Cannabis is the most widely used illicit substance in France, followed by cocaine, although at much lower levels. Cannabis and cocaine use have increased in the last two decades, while the last year prevalence of MDMA/ecstasy use peaked in 2014. Lifetime prevalence of synthetic cannabinoid use is 1.3 % among 18- to 64-year-olds.
Paris and Bordeaux participate in the Europe-wide annual wastewater campaigns undertaken by the Sewage Analysis Core Group Europe (SCORE). This study provides data on drug use at a municipal level, based on the levels of illicit drugs and their metabolites found in wastewater. The results from Paris suggest a decreasing trend in MDMA levels between 2012 and 2016, with an increase in 2017 and a subsequent decrease in 2018. The data for Bordeaux suggest that there has been an increasing trend since 2016. Levels of cocaine use remained relatively stable until 2016, but an increase was recorded in 2017 and 2018. Levels of amphetamine and methamphetamine were very low, indicating limited use of these substances in Paris and Bordeaux.
Data on drug use among students are reported by the 2015 European School Survey Project on Alcohol and Other Drugs (ESPAD). This survey has been conducted in France every 4 years since 1999 and collects data on substance use among 15- to 16-year-old students. Lifetime use of cannabis reported by French students was about twice as high as the average (of 35 countries), while lifetime use of new psychoactive substances (NPS) was close to the average, as was heavy episodic drinking in the past 30 days.
Studies reporting estimates of high-risk drug use can help to identify the extent of the more entrenched drug use problems, while data on first-time entrants to specialised drug treatment centres, when considered alongside other indicators, can inform an understanding of the nature of and trends in high-risk drug use.
In France, the estimated high-risk opioid use rate is around 5 per 1 000 of the adult population. Heroin and other opioids, such as illicitly used methadone, buprenorphine and morphine sulphate, tend to be injected, although it is becoming increasingly common to smoke or inhale heroin. In 2017, the estimated number of people who inject drugs was 117 000 (2.89 per 1 000 of the adult population). According to data from low-threshold facilities, a notable proportion injected cocaine.
Data from the 2014 Health Barometer suggest that 2.2 % of adults (18- to 64-year-olds) exhibit high-risk cannabis use behaviour and the level of high-risk cannabis use has remained more or less stable over the years, despite the reported increase in the prevalence of cannabis use in recent years. Data from addiction treatment and prevention centres indicate that cannabis was the most commonly reported primary substance for first-time clients entering treatment in 2017, followed by opioids (mainly heroin) and cocaine. Approximately one out of five treatment clients is female; however, the proportion of females receiving treatment varies by primary drug and the type of programme. Since 2014, a noticeable increase in the number of first-time treatment entrants for primary cocaine use has been reported. However, data and trend interpretation is difficult because of the limited participation of specialised drug treatment centres in the treatment reporting system.