France to create a network of ‘safe consumption sites’ for drug addicts

France's health minister Olivier Véran has announced that two new shooting galleries will be created every year, as health authorities struggle to deal with problems caused by drug addicts.

An employee prepares a users' kit at the supervised injection site in Strasbourg, one of two such facilities in France.

“We have approved funds to finance treatment and addiction centres,” Véran told France Inter radio on Wednesday. “I will provide health and social teams to wean off consumers who are currently on the street.”

As part of the project, the safe consumption rooms have been re-dubbed haltes soin/addiction – recovery/addiction centres (halte can be interpreted as a place to rest, or an order to stop), although they are also popularly referred to as salles de shoot (shooting galleries).

In a letter read out during a Fédération Addiction conference last week, Véran wrote that the goal of the new terminology was to “be done with the caricatures about ‘shooting galleries’ and concentrate on care”.

Extending the network

Véran said two new centres would be created each year at a national level. A law from 2016 authorises the creation of low-risk consumption rooms, but so far just two have been set up – one in Paris and one in Strasbourg. Those test facilities were due to run until 2022, but the government announced last week that they would be extended until 2025.

“I myself was an MP in 2015, involved in the creation of the first consumption room in Strasbourg and things are going very well,” he said.

“We therefore have proof that in our country this type of structure, providing support for withdrawal to avoid risk and unsanitary conditions and to better support the most vulnerable people, works.

In August, Paris Mayor Anne Hidalgo announced plans to create four new facilities in the capital. On September 15th, Prime Minister Jean Castex gave the green light for three of the four sites, but after discussions city hall decided to abandon the fourth site, which was due to be situated on rue Pelleport in the 20th arrondissement.

Crack smokers light their crack pipes on the docks at Stalingrad Square in Paris.

Crack smokers light their crack pipes on the docks at Stalingrad Square in Paris. Photo: JOEL SAGET / AFP.

The proposition had drawn criticism from local residents, who complained the site was too close to a school.

“We need coherent proposals for sites, meaning not 15 metres from a nursery or primary school,” Véran said on Wednesday.

Crack consumption is a long-standing problem in Paris, and users were once again evacuated from the jardins d’Eole and Stalingrad areas, towards Porte de la Villette in the 19th arrondissement on Friday.

Residents of the Pantin suburb of Paris denounced a “wall of shame” over the weekend, after authorities bricked up a tunnel under the Paris ring road to stop dispersed addicts from moving out of the capital.

How France compares to its neighbours

“France had fallen 40 years behind. The first low-risk consumption room in Geneva is more than 40 years old,” Véran told France Inter.

In fact, Europe’s first supervised drug consumption room was opened in Berne, Switzerland in 1986. In the 35 years since then, the concept has spread throughout the continent.

There are currently 78 official facilities spread across seven of the countries which report to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) – that includes the EU27 as well as third countries such as Switzerland and Norway.

In 2018, in addition to France’s two centres, there were: 31 facilities in 25 cities in the Netherlands; 24 in 15 cities in Germany; five in four cities in Denmark, 13 in seven cities in Spain; two in two cities in Norway; one in Luxembourg; and 12 in eight cities in Switzerland, mostly in German-speaking areas.

A map shows the locations of 78 safe drug consumption facilities in Europe.

As well as clean injection equipment and health advice, many of the centres offer access to primary healthcare and the possibility to take a shower and wash clothes.

According to the EMCDDA, “There is no evidence to suggest that the availability of safer injecting facilities increases drug use or frequency of injecting. These services facilitate rather than delay treatment entry and do not result in higher rates of local drug-related crime.”

The EU agency highlights the effectiveness of drug consumption facilities to “reach and stay in contact with highly marginalised target populations”, while the presence of facilities has also been shown to reduce behaviours such as syringe sharing that increase the risk of HIV transmission and overdose death.

While plans for drug facilities in Paris have proved controversial with residents, where centres do exist, they have been linked to a decrease in public injecting.

“In Barcelona, a fourfold reduction was reported in the number of unsafely disposed syringes being collected in the vicinity from a monthly average of over 13 000 in 2004 to around 3 000 in 2012,” the EMCDDA states.

READ ALSO French health system to offer free psychologist sessions

Member comments

Log in here to leave a comment.
Become a Member to leave a comment.


Carte vitale: France to adopt a new ‘biometric’ health card

The French parliament has approved a €20 million project to launch a 'biometric' version of the carte vitale health insurance card.

Carte vitale: France to adopt a new 'biometric' health card

As part of the French government’s package of financial aid for the cost-of-living crisis, €20 million will be set set aside to launch a biometric health card, after an amendment proposed by senators was approved.

Right-wing senators made this measure a “condition” of their support for the financial aid package, according to French left-wing daily Libération, and on Thursday the measure was approved by the Assemblée nationale.

While it sounds quite high tech, the idea is relatively simple, according to centre-right MP Thibault Bazin: the carte vitale would be equipped with a chip that “contains physical characteristics of the insured, such as their fingerprints” which would allow healthcare providers to identify them.

The carte vitale is the card that allows anyone registered in the French health system to be reimbursed for medical costs such as doctor’s appointments, medical procedures and prescriptions. The card is linked to the patient’s bank account so that costs are reimbursed directly into the bank account, usually within a couple of days.

READ ALSO How a carte vitale works and how to get one

According to the centre-right Les Républicains group, the reason for having a ‘biometric’ carte vitale is to fight against welfare fraud.

They say this would have two functions; firstly the biometric data would ensure the card could only be used by the holder, and secondly the chip would allow for instant deactivation if the card was lost of stolen.

Support for the biometric carte vitale has mostly been concentrated with right-wing representatives, however, opponants say that the implementation of the tool would be costly and lengthy.

It would involve replacing at least 65 million cards across France and repurposing them with biometric chips, in addition to taking fingerprints for all people concerned.

Additionally, all healthcare professionals would have to join the new system and be equipped with devices capable of reading fingerprints. 

Left-leaning representatives have also voiced concerns regarding the protection of personal data and whether plans would comply with European regulations for protecting personal data, as the creation of ‘biometric’ carte vitales would inevitably lead to the creation of a centralised biometric database. Additionally, there are concerns regarding whether this sensitive personal information could be exposed to cybercrime, as the health insurance system in France has been targeted by hackers in the past.

Finally, there is concern that the amount of financial loss represented by carte vitale fraud has been overestimated. The true figures are difficult to establish, but fraud related to carte vitale use is only a small part of general welfare fraud, which also covers unemployment benefits and other government subsidy schemes.

The scheme is set to begin in the autumn, but there us no information on how this will be done, and whether the biometric chip will just be added to new cards, or whether existing cards will be replaced with new ones.