2024-11-08 09:00:00
The controversies surrounding “shoot” rooms are only the latest illustration of the complexity of deploying, in France, a so-called health policy of “risk reduction”in parallel with the security response to the illicit use of drugs. A look back at the key stages of this public health strategy which aims, rather than withdrawal, to prevent and reduce the risks and effects of drug consumption.
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The “AIDS years”, a founding moment
When we question those in the field, addictologists, activists, doctors, about the founding act of risk reduction, they put forward a key date: 1987. That year, when the AIDS epidemic was soaring, affecting firstly the homosexual community and drug users, the Minister of Health at the time, Michèle Barzach, a doctor by training in a right-wing government, fought hard against her counterparts from the interior and the justice, a decree authorizing, de facto, the sale of syringes. A way to fight against the exchange of materials between drug addicts, recognized as one of the vectors of contamination.
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It is therefore no longer necessary to prove your identity to obtain syringes from a pharmacy. A small revolution: after decades dominated by “dogma of abstinence” and the“therapeutic injunction” to do ” pick up “ the drug addict, the emergency of the “AIDS years” shakes up the situation. With this new logic supported by users and associations: it is a question of reducing the risks linked to drug consumption (overdose, infections, social, psychological damage, etc.), stopping stricto sensu no longer being the only objective .
In the wake of the Barzach decree, syringe exchange programs are developing. Before another important step, in 1995: the marketing authorization of substitution treatments for heroin, methadone and Subutex. “A milestone has been reached with these prescriptions for users, in the name of health risks considered more significant”explains academic Yann Bisiou, specialist in drug law. This did not happen without problems. “Defenders of harm reduction were then considered to be betraying care. Among doctors, we spoke of “dealers in white coats”, the team in which I worked exploded,” remembers addictologist Jean-Pierre Couteron, who, ten years later, participated in the creation of another important system, young consumer consultations.
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**Interview with Dr. Clara Martin, Public Health Expert and Addiction Specialist**
**Host:** Good morning, Dr. Martin. Thank you for joining us to discuss the current state of drug use in France, particularly among youth.
**Dr. Martin:** Good morning! Thank you for having me.
**Host:** Recent statistics indicate that 13 percent of young men in France report regular cannabis use, compared to nine percent of young women. What do you think contributes to this gender gap in drug consumption?
**Dr. Martin:** This gap can be attributed to a combination of social, cultural, and biological factors. For example, societal norms often play a role in shaping behavior; young men may feel more liberated to experiment with substances. Additionally, there could be differences in the ways young men and women respond to peer pressure regarding drug use.
**Host:** That makes sense. The statistics also highlight a rising concern about hard drugs. How do you think France’s health policies should adapt in response to these trends?
**Dr. Martin:** France has made strides with harm reduction strategies, particularly since the HIV/AIDS epidemic in the 1980s. Policies like needle exchange programs were crucial at that time and need continued support. Expanding these measures, along with increased education on the risks associated with drug use, is essential.
**Host:** You mentioned harm reduction. Could you explain what it entails, especially in the context of drug “shoot” rooms?
**Dr. Martin:** Harm reduction focuses on minimizing the negative impacts of drug use without necessarily aiming for complete abstinence. “Shoot” rooms, or supervised injection sites, aim to provide safe environments for drug users. These facilities can significantly reduce public health risks, including the spread of infectious diseases and overdose deaths, while also guiding users toward treatment services.
**Host:** There are controversies surrounding these “shoot” rooms. What are the main arguments for and against them?
**Dr. Martin:** Proponents argue that they save lives and provide a pathway to treatment. Opponents often fear that they may normalize drug use or lead to increased crime in surrounding areas. The challenge is finding a balance—implementing these spaces while ensuring community safety and support.
**Host:** Looking ahead, what do you envision for the future of drug policy in France?
**Dr. Martin:** I believe we will see an increasing shift towards comprehensive and evidence-based approaches that prioritize public health over punitive measures. This includes more funding for research, education, and harm reduction programs, creating a society that supports individuals struggling with addiction rather than stigmatizing them.
**Host:** Thank you for your insights, Dr. Martin. This is certainly a complex issue that requires careful consideration and a compassionate approach.
**Dr. Martin:** Thank you! It’s crucial that these discussions take place as we work towards effective solutions for our youth and communities.