[Diagnosis of drug addictions]

The recognition of harmful drug use or the dependence on psychoactive substances is aided above all by simple, systematic history taking on the consumption (frequency and quantity) of tobacco, alcohol and illicit products, as an integrated part of the social history. The diagnosis of alcohol addiction takes into account the declared consumption of alcohol, using standard questionnaires (DETA/CAGE and AUDIT) and biological markers to confirm or objectify the diagnosis. The diagnosis of cannabis addiction is made by a clinical evaluation of harmful usage and dependence, the frequency and the quantity of consumption, and the search for complications. It is possible to make use of an auto-questionnaire. Urinary screening can be used to help orientate the history taking. These tests are only of interest in the context of a project of healthcare that has been freely consented to. The diagnosis of tobacco addiction takes into account the significance of the dependence that can be quantified, thanks to Fagerström's test (or more simply by the short Fagerström test). The expired CO level is an objective test of tobacco intoxication and its consequences on respiratory function. It is a good instrument of measurement of motivation. The continine level is still a little known test. The practitioner must also evaluate the factors of severity: certain modalities of consumption, certain personality characteristics or the presence of psychiatric pathology, certain family characteristics or social environments. Finally, he should evaluate the level of motivation for change.