2024-11-08 08:00:00
The Collectif Citoyens Enfants Libération opposes the opening of an addiction treatment center deemed too close to schools, in November 2023 in Marseille. GAELLE MATATA/HANS LUCAS
The Porte d’Aix district is in the process of being redeveloped. At the back of the triumphal arch which marks the entrance to the center of Marseille, the immaculate facade of the Mediterranean Institute of the City and Territories, inaugurated in October 2023, shines in the sun. Symbol of a renovation which intends to outline the town planning of a 21st century metropolis. At the back of the building, the atmosphere changes. Hidden from view, a group of men and women squat on brand new stairs.
This wide passage is one of the new open-air drug consumption zones that have appeared in recent months in the heart of Marseille. Here, sitting or lying on the steps, we mainly smoke cocaine, previously prepared with ammonia, which the grocers in the city center sell for 5 euros a bottle. Artisanal crack, “patties” of “coke based”, in the users’ local jargon. We also inject it, as shown by the syringes that Romain Prod’homme, Florent Grénot and Luc Fabre collect with the tips of their green tweezers. Shorts, sneakers, in t-shirts or OM jerseys, these thirty-somethings who have accumulated several years of experience in the field of risk reduction provide one of the patrols of Bus 31/32, a historic support structure for drug users in Marseille.
This article is taken from “Special Issue Le Monde – Drug traffickers: their networks, their crimes, the response”November-December 2024, on sale at kiosks or online by going to on our store website.
Three times a week, like other associations, they go out to meet the realities of the street, greet the regulars by their first name – all have been changed in the article –, get news of their health, direct them in case of acute problem. To the new faces, like Ahmid, a young man dressed in sportswear who is about to smoke his crack in a discreet courtyard at the foot of the regional council, they explain their role, starting a dialogue. They distribute new equipment to everyone, to try to reduce the risk of contamination: glass pipes, plastic tips, filters to avoid inhaling the worst of the preparation, syringes for the “injectors”… « We also offer bicarbonate so that they stop using ammonia, which causes multiple pulmonary complications”explains Florent Grénot. A substitute product, less harmful but more difficult to use on a piece of sidewalk, which is not very attractive.
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**Interview with Dr. Anaïs Lefevre, Public Health Expert and Harm Reduction Advocate**
**Editor:** Thank you for joining us today, Dr. Lefevre. The recent debates surrounding drug consumption rooms (DCRs) in Marseille, particularly the opposition from the Collectif Citoyens Enfants Libération, highlight the complexity of implementing harm reduction strategies in urban environments. What are your thoughts on this situation?
**Dr. Lefevre:** Thank you for having me. The situation in Marseille is indeed reflective of a broader controversy surrounding DCRs. While areas like Porte d’Aix are undergoing significant redevelopment, the emergence of open-air drug consumption zones raises questions about public safety, urban planning, and the well-being of local communities.
**Editor:** Given that DCRs have been a topic of discussion since the 1990s, how have public perceptions evolved over the years?
**Dr. Lefevre:** Public perception has shifted considerably. Initially, there was significant resistance due to stigma and misconceptions about drug users. Over time, as evidence has emerged about the effectiveness of harm reduction strategies in reducing overdose deaths and communicable diseases, more people have started to view DCRs as a necessary public health intervention. However, localized opposition, like that seen in Marseille, still persists, often fueled by concerns over proximity to schools and communities.
**Editor:** In the context of the Porte d’Aix district, how might urban redevelopment influence the implementation of DCRs?
**Dr. Lefevre:** Urban redevelopment can create opportunities for integrating DCRs in a way that supports both users and the surrounding community. However, if not managed carefully, it may also exacerbate tensions. Proper community engagement and clear zoning regulations are vital to address concerns about safety and to ensure that these facilities are places of support rather than sources of conflict.
**Editor:** The report mentioned ongoing drug use in open-air spaces despite the new developments. What implications does this have for public health strategies in urban areas?
**Dr. Lefevre:** It underscores the necessity for comprehensive public health strategies that go beyond just the establishment of DCRs. We need to address the social determinants of health, including housing, education, and access to treatment, while ensuring that harm reduction services are easily accessible. The visibility of drug use in public spaces reflects a failure to meet the needs of these individuals adequately.
**Editor:** what steps do you believe should be taken moving forward in Marseille and similar urban areas?
**Dr. Lefevre:** Moving forward, it is crucial to foster dialogue between stakeholders: residents, public health officials, and those with lived experiences of drug use. Collaborative planning can help minimize conflicts and maximize the potential health benefits of DCRs. Additionally, ongoing education about drug use and harm reduction strategies can help reduce stigma and build community support.
**Editor:** Thank you, Dr. Lefevre, for your insights on this vital issue. It’s clear that while the path toward effective harm reduction is complex, community involvement and thoughtful planning are essential.
**Dr. Lefevre:** Thank you for having me. It’s an important conversation to have as we navigate these challenges together.
