Drugs and addictions in overseas France - State of play and issues - Summary
The aim of the Théma issued today in French and in English (summary) is to provide an overview of the situations and problems currently observed in the French Overseas Territories with regard to drugs and addictions, based on the most recent statistical data and the main studies carried out in these territories. The French Overseas Territories include 12 territories of varied political and institutional statuses spread over several continents and three oceans (Atlantic, Indian, Pacific).
Overseas France is receiving increasingly targeted attention from public authorities, however, knowledge of the issues specific to these territories remains partial. A certain amount of data is nevertheless available and makes it possible to draw up an overview focusing on the former French overseas departments (Guadeloupe, Martinique, Guiana, Réunion) supplemented by occasional data from New Caledonia, French Polynesia and Mayotte .
The report, as well as its summary, considers 3 major aspects :
- The large supply of drugs in Overseas France and especially the cocaine market in the French West Indies-Guiana region.
- A less widespread use than in metropolitan France but more concentrated in certain populations.
- The strong mobilisation coverage of the care provided that falls far short of needs while a significant part of the police force activity is focused on narcotics.
Cannabis sales revenue in France - A new direct estimate by expenditure
Estimating the amount of cannabis sales revenue is important and provides a measure of the influence of this economic sector. However, this exercise faces two major obstacles, since both the quantities sold and the retail prices of an illicit product remain, by definition, unknown in public statistics.
In order to get around these difficulties, the OFDT has introduced in 2017 a specific module in two general population surveys (Health Barometer and ESCAPAD) which directly questions users on the frequency of their cannabis purchases during the year and the amount of their last expenditure. If the primary objective is to renew the estimate, it is also a question of testing a calculation method that is easily reproducible and comparable over time.
This issue of Tendances, which was first published in French in March, reports on the use of these new questions asked simultaneously in these two surveys and proposes a new estimate of the cannabis market in France’s sales revenue which reached 1.2 billion euros (1.3 billion $) in 2017. The relative simplicity of this method should facilitate the integration of the questions into other surveys, particularly those conducted in other European countries, and thus make international comparisons more reliable.
Bulletin TREND COVID-19 n° 2
The development of the COVID-19 epidemic and the implementation of lockdown measures by the French public authorities in mid-March 2020 changed the consumption practices of drug users and disrupted the activities of trafficking networks.
In order to better understand these developments, the French Monitoring Centre for Drugs and Drug Addiction (OFDT) has appealed to the eight local centres in its Emerging Trends and New Drugs (TREND) monitoring system (Bordeaux, Lille, Lyon, Marseille, Metz, Paris, Rennes, Toulouse).
After an initial bulletin covering the first three weeks of lockdown (from mid-March to the first week of April 2020), this updated overview includes the data collected between 7 April and 7 May in order to document in greater detail the following three themes:
- the adaptation strategies adopted by users (abstinence and forced or consensual withdrawal, overconsumption, compensation and transfers to other products, etc.);
- the ways in which health care and risk reduction facilities have changed their practices and activities in order to best pursue their missions;
- and the transformations concerning trafficking networks.
Bulletin TREND COVID-19 n° 1
The development of the COVID-19 epidemic and the implementation of lockdown measures by the French public authorities in mid-March 2020 changed the consumption practices of a large proportion of drug users and disrupted the activities of trafficking networks.
To better understand these developments, the OFDT has implemented a qualitative monitoring through the feedback from its TREND scheme and network (Bordeaux, Lille, Lyon, Marseille, Metz, Paris, Rennes). This first information Bulletin (15 pages in French) was released on April 15. An English summary is now available online.
Tobacco smoking and tobacco cessation in 2019
The 2019 edition of the annual OFDT overview on tobacco describes the repercussions of successive rises in prices of tobacco in the tobacconist network and the continuous increase of the number of people following a treatment to stop smoking. These elements are completed by a report of the results of public surveys carried out in 2019 which witnessed a drop in smoking.
- On the whole, the total number of tobacco sales are 46 962 tonnes and the decrease in volumes sold in the French tobacconist network reaches 6.6% (on a constant number of delivery days).
- For the third consecutive year, sales of treatments to help quit smoking have rocketed and now correspond to almost 4.3 million equivalent “treated patients”, that is one third more than in 2018.
- In parallel, the prevalence of daily smoking has dropped in 2018 among adults (aged between 18 and 75 years old) and secondary school students. In comparison, the number of electronic cigarette users continues to grow among adults, and e-cig experimentation is increasing among adolescents.
Users, markets and psychoactive substances: recent developments (2018-2019)
Since 1999, the Emerging Trends and New Drugs (TREND) unit of the French Monitoring Centre for Drugs and Drug Addiction (OFDT) has been monitoring emerging trends and phenomena in the field of drugs. It focuses on populations that mostly consume psychoactive substances and is based on qualitative data collected by the network of TREND sites located in eight metropolitan areas.
The developments observed in 2018 confirm those highlighted in previous years. With regard to users, the living conditions of the most marginalised are deteriorating, as observed cyclically, especially in the case of young people and/or migrants. Some networks are rationalising their activities by adopting the organisational methods of traditional companies: marketing strategies, reducing stock, making the workforce more flexible, etc. At the same time, the diversity of available products is steadily rising and consumption of substances previously confined to certain environments (ketamine, GHB-GBL, nitrous oxide) is expanding.
Exposure to alcohol marketing among 17-year-olds
In France, despite legal restrictions on authorised media and content, alcohol advertising is subject to significant private investment.
In order to measure exposure to alcohol marketing as perceived by adolescents, the OFDT has developed a set of questions (the French Alcohol Marketing Exposure Scale, FAMES) that can be used in general population surveys among adolescents. Introduced during the 2015 ESPAD survey, this module was revised and then offered to a representative sample of 17-year-olds in the ESCAPAD survey in 2017.
Tendances No. 135 reports on the responses of 10 591 girls and boys aged 17 who recalled an advertisement for an alcoholic beverage. It first explores the level of remembrance of the last alcohol advertisement seen or heard by young people, as well as certain factors likely to influence their consumption (attractiveness or incentive, proximity of the product). The issue then looks at the different environments where young people report being exposed to marketing. The comparisons presented illustrate significant statistical differences.
Direct drug-related deaths - Assessment of their number in France and recent developments
The epidemic of opioid overdose deaths in the United States highlights the issue of drug-related deaths. In response to the crisis on the other side of the Atlantic, the public authorities are mobilising in France and Europe to prevent any developments that could lead to this kind of situation. Beyond this specific concern, reducing these premature and preventable deaths, even when they appear to be fewer in number than in other countries, remains a major challenge for public policy in the field of drugs. In this context, it seems more necessary than ever to assess the number of deaths related to illicit drugs and opioid medications (substitution medecines or analgesics) in France.
What data is available? What are the limitations? What trends are emerging? These issues were already addressed in Tendances in 2010. At that time, drug-related deaths were still fully assimilated with overdose deaths by drug users. The concern today is also the deaths of people who have been prescribed opioids to treat pain. Tendances No. 133 is an update on direct drug-related deaths, as well as an update on their variation in numbers up to 2015-2017. It also explores possible explanations for these variations.
Drugs and drug addictions in France - overview on recent trends and perspectives
Drugs and addictive behaviour represent major public health and safety issues, whether in terms of preventing health and social harm or combatting trafficking. This publication provides an update on the addiction situation in France, offering an overview of evidence-based data and outlining the most recent developments, five years after the previous edition.
Over the past two decades, the field of addiction expanded considerably. Moving beyond licit (alcohol, tobacco) or illicit drugs (heroin, cocaine, cannabis, etc.), the concept of "addiction" has been extended to "behavioural addictions" (interactive screens and video games, gambling, etc.) which are likely to cause disorders similar to abuse or addiction.
How many people use drugs in France and how many are experiencing difficulties with their use? What is the extent of behavioural addictions today? What are the main developments in the supply of psychoactive substances? How are public policy responses structured?
This overview also offers areas for reflection based on recent developments in the field.
Levels of screen use at the end of adolescence in France in 2017
In 2017, in order to contribute to reflection on so-called "substance-free" addictions among adolescents, the French Monitoring Centre for Drugs and Drug Addiction (OFDT) integrated a new module on the use of various electronic devices with screens into its Survey on Health and Use on National Defence and Citizenship Day (ESCAPAD).
This memo reports the main results on the issue of the amount of time 17-year-olds spend on screens, distinguishing between the different types: televisions, game consoles, computers, tablets and mobile phones. Furthermore, in an exploratory and transversal approach to the various different kinds of screens, the memo focuses on the relationship between adolescents and social networks in terms of excessive use, as well as their ability to disconnect from their mobile phones.
Cannabis legalisation in the United States - Towards a regulated market?
This memo describes the regulatory models that have been implemented since 2014 in the American states that have legalised cannabis, highlighting their differences and similarities. It also discusses the reform processes and common features of states that have legalised cannabis for medical and recreational use.
After five full years of reform in Colorado and Washington State (2014-2018), first outcomes can be reported - although it is not clear whether they are directly attributable to cannabis being legalised. The most significant effects relate to the quick and large-scale industrial expansion of the cannabis supply chain. However, this economic boom has also seen the emergence of three public health concerns:
- The substance is now aimed at all population profiles, from people who have never tried it to regular users and from young people to seniors. The increase in supply and its diversification have increased the incentives to use it, which is only made worse by marketing strategies emphasising cannabis’ "therapeutic virtues" or its dimension of socialisation.
- The increase in the number of emergency calls and hospitalisations following acute intoxication highlights the difficulty of effectively regulating substances put on the market (particularly in terms of the concentration of active ingredients). At the same time, cannabis-related treatment demands have declined.
- The decline in both the perceived dangerousness of cannabis and retail prices have led to it becoming more accessible and the substance being "normalised" which, according to public health stakeholders, could ultimately increase the risks and harm associated with its use (particularly among the younger generation).
Drugs: perceptions of substances, public policies and users
Since 1999, the OFDT has been quantifying the opinions and perceptions of the French population on drugs and related public policies through the EROPP survey (Survey on representations, opinions and perceptions regarding psychoactive drugs). For this fifth edition, a sample of 2 001 individuals, representing the French population aged 18 to 75, was selected based on quota sampling. The survey makes it possible to see how opinions are structured around issues in the public debate but also to consider how opinions in France have developed over the last twenty years. For continuity, most of the themes studied in previous surveys have been kept (for example, the perceived dangerousness of different psychoactive substances, the representation of heroin users and opinions on drug legislation). In addition, questions on current topics and new issues have been added.
In 2018, the EROPP survey focused on five psychoactive substances: tobacco, alcohol, cannabis, cocaine and heroin. Tendances No. 131 first discusses drug-related knowledge and how dangerous they are perceived to be. Secondly, it reports on individuals’ adherence to public policies that are currently in force or being discussed in France or in other countries. Finally, a final section summarises cannabis users’ opinions through a classification that groups together individuals with similar views. Where possible, the results are compared with those from previous surveys.
2019 report about drugs in France
Each year, like all the other Reitox focal points in Europe, the OFDT submits to the European Monitoring Center for Drugs and Drug Addiction (EMCDDA) its national report on the state of the drug phenomenon in France.
The report is now divided in 10 workbooks: Drug Policy, Legal Framework, Drugs, Prevention, Treatment, Best Practice, Harms and Harm Reduction, Drug Market and Crime, Prison and Research. The 2019 report is available for downloading.
Female-oriented programmes in addiction care
As a minority in specialised care services, French women presenting with addictions represent 23% and 18% of the public seen in specialised drug treatment centres (CSAPA) and harm reduction facilities (CAARUD) respectively. However, these women show, more than men, many social and health vulnerability factors (suicidal history, psychiatric comorbidity and an abnormally high death rate related to drug use, single parenthood, violence, etc.) and report a greater fear of being stigmatised. When facing these situations, which can be exacerbated during pregnancy or when children are involved, addiction care services have sometimes developed specific care arrangements to meet women's needs. These specific answers take various forms: from ad hoc interventions to the implementation of a framework of follow-up and appropriate care. In 2018, the French Monitoring Centre for Drugs and Drug Addiction (OFDT) launched the Ad-femina online survey to provide an overview of addiction schemes tailored specifically to women in 2017 in France. The results are provided in Tendances No. 130.
About 2,650 women were seen in 80 schemes in 2017, a modest number compared to around 72,000 women who annually attend CSAPAs and CAARUDs. Like all women received in specialised services, these beneficiaries are mainly polydrug users, often misuse alcohol and have social and health vulnerabilities, deterring them from asking for care. Finding ways to get them into care as early as possible and keeping regular contact with them are some of the main challenges faced by the teams.
Drugs, Key data 2019
Since 2007, OFDT has been publishing Drugs, Key Data, an overall perspective digest with the most recent and detailed facts and figures. This 8th issue, a 10-page document produced in 2019, is released to mark International day against drug abuse and illicit trafficking. It provides the most relevant figures in order to measure and present a quick overview of the French drug-related phenomena in 2019.
This document summarises for the main substances the levels of use observed in the French population as a whole. Then, it provides detailed information on use, treatment, health and social consequences as well as trafficking data per product. When possible, trends in these areas are provided.
Drugs in Europe
What do the latest data tell us about the European drug market? What are the new trends in drug use among European adults and school students? What are the harms associated with drug use and what is being done to counter them? These and other questions are explored in the 2019 EMCDDA European Drug Report.
Country drug reports 2019
Developed by the EMCDDA, in cooperation with the Reitox national focal points, these graphic-rich reports cover: drug use and public health problems; drug policy and responses and drug supply.
The European Union and the drug phenomenon
The European Union & the drug phenomenon : Frequently asked questions, joint publication between the EMCDDA and the European Commission, october 2010, 12 p.