[Consultation/liaison addiction medicine: Tools and specificities]

Area of Science:

• Addiction Medicine
• Psychiatry
• Public Health

Background:

• Consultation/liaison (CL) psychiatry teams provide psychiatric assessment and treatment for inpatients in non-psychiatric settings.
• In France, specialized CL addiction services, known as Équipes de Liaison et de Soins en Addictologie (ELSAs), were established in 2000, separate from CL psychiatry.
• While sharing some aims, ELSAs possess distinct features compared to traditional CL psychiatry.

Purpose of the Study:

• To delineate the specific characteristics and practices of CL addiction services (ELSAs) in France.
• To highlight the differences and overlaps between ELSAs and CL psychiatry teams.
• To emphasize the unique contributions of ELSAs in managing substance use disorders within hospital settings.

Main Methods:

• Analysis of the daily practices of ELSAs, focusing on interventions such as screening, brief intervention, and referral to treatment (SBIRT).
• Examination of the required skills, including motivational interviewing, for managing patients with substance use disorders.
• Review of the role of ELSAs in providing somatic expertise and advising on substance-specific medical consequences.
• Exploration of extended liaison interventions in outpatient settings integrated with other specialties (e.g., hepatology, oncology).

Main Results:

• ELSAs frequently employ SBIRT and motivational interviewing, which are core to addiction medicine but less common in other CL teams.
• ELSAs offer crucial somatic expertise to advise non-psychiatric physicians on managing medical consequences of substance misuse.
• Integrated outpatient liaison interventions by ELSAs have shown to improve patient motivation and treatment outcomes.
• Despite separation, CL psychiatry and ELSAs share target populations and missions, suggesting potential for collaboration.

Conclusions:

• CL addiction services (ELSAs) in France have unique practices, including SBIRT, motivational interviewing, and somatic expertise, differentiating them from CL psychiatry.
• The integration of ELSAs into outpatient settings and their collaborative potential with CL psychiatry are key for comprehensive patient care.
• Addressing the overlaps between CL psychiatry and ELSAs is crucial for developing integrated and collaborative services within broader hospital settings.