Annual reports sent to the EMCDDA (European monitoring center for drugs and drug addiction), giving an overview of the latest developments on the drug problem in France.
National report to the EMCDDA - 2005
Political context 2003-2004
The 2004-2005 year has been mainly marked by the publishing of the national reference document pertaining to risk reduction actions (decree n°2005-347 of April 14th, 2005). In February 2005 an important media campaign to raise youth awareness upon cannabis damaging effects has been carried out: “Cannabis Is Real”. On the whole it can be said that government and media have actually been focused on cannabis for months.
The 2003 ESCAPAD Survey shows for the first time some signs of a slowdown in cannabis use among young males of 17-18 (Beck et al., 2004b, and section 2). Thanks to the same survey, during the 2000-2003 period of time, a slight increase has been observed in some experimentations among the 17-18 year-olds: poppers, ecstasy, amphetamines, and cocaine.
Among recent use tendencies observed in France, a development of hallucinogenic plants has been observed, and more particularly in the recreational area (Bello et al., 2005c, section 4 and the selected issue on “drug use in French recreational areas”). The end of year 2004 and the beginning of 2005 have singled themselves out for intoxication cases due to a cocaine and atropine combination. Twenty-six cases have been recorded, and subjected to a health alert taken over by national press coverage (section 6).
Health, social and legal indicators
For the first time in 2003 cannabis (and its by-products) is the substance bringing about the greatest number of treatments among new patients attending facilities, and ranking just above opiates (Palle et al., 2005, section 4). The various indicators available validate a decrease in injection practices among drug users (section 4).
“SAM” Survey (Section 6): Results from the Road Safety epidemiological survey on narcotics and fatal road accidents
Carried out by the INRETS (National Institute for Research on Transport and Safety) and coordinated by the OFDT (French Monitoring Centre for Drugs and Drug Addiction) thanks to a DGS (General Health Department) financing, this survey is the first one to enable an accurate evaluation of risks due to cannabis use on driving behaviours. The 10, 748 exploitable reports of immediately fatal accidents make possible to determine that drivers under the influence of cannabis run 1.8 times more risks to be responsible for a mortal accident than drivers having not used that substance. The over-risk for drivers on alcohol, all alcohol levels taken into account, is comparatively of 8.5 times. Otherwise the share of fatal accidents due to cannabis positivity registers around 2.5%. All things considered, in France, on a basis of 6,000 mortal accidents, the number attributable to responsibility over-risk relating to driving on cannabis would be around 180 killed individuals. In proportion, these victims are more frequently young males (18-24 years-old) than those dead in an accident involving a responsible driver who has not used cannabis. The survey also establishes a dose-effect as for alcohol.
In 2004, 69 overdoses have been recorded, a level that proves the lowest one ever reached in France. As we follow up observations made ever since the beginning of years 2000, heroin is less and less causing overdoses unlike psychotropic medicines and cocaine (section 6). The various legal pointers (arrests, sentences, and incarcerations for drug-law offences) are still on the rise in 2004 (steady increase since year 2002, section 8). Thirty-one percent of prison entrants’ acknowledge an alcohol overuse, and 33% of them a regular and long-lasting illicit drug use during the last twelve months prior to their incarceration (Mouquet, 2005). Meanwhile a survey has been performed on health and social care for prisoners showing some addiction or experiencing an abuse of licit or illicit substances (Obradovic, 2005). That study concludes that even if care is mostly satisfactory in prison, improvements remain to be done in terms of access to substitution treatments and nicotinic substitutes.
Summary of specific indications
Gender differences (F. Beck, S. Chacker et S. Legleye)
While Anglo-Saxon countries have developed studies centred on gender and gender approach for a long time in a more wideranging way, France proves significantly late in that field. It was not until the eighties that such an issue gradually became obvious in researches, as it focused upon discriminated alcohol uses among males and females. These last years, research teams and contributors (prevention, risk reduction) including that issue in their actions have accounted for a lack of funds granted to that theme, whereas epidemiological data confirm a noticeable difference between genders. The use of licit or illicit psychoactive substances is more a male behaviour; only exceptions to the rule: the use of psychotropic medicines proves mostly female, whereas tobacco addiction has become more and more unisex. Other example: as far as resorting to care is concerned, save for attending tobaccology consultations, males are a lot more present (70 to 80% of the population) than females.
European drug policies: extended beyond illicit drugs? (I. Obradovic et C. Diaz Gomez)
Since 1999, the realm of action of the Interministerial Mission of the Fight against Drug and Drug Addiction (MILDT) has included licit substances, doping, and illicit ones, giving then top priority to use behaviours rather than to substances, and developing the addiction concept. However the principle of extending the drug concept to licit substances has not proved indisputably acquired (e.g.: interventions in the field of prevention, care, or repression, specific status of alcohol and wine in France); that is particularly why the last five-year plan, without reconsidering the legitimacy of a global approach, has chosen to favour an approach per substance. As it coordinates and puts the “drug and drug addiction” programme into action, the plan defined by the MILDT is then taken over by various actors and field contributors (project leaders, CIRDD…).
Drug use in French recreational areas: situation in 2004 and recent evolutions (P.-Y. Bello, C. Reynaud-Maurupt, A. Toufik, M. Gandilhon, I. Evrard and the TREND network)
Thanks to the TREND system, the uses of psychoactive substances occurring in the French techno recreational area have been observed and followed up for some years; regular qualitative surveys have also strengthened that device set up from 1999 onwards. Ever since the end of 2001, a legal framework has been established as far as organizing recreational meetings is concerned, and that has immediately affected the type of events organized, the locations, the attendance, and the substances used in such a context. In the recreational area the most used substances rank as follows: alcohol and tobacco, then cannabis; among illicit substances other than the latter, the use of stimulants and hallucinogens has been increasing these last years.
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