Chemsex refers to sexual activity under the influence of a psychoactive substance. Treatment in general practice is poorly described.This study aimed to analyze the perceptions of General Practitioners (GPs) in XXX regarding chemsex, its inherent problems and GPs’ views on the users’ care.This qualitative study used semi-structured interviews with GPs in XXX. The interview guide explored risky sexual behavior, the use of drugs during sex, chemsex, and GPs’ view of this behavior and its perception in their practice. A manual thematic analysis inspired by phenomenological interpretative analysis was conducted by two independent researchers.Nine GPs (four women) were interviewed. Data sufficiency was considered achieved after the ninth interview. GPs often poorly understood chemsex. Pre-exposure prophylaxis (PrEP) prescribers had a more precise perception of chemsex. GPs considered that early awareness of sexuality at school and in primary care could help limit young people’s entry into chemsex. The changing relationship to sex, easy access to drugs and new communication modes were factors favoring this behavior.A similar study in larger cities would refine these results. A chemsex user interviewed lacked knowledge about the current healthcare offer and the role GPs could play in his care.An analysis of perceptions of chemsex by GPs in XXX revealed that they often poorly understood the phenomenon. PrEP prescribers had a more precise perception of chemsex. GPs considered that early awareness of sexuality at school and in primary care was the main avenue for action to limit the entry of young people into chemsex. A similar study in large cities would help to clarify these results. An analysis of the transposition of certain specialized techniques into primary care could also be of interest. The chemsex user interviewed seemed to lack knowledge about the current healthcare offer and the role that GPs could play in his care.

Seizures are an infrequent complication of intoxication, it may be caused by a wide range of drugs and toxins.This study aimed to describe the epidemiological and clinical profile of patients presenting to the emergency department (ED) following acute intoxication associated with a seizure.This was a retrospective study conducted over a 5 year period from October 2020 to September 2025, in the ED of xxx. We included patients aged from 14 and over who consulted for seizures after acute intoxication. Data regarding demographic, clinical history, characteristics of the intoxication type of molecule and presumed ingested dose (PID), clinical presentation, consultation delay, seizures before or during the consultation and the anti-seizure treatment used and were collected and analyzed.A total of 68 patients were included, predominantly male (58.8%), with a median age of 29 years [21–41] and a median consultation delay of 9 hours [3–24]. Substance misuse was reported in 39.7%, mainly cannabis (65.4%), pregabalin (46.2%), and cocaine (19%). The primary exposure route was drug ingestion (63.2%), followed by carbon monoxide (CO) inhalation (29.4%). Causes included recreational use (33.8%), accidental intoxication (32.4%), and suicide attempt (25%).  The main substances implicated were pregabalin (16.4%), cannabis (9.6%), carbamazepine (8.2%). The mean PID was 806 ± 460 mg for pregabalin and 4,333 ± 3,215 mg for carbamazepine, with a mean plasma concentration of 11.7 ± 9.3 mg/L. In CO intoxication, mean carboxyhemoglobin was 16.4% ± 11.7%, and SpCO 10.9% ± 12.3%. Oxygen therapy was administered in 66.7% of CO cases, with hyperbaric oxygen in 20.8%. Most seizures (92.6%) occurred before consultation, with 93.7% resolving spontaneously, while 10.3% experienced seizures and 9% required antiepileptic treatment. Initial clinical examination was generally stable (median GCS 15, HR 87 bpm, SpO₂ 98%). Regarding outcomes, 43.8% were admitted to intensive care, 31.3% discharged home, and 26.6% referred for follow-up, mostly to neurology and addiction services.These findings show that intoxication-related seizures occur mainly with recreational substance use or CO inhalation, with most episodes resolving spontaneously before medical evaluation.This study highlights the need for improved prevention and monitoring of substances involved, and targeted neurological and addiction follow-up.

With the increasing popularity of digital media, concerns have grown regarding the “addictive” potential of internet use and video games, particularly among children and adolescents. Research suggests that individuals who engage in intensive video gaming may develop symptoms that lead to various functional and social problems in their lives.This study aims to examine meta-analyses and review studies focusing on internet addiction and internet gaming disorder in adolescents, as well as the treatment approaches applied, while also raising awareness of the subject.A search of the PubMed scientific database using the terms “internet gaming disorder” or “internet addiction” yielded approximately 5200 publications published in the last two decades (2006 to 2026). When the keywords “adolescent” and “treatment” were added and the age range was limited to 13–18 years, 53 publications were identified. Meta-analyses and review studies were selected from this pool.The literature indicates that a variety of treatment approaches are available. Among the reported treatment apporaches there are non-pharmacological interventions such as mind-body exercise, physical activity interventions, cognitive behavioural therapy (CBT), peer support, family counselling, multi-level consultation programs conducted within the framework of individual counselling, family therapy, various therapeutic modalities, psychological interventions, internet addiction prevention programs, and group counselling based on the Adlerian approach. Combinations of different treatment modalities were found to be more beneficial and effective than single interventions.The reviewed studies emphasized the importance of treating comorbid conditions and initiating appropriate psychosocial interventions. From a clinical perspective, attention was drawn to the need for physicians to recognize the signs and symptoms of internet addiction. The findings suggest that public mental health approaches addressing adolescent developmental characteristics should be developed. Additionally, the need for further studies evaluating the effectiveness of school-based prevention programs was highlighted.For the treatment of Internet Gaming Disorder in adolescents, identifying risk factors is a critical first step. Awareness among primary care providers, particularly family physicians, should be increased regarding Internet Gaming Disorder and its associated psychopathologies.

Chemsex refers to the intentional use of psychoactive substances to initiate, intensify, or prolong sexual experiences. While mainly described among men who have sex with men (MSM), recent data suggest its emergence in other groups, including women. However, data concerning this population is limited.This study explores the characteristics of Chemsex among women and determines their needs and expectations in general practice.We conducted semi-structured interviews with seven women engaging in Chemsex and living in XXX. We then analysed our findings by using Interpretative Phenomenology Analysis (IPA) and running our data through Atlas.ti software.Participants, who were socially integrated and of diverse sexual orientations, engaged in Chemsex as part as a broader pattern of recreational substance use. They consumed various substances and relied on self-directed risk management. Motivations included seeking disinhibition, emotional connection, intensified sexual experiences, and coping with pre-existing sexual difficulties or sexual dysfunctions. Reported negative effects included somatic issues (e.g., cystitis and genital pain), psychological consequences, substance use disorders, and altered relationships with sexuality. Consent was a central concern, particularly during group sex encounters and under the influence of central nervous system depressant substances. Participants also expressed a need to identify with the practice,  and expected non-stigmatising, informed, and harm-reduction-oriented attitudes from primary care providers as well as addressing sexuality in consultations.The present study demonstrates that women engaging in chemsex face specific physical, psychological, and sexual risks, yet these risks remain largely invisible due to MSM-centred representations and their social integration, which limits contact with specialised services. This invisibility is a significant contributing factor to the unmet health needs of individuals. Due to their accessibility and non-stigmatizing approach, general practitioners are perceived as key actors in helping individuals identify their practices and adopt risk-reduction strategies.Chemsex among women encompasses diverse practices involving specific physical, psychological, and sexual health-related risks. The participants in our study experienced a threefold invisibilisation : as women, as socially integrated users, and as Chemsex users. The study underscores the need to broaden representations of Chemsex to include women’s experiences and to strengthen the role and training of general practitioners.

Alcohol use disorder (AUD) is a major risk factor for morbidity and mortality, yet despite its high prevalence, effective prevention and treatment in primary care remain insufficient.The aim of this clinical study is to present a practical model for monitoring and managing AUD as a key risk factor for the onset or complication of socially significant diseases within the primary outpatient care setting.This is a prospective, population-based cohort study conducted in Razgrad, Bulgaria, between 2023 and 2025. It involved 62 men with established alcohol abuse/dependence who were divided into two cohorts: one with a new diagnosis of hypertensive heart disease at the initial visit (n=27), and the other without existing socially significant diseases (n=35). Participants were monitored for 10 specific parameters. Statistical analysis utilized descriptive statistics, comparative correlation analysis, and logistic regression.The statistical analysis established strong and significant associations between several studied parameters. Symptoms of physical and mental dependence, as well as elevated gamma-glutamyltransferase (GGT) levels, showed a very clear link with adverse health consequences (p<0.05). Interestingly, initial values of pulse and arterial pressure did not show such a link. Logistic regression identified GGT, HDL-cholesterol, and symptoms of physical dependence as key independent risk factors for the development of chronic diseases and cardiovascular mortality (p<0.001).The findings regarding the lack of significant differences in the initial clinical presentation between the examined cohorts, and the established biochemical and clinical predictors for the development of socially significant diseases in AUD, are consistent with existing scientific literature. These results underscore the potential for early intervention by general practitioners.Chronic alcohol consumption leads to a significant deterioration of numerous health indicators and determines the necessity of early, targeted prevention and intervention strategies within general practice. The proposed model facilitates systematic follow-up, helping to de-stigmatize the condition and foster a supportive, solidarity-based approach to patient care.

Although the health benefits of sport are well established, the contemporary emphasis on physical appearance and performance has contributed to the normalisation of performance-enhancing substances. Doping is often associated with elite athletes but most users are amateurs, and the associated physical and psychological harm is significant. General practitioners (GPs) are central to promoting physical activity and supporting athletes, yet they often feel insufficiently trained to address doping. This generates anxiety and uncertainty, as well as straining doctor–patient relationships.This study aimed to explore the experiences of GPs when dealing with patients who use doping substances.A qualitative study based on grounded theory principles was conducted. Practising GPs were recruited through theoretical purposive sampling, beginning opportunistically and continuing by snowball sampling according to emerging data. Semi-structured interviews were conducted between February 2020 and January 2022. These were recorded, transcribed verbatim, anonymised, and returned to the participants for validation. Data collection, coding, and axial and selective analysis were performed using NVivo, with methodological triangulation. Ethical approval and data protection compliance were secured, and informed consent was obtained.Thirteen interviews were conducted, with data saturation being reached by the eleventh's. GPs reported emotional distress, biases, frustration and feelings of incompetence when confronted with doping use. Some GPs moved towards coaching behaviours, while others struggled with patients’ denial, motivation, or external pressures. Many identified knowledge gaps and legal uncertainties. However, GPs could build therapeutic alliances through communication, empathy, and motivational interviewing. This allowed them to understand motivations, detect addictive patterns, and guide patients towards safer practices or behavioural change. Several emphasised the need for improved competence, multidisciplinary collaboration, and greater awareness of anti-doping medical support services.GPs face professional, emotional and ethical tensions when managing doping users. Their responses evolve through self-reflection, communication and continuing education. However, structural barriers, particularly legal ambiguity and limited training, constrain optimal care.GPs require greater support, training and awareness of specialist anti-doping services to meet the needs of patients who use doping substances. Improving communication skills and multidisciplinary collaboration could enhance patient safety, autonomy, and engagement, while also helping to reposition GP care within a sports health framework.