"Better freedom of speech": the Minister of Health takes stock of the new Addiction Prevention Center in Monaco

Somewhere between the big top and the Fontvieille school, surrounded by greenery, the Addiction Care, Support, and Prevention Center (Csapam) has been welcoming patients with addiction problems since September. They are anonymous and free of charge. Dr. Goldbroch, the center's head, is delighted with the first few months of operation, where patients have been able to come "with ease" thanks to its setting, which contrasts with the hospital environment. "This allows us to work differently in a partnership ," says the center's manager. "We're there to best support them with their requests; they're the ones who decide. We don't want it to be a place of abstinence or withdrawal, but rather a place of well-being." And the recipe is working rather well, as the facility has welcomed around 120 people since opening its doors. Christophe Robino, Minister of Social Affairs and Health, gives an update on the facility's first steps.

What is your initial assessment of this center after almost a year of opening?

This is a very positive assessment, as the facility is a resounding success. You might say this isn't necessarily good news, but I'd tend to say it is, since addictions are a real concern for the government. It has been noted that, like elsewhere, we are victims of this scourge that affects all ages. Surprisingly, many patients are over 65. This shows that there was a real need and expectations.

What's the difference with the CHPG psychiatry/addiction service? Do the two complement each other?

Everyone plays their part. The CHPG psychiatry department is called upon to provide inpatient care to patients with serious and complex conditions in a hospital setting. The advantage of the Csapam is that it can, outside of a hospital setting, welcome people who believe they are victims of addiction to anticipate their treatment. And, if necessary, to enter a phase of treatment. All this in a pleasant environment that is free from the pressures of the hospital environment. This allows us to reach more people and encourage greater freedom of expression.

The biggest challenge is attracting people because the first appointment remains the most difficult step for the patient?

This structure is formatted to respond to this specificity. It is sometimes very difficult to take the steps to reach a doctor or even a hospital structure. Here, in a setting where anonymity is preserved, with ease of access and free of charge, I believe we have the right formula to reach as many people as possible.

The fight against addiction is also being played out in the legislative arena with the recent adoption of a bill on smoking...

As early as July 2023, I spoke out about banning puffs, and not just that, as provided for in the National Council's bill. I had a much broader focus and also aimed for legislative adjustments on the places where the consumption of tobacco or its derivatives could be prohibited.

Addiction is listed as a priority in the government's 2022-2027 mental health plan...

This is a very indicative plan of everything that could be done in the field of psychiatry and addiction. Within all the proposals that were made, I wanted to prioritize the treatment of addiction because it's something that affects young people, and those not so young, in different forms – very often alcohol, drugs, screens, gambling. It was very important to prioritize this action within the plan, which is a large catalog of everything we could imagine.

In a public session, Councilor Nathalie Amoratti-Blanc raised the idea of ​​an "ambitious and targeted" awareness campaign in addition to this bill. Are communication and prevention key in the fight against addiction?

One of Csapam's actions is to develop communication and warn against addictions. To inform about the nature of these addictions and what can be done to combat them. The government has discussed this and will continue to develop it: we need to have communication campaigns throughout the year, not just spontaneously during No Tobacco Month, for example. What we realize is that if we don't regularly remind people of everything the Principality has put in place, people forget about it, and we are criticized for not doing anything, even though many things are already in place.

Is this center intended to expand in the months and years to come?

Obviously, the size of this center is bound to evolve according to needs. Today, it meets a primary need, which is to evaluate the actions to be implemented in the future based on the success and progress of the people being cared for. To the extent of our capacity, we will give ourselves the means to evolve the structure to arrive at the most comprehensive response possible to this issue, which is a real concern for society.