Wednesday, December 5, 2012

French safe injection sites: From public health to politics

By: Jennifer Halliday 
Produced and edited by: Leisha Lininger 

In the 1970s, the Netherlands opened their first safe injection facilities, which provided a safe and humane environment for those marginalized in society by addiction to inject their drugs in a supportive, non-judgmental way. Safe injection rooms, or legalized “shooting galleries” are facilities where addicts can inject heroin and other drugs with sterile needles provided by medical professionals. Since the 1970s, these facilities have spread throughout several European countries such as Germany, Luxembourg, Norway, and Spain and have even moved across seas to Canada and Australia.

With growing concern for both drug-related injuries and transmission of blood-borne diseases in the country of France, Marisol Touraine, France’s health minister, has announced a trial run of safe injection facilities. 

“I hope that experimental trials will be announced before the end of the year,” Touraine told French BFM television.

France has become a natural distribution point for drugs moving toward North America from Europe and the Middle East. The country’s overseas territories in the Caribbean, its proximity to North Africa, and its participation in the Schengenopen border system, contribute to its desirability as a transit point for drugs. In fact, the Bureau for International Narcotics and Law EnforcementAffairs reports that drugs from Morocco, South America, Afghanistan, Turkey, Belgium, the Netherlands and Germany all find their way into France.

“One of the most dangerous drugs, one of the most prevalent drugs, one of the most addicting drugs, that we’re dealing with is heroin,” said Dr. Michel Craplet of the Association Nationale de Prevention en Alcoologie et Addictologie.

Heroin is an opiate analgesic synthesized from the opium poppy plant. According to a study by Carpentier and Costes, an estimated 160,000 heroin addicts live in France alone.
The country currently offers three forms of drug addiction treatment financed by the French social security system: outpatient care, inpatient care, and treatment for prison inmates. 

“If you combined all three types of this treatment, there’s still only about 270 of these centers throughout the entire country,” said Craplet.

And according to Carpentier and Costes’ study, heroin-related deaths in the country have jumped thirty percent since 2000. As a result, many public health organizations are calling for a rapid start to the safe injection room program. 

Other countries’ safe injection rooms have shown a benefit to the public health situation,” said Christian Andreo, manager of the French AIDES National Program. “They have proven to cause a reduction of HIV and AIDS contamination as well as provide more access to care.”

Supervised injection sites are credited with lowering overdoses, reducing the spread of blood-borne diseases, improving client heath and public health, providing entry to drug treatment and other medical and social services, and reducing public disorder. They have also been linked to reductions in neighborhood crime.

However, despite numerous studies that support the implementation of safe injection rooms, Andreo has serious doubts that they will be up and running by the end of the year.

“I have doubts concerning the possibility to open such a program by the end of the year,” said Andreo. “It’s a lot of work to do with the competition from local authorities and police.”
Opposition for the implementation of safe injection rooms is widespread throughout France.

In an opinion poll conducted in September by French polling agency Ifop, 55 percent of those questioned said they were against them, while 45 percent said they were in favor.
However, the program’s largest opposition is France’s conservative UMP party, which has said it was against the opening of such trial centers.

“Opening consumption rooms does not help fight against the scourge of drugs, but rather trivializes drug use and legalizes the use of the hardest drugs at the taxpayer’s expense,” said Camille Bedin, the party’s national secretary in a statement to the press.

The idea of safe injection rooms opening in France has made headlines in the country since 2010. However, public health organizations are asking people to put the politics aside.

“On the topic of drug rooms, it’s really hard to focus on just what the science says,” says the AIDES program’s Andreo. “We will always debate and we will have a political party in favor of the opposing side, but we must focus on the health involved.”

Despite heavy political opposition, the French public has shown signs of supporting the implementation of safe injection rooms. In April’s presidential campaign, the PS candidate Francois Hollande was elected over the UMP’s incumbent Nicolas Sarkozy. During his campaign, Hollande said the he would oversee the opening of France’s first “shooting galleries.” Medecins du Monde, along with other organizations, has since called on Hollande to see his word into action.

“We advocate for the opening of safe injection rooms, but you can’t open these programs without a legal basis, we need that legal basis,” said Medecins du Monde’s Emmanuelle Hau.

President Hollande has received support for his move to open safe injection rooms from fellow party member Jean-Marie Le Guen, of the Assemblee Nationale.

“I would prefer that these destitute drug abusers inject themselves in specialized rooms, rather than in the street or apartment building stairwells, as is the case today,” says Le Guen. “I would prefer that they are surrounded by medical professionals.”

The political stigma that surrounds drug-related issues such as the opening of safe injection rooms led to a two-year debate, prolonging possible public health services to thousands of French citizens. Some public health organizations say that the best move for public safety is to remove this stigma altogether.

“We aim for the end of the criminalization of drug use,” said the AIDES program’s
Andreo. “We want to prove that, with certain practices, people can really reduce the risks.”

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