CONTROL OF CONSUMPTION: ABILITY OR INABILITY
The population concerned with rehabilitation is very heterogenous and the first step is to caracterize it. The object of the rehabilitative action is the relationship between consumption and driving. A concept which is obvious when we talk about consumption or about driving is the notion of control. Why not use it as classification axis ?
The control may apply first on consumption. If someone is unable to refrain from consuming when he decides, we have to believe that at one time or another he will drive under influence or with withdrawal symptoms. We consider therefore this kind of consumption is a case of inability to drive because of control loss which suggests toxicodependance. Any modification of the way of life must be accompanied by a profound modification from a psychological point of view.
The control may also apply to the decision to drive after having drunk. This is a typical case in social drinking. Desinhibition due to the effect of alcohol, cannabis or cocaine then affects the power of deciding his behaviour. If there is no dependancy, adjustment of behaviours may avoid risky situation.
The other cases of driving under influence without loss of control should be classified into lack of knowledge inducing wrong attitudes or into attitudes of denial.
We think that the split between ability and inability, and by extention between different rehabilitation strategies, is to be based on keeping or losing the control of consumption. If the control is kept, modification of behaviour and attitudes may be reached by an educational approach. If the control is lost, an effective action calls for a therapeutic approach.
In all cases, the problem arises for drugs and medicines as well as for alcohol. In all cases, driving hould be forbidden. In all cases too, the question of rehabilitation in traffic will be raised at one time or another.
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