SINTES system (National Identification System for Toxics and Substances)

SINTES contributes to two early-warning systems for emerging phenomena linked to psychoactive substances: the Early-Warning System (EWS) of the European Monitoring Centre on Drugs and Drug Addiction (EMCDDA) and the national ‘Signal Drogues’ alert system coordinated by the National health directorate of the Ministry of Health (DGS).

Background

The monitoring system was set up by the OFDT in 1999, as part of the 1999-2001 three-year plan to combat drugs and prevent addiction, drawn up by the (French) Interministerial mission for the fight against drugs and drug addiction (MILDT). The mission statement sent by the government to Nicole Maetracci, a magistrate who chaired the MILDT at the time, emphasised the need for knowledge about changes in patterns of use of psychoactive substances other than tobacco and alcohol, and in particular the development of polydrug use.

The OFDT proposed setting up a ‘permanent monitoring scheme’ with who components: Emerging Trends and New Drugs (TREND (lien vers la page A306)) and the National Identification System for Toxics and Substances (SINTES (lien vers la page A304)). This new preoccupation on the part of the public authorities was, and remains, linked to the changes in the field of drugs since the early 1990s and the need for better documentation of these changes, such as the appearance of new substances such as MDMA/ecstasy and crack cocaine; the spread of existing products such as cannabis, LSD, and cocaine; the development of polydrug use and modes of use other than injection (oral, sniffing, smoking); the increase in the use in new party contexts; the diversification of user profiles and groups, and so on. The development of the techno-cultural movement and the proliferation of associated events (rave parties, free parties, etc.) have played a role in the spread of some of these phenomena.

Created exclusively to describe the composition of synthetic drugs that appeared in the 1990s, SINTES was adapted in 2006 and now covers all psychoactive substances used outside the therapeutic framework, based on chemical analyses of substances collected by social and health workers directly from drug users at a stage in their lives where these substances will no longer be cut.

Partnerships

The system, which is coordinated by the OFDT’s FOCUS unit, is based on partnerships with 17 organisations which coordinate the system locally. The 715 social and health workers collecting samples from people who use drugs work in harm reduction facilities (CAARUD), specialised drug treatment centres (CSAPA), mobile teams or harm reduction prevention associations which intervene in particular in party environments.

Through SINTES, the OFDT takes an active part in the national health surveillance network alongside a number of partners: the Ministry of Health (DGS), the national Public Health Agency (Santé publique France), the National Agency for Medicines and Health Products Safety (ANSM), the National Agency for Food, Environmental and Occupational Health and Safety (ANSES), the Interministerial Mission for Combating Drugs and Addictive Behaviours (MILDECA), the national Network of the Regional Abuse and Dependence Monitoring Centres (CEIP-A) and the Poison Control Centres (toxicovigilance) (CAP-TV). As such, the OFDT interacts with players in the social health and addiction fields by sending them information on health alerts, and professionals take part in health monitoring by contributing to TREND and SINTES schemes.

Network of laboratories

SINTES has access to accredited laboratory facilities. Its longstanding laboratories’ network consists of: 

• a network of 11 Customs laboratories among which 6 may perform narcotic analysis
• a network of 5 Police forensic laboratories
• the Gendarmerie Institute of Criminal Research

All these laboratories comply with good laboratories practices (GLP) and therefore are ISO 17025 certified. The Customs facilities are also ILAC accredited.

Therefore, SINTES has access to all possible forensic and toxicological analyses developed throughout France, but it focuses on non-biological matrixes collected from people who use drugs. The law enforcement-related laboratories (Customs, police, Gendarmerie) analyse several thousands of samples every year (SINTES collected products and seizures combined).

Regarding new psychoactive substances (NPS), this network has the capacity to process this type of samples and to carry out first identification and structural elucidation. Therefore, NPS detection is performed routinely (several times a week).

Thanks to all these capacities, SINTES therefore has a national coverage.

Methods

Two areas have been developed, providing access to information with different objectives: monitoring and observation.

• The ‘Monitoring’ component is a permanent rapid information system that is part of a public health approach and seeks to detect the presence of new or unexpected substances in psychoactive substances in circulation. It is based on the toxicological analysis of products collected from voluntary drug users. The products are collected following the onset of unexpected or adverse effects, but also because of their novelty. After analysis of the samples by partner laboratories, the results are assessed by the OFDT national coordination and then presented back to the volunteer users. All professionals in the field may contribute.
• The ‘Observation’ component, which is more ad hoc, enables a more precise observation of a specific substance circulating in France during a given period. This relies on the results of specific surveys based on the collection of product samples directly from users, organised by the OFDT and carried out exclusively by the TREND-SINTES sites. These specific surveys allow samples to be collected indiscriminately (without any particular reason). The ‘Observation’ surveys concerned: cannabis in 2005, cocaine in 2006, heroin in 2007 and 2008, synthetic substances in 2009, MDMA in 2014, crack cocaine in Île-de-France in 2019-2020.

SINTES Observations

• New psychoactive Substances - Ten-year overview of the situation in France, Tendances n° 127, October 2018
• New psychoactive substances and the Internet: current situations and issues, Tendances n° 84, January 2013
• Recent information on the synthetic drugs circulating in France, Tendances N° 34, February 2004

• Ecstasy and other synthetic products in France: situation portrayed by the SINTES facility, 1999-2002, Tendances N° 32, September 2003

Results

The results of the analysis of drug collections are published annually in a briefing note entitled Point SINTES.