceeding from the care of 1000 drug-fiends, plus a dialogue with 3000 schoolers and the interview of about one thousand drug-fiends on their way to recovery. Four stages have been made clear in the evolution of the disease. Stage 1--Contamination of 12 to 18 year-old-individuals, among whom 90% find a safe escape through mere self-defense (contamination from the cannabis "joint" in 95% of cases). Stage 2--Occasional users, one or two "joints", now and then, several times a month, for fun, out of submissiveness to a group or search for adventure or challenge. Stage 3--Regular use of one or several drugs entailing the spiral of dependency resulting in a distorted psyche, a disinterest in studies, marginality delinquency. Recovery is possible provided they give up the use of any drugs whatever thanks to firm ans understanding help from the family or and institution, avoiding any psychiatric response. Stage 4--Drud-fiends hooked to hard drugs such as cocaine, heroin, polytoxicomaniacs they have become the slaves of drugs, undergoing a severe physical and psychic decay, they feel lovely, consider drugs as they only friend, they have a suicidal behaviour. The immuno-deficiency caused by drug-use makes intercurrent diseases likely to strike. Recovery is still possible through drastic weaning treatment, even under constraint since they endanger their own lives, and a 12 to 18 months treatment of remotivation as well as training for social reinsertion. The therapeutic community, well organized and governed, is able to provide low cost solutions to a plague that too often comes to a deadlock. Although we can't say that first and second stage teenagers are real drug-fiends, on the contrary, third and fourth stage patients have necessary gone through stage 1 and 2. It can't be denied that they suffer from the same disease. Stage 1 and 2 teenagers and cured patients don't show the psychic decay and suicidal impulse of stage 3 and 4 patients. Such symptoms are the result of the use of drugs and not its cause. Consequently the role of the narcotic product is prevailing in the evolution of the disease.
authors.affiliation: Comité National d'Information sur la Drogue, Saint Gratien.
authors.forename: L
authors.initials: L
authors.lastname: Hovnanian
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D006801:Humans; D019966:Substance-Related Disorders / Q000523:psychology*
vernacular_title: Les quatre stades de la toxicomanie (d'après une expérience clinique de 5,000 drogués).