CAARUD client profiles and practices in 2015

Tendances n° 120, OFDT, 6 p.
October 2017

Support centres for the reduction of drug-related harms (CAARUDs) are designed to carry out harm reduction measures aimed at psychoactive substance users. Tendances No 120 presents the 2015 results of a national survey of users attending these centres, named “ENa-CAARUD”.

The survey confirms the increasing attendance of CAARUDs by socially integrated substance users, with an instability level that nonetheless remains much higher than in the general population.

Regarding substance use, for the first time, the study reveals the central position of alcohol drinking by illegal drug users, regularly highlighted by professionals.

Cocaine use is increasing, probably related to the increased segmentation of the doses sold, to adapt to the financial capacities of the “poorest” users and with an average cocaine purity that has been increasing since 2011. The proportion of clients using base product, bought in the form of crack or freebased subsequently, continues to grow. As regards medication, the 2015 focus confirms the qualitatively known disparities in their status among CAARUD clients, between “getting stoned” and treatment. Morphine sulphate and methadone use became markedly more widespread between 2008 and 2015, as did benzodiazepine use. In the case of methadone, this progression is largely related to its growing use in the context of opioid substitution treatment.

One of the key points of this year’s survey is an increase in equipment requirements related to repeated injections of stimulants, more difficult access to CAARUDs in the context of disruptions relating to urban safety measures or due to distance.

In parallel, recent injecting has not fallen since 2008 and has stabilised at a relatively high level. However, the proportion of users never having injected continues to rise and the age at which they start is increasing.Finally, the proportion of users never having undergone an HIV and HCV test is no longer falling, and is even increasing for HCV.

Authors : Aurélie Lermenier-Jeannet, Agnès Cadet-Taïrou, Sylvain Gautier

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