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Harm reduction overview for France

Map of France

1. National context

The Government Plan for Combating Drugs and Addictive Behaviours 2013–17 includes risk reduction objectives as part of the prevention of drug use and care of people who use drugs. Since 2004 harm reduction policies have been incorporated in public health regulations and state jurisdiction. Harm reduction is officially defined as aiming at the prevention of the transmission of infections related to drug injecting, of death from overdose, and at reducing social and psychological damage linked to drug addiction by substances classified as drugs.

Services designed to reduce risk and harm have been implemented to complement the specialised drug treatment centres (CSAPA). A network of 154 low-threshold agencies (CAARUD), which receive funding directly from the social security system, forms an important component of the response. Only 11 of 101 departments do not have a CAARUD. Harm reduction services include: the open sale of syringes in pharmacies (since 1987); fixed location needle and syringe programmes (in CAARUD) and mobiles buses at 39 sites. In addition, two methadone buses operate in order to improve access to OST. Frontline and outreach teams (in 84 sites) further improve the service provision to drug users. Syringes are also available from 283 dispensing machines. The latest available data indicates there were 4.5 million syringes sold in 2011 in pharmacies, while around 5.2 million syringes were distributed in CAARUD or by automatic dispensing machines in 2010. Harm reduction measures have been expanded in recent years, and follow drug use trends. Sniff and base kits, foil and condoms are also being made available to drug users at harm reduction sites. The government is preparing a public health law, which would include possibilities for opening experimental supervised drug facilities. This law was submitted to vote at the start of 2015, and in April 2015 a six-year trial of drug consumption rooms was approved; it is expected that facilities will be opened in three cities within the coming months.

Screening for infectious diseases (HIV and HCV) is facilitated by free anonymous screening centres (CDAG). In 2006 some 307 of these centres were operating in the community and 73 within prisons. Hepatitis B virus (HBV) vaccination is recommended for children and adolescents and is also mandatory in some specific health occupations where employees are at risk. CSAPA (specialised addiction treatment support and prevention centres) also provide free screening for HIV and HCV and free vaccination against HBV for any drug users attending a centre. Moreover, new 2014 hepatitis treatment recommendations stipulate that priority should be given to drug users with chronic HCV infection, regardless of their fibrosis score.

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2. Responses to prevent and reduce drug-related infectious diseases

Needle and syringe programmes Country  data
Availability of  NSP programmes  Full
% NSP availability at NUTS3  99 %
Drug use equipment distributed at specialised drug agencies (standard prevention material) 
availability of alcohol pads Yes
availability of dry wipes  Yes
availability of containers  Yes
availability of water  Yes
availability of condoms  Yes
availability of foil  No

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
For an explanation of terms used, see the definitions of terms.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.
Testing, vaccination and treatment of infections Country  data
Availability of Hepatitis C testing in the community  Extensive
Availability of universal hepatitis B immunization programme  Yes
Hepatitis B vaccination programme specific for high risk groups  Yes
ARV treatment of HIV infection  Extensive

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.
Health promotion responses Country  data
Availability of individual counselling programmes  Full
Availability of programmes for practical advice and training on 'safer use/safer injecting'  Full
Involvement of peer educators in the response to infectious diseases prevention  Yes

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.

Drug Treatment

See the country specific treatment profile.

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3. Responses to prevent and reduce drug-related deaths

Availability of drug-related death responses in the community Country  data
Availability of overdose information materials  Extensive
Availability of individual overdose risk assessment (provided by trained drugs or health workers)  Rare
Availability of overdose response training  Rare

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.
Availability of drug consumption rooms Country  data
Number of facilities n.av.
Number of cities n.av.
Number of consumptions per year n.av.

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2011.
N.Av. stands for ‘The intervention is not available in the country’.

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4. Responses to prevent and reduce drug-related harms in recreational settings

Provision of specific responses implemented in night clubs and festivals Free, accessible, cold water Immediate First Aid ‘Chill out’ rooms Information material Outreach work Amnesty bins
Night clubs  Limited  Limited  :  Limited  Rare  :
Festivals  Limited  Limited  Extensive  Extensive  Extensive  :

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2011.
Provision expert rating scale:

  • Full – in nearly all night clubs/festivals.
  • Extensive – a majority of night clubs/festivals provide the intervention (but not nearly all of them).
  • Limited – more than a few night clubs/festivals provide the intervention (but not a majority of them).
  • Rare – just a few night clubs/festivals provide the intervention.

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5. References and links

Related EMCDDA resources

 

About the EMCDDA

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the reference point on drugs and drug addiction information in Europe. Inaugurated in Lisbon in 1995, it is one of the EU's decentralised agencies. Read more >>

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Page last updated: Monday, 01 June 2015