France

"Cannabis is still by far the most widely used illicit substance, both among teenagers and the adult population, with 17 million people having already tried it (i.e. 41% of 15 to 64 year-olds). The overall proportion of recent users (in the last month) is 6.6%, and regular use (at least 10 times per month) concerns nearly 1.5 million people in France.
"Among last year users aged 18 to 64 years, according to the 2014 INPES Health Barometer Survey, the proportion of those at high risk of problem cannabis use is 21%, i.e. 2.2% of the French population aged 18 to 64 years. Cannabis is also the most frequently reported substance mentioned as the principal reason for entering drug treatment (CSAPA). As far as synthetic cannabinoids are concerned, 1.7% of adults aged 18 to 64 state that they have already used such substances. Their use levels are similar to heroin or amphetamines.
"Cannabis use has been on the rise since the beginning of the 2010s, regardless of age group and frequency of use: this rise is part of a context of a marked increase in cannabis supply in France, particularly home cultivation and local production of herbal cannabis, while the cannabis resin market is still very dynamic.
"The use of cocaine, the second most frequently used illicit substance, is far below that of cannabis and concerns approximately one tenth the number of people. However, the proportion of lifetime cocaine users aged 18 to 64 has increased four-fold in two decades (from 1.2% in 1995 to 5.6% in 2014). This statistic includes those who have used cocaine at least once in their life (lifetime users) or at least once in the last year. This variation indicates the wider diffusion of a substance once limited to well-off categories, and affecting all social groups in recent years. The levels of lifetime use for synthetic drugs such as MDMA/ecstasy and amphetamines are 4.3% and 2.3%, respectively. The proportion of current MDMA/ecstasy users increased significantly between 2010 and 2014 (from 0.3% to 0.9%), thus reaching a peak since the last decade.
"The prevalence of lifetime use of heroin is 1.5% in the entire 18 to 64 year-old population and current use seems very rare (0.2% of those surveyed)."

Click here for complete datatable of Estimated Number of Users of Psychoactive Substances in Mainland France among 11 to 75 year-olds

"Among first-time clients entering specialised drug treatment in 2021, or most recent year available, with heroin as their primary drug, 19% (down from 38% in 2013) reported injecting as their main route of administration. In this group, levels of injecting vary between countries, from less than 10% in Denmark, Spain, France and Portugal to 60% or more in Czechia, Estonia, Latvia, Lithuania, Romania and Slovakia."

"The initial results of the recent HBSC, ESPAD and ESCAPAD surveys are consistent in terms of the particular use of cannabis amongst adolescents in France. Cannabis is the most widely consumed illicit product amongst 11-17 year-old adolescents, especially males. In terms of lifetime use, in 2010, the use of cannabis was extremely rare amongst 11 year-olds and concerned 6.4 % of 13 year-olds (representing an increase compared to 2006 figures) and stabilised at 28.0 % amongst 15 year-olds (HBSC).
"Amongst older subjects, almost two out of five young people (39 %) born in 1995 (aged 16 in 2011) have used at least once cannabis during their lifetime. A higher percentage was recorded amongst the girls. This represents an increase compared to the last data recorded in the 2007 ESPAD survey (30 %). Amongst 17 year-olds, in 2011, 41.5% of these young people had used cannabis at least once in their life, with a stable trend being recorded over the 2008-2011 period. This stability is based on the continued decrease in boys and an upturn – albeit non significant - in young girls.
"The reported use of cannabis over the last 30 days has proved to be marginal amongst the under 15 year-olds (HBSC). Cannabis is used by 24.0% of 16 year-olds (ESPAD), representing a significant increase compared to 2007 (15.0%), stabilising amongst 15 year-olds (HBSC, 12.5% vs. 14.4%, non significant change) and decreasing slightly in 17 year-olds (ESCAPAD) (22.4% vs. 24.7% in 2008)."

"The data available have limitations in respect to quality and coverage, however, the information available suggests that heroin was only present in the majority of overdose deaths in a relatively small number of EU countries. A significant share of overdose deaths was reported by Austria (67%), Italy (56%), Ireland (46% in 2017), Poland (44% in 2016) and Romania (43%). In 7 other European countries, heroin was found in approximately a quarter to a third of reported overdose deaths: Portugal (37%), Slovenia (33%), Denmark (36%), France (33% in 2020), Türkiye (32%), Spain (28% in 2020) and Norway (23%). In 2021, in the north of Europe, less than 1 in 6 overdose deaths in Finland, Sweden and in the Baltic countries was reported to involve heroin."

"In France, as elsewhere, people who inject drugs (PWID) faced a dramatic HIV epidemic in the 1990s. In response, the French government’s harm reduction policy, which first developed programmes for access to sterile injection material in 1987, extended access in 1994 to include syringe vending machines and the sale of ready-to-use injection kits (Steribox) in community pharmacies,¹ as well as new state-funded needle exchange programmes (NEP).² These public health initiatives were concomitant with opiate maintenance treatment (OMT) programmes with methadone (available since 1994) and buprenorphine (available since 1995)^{3 4} and HAART for HIV-infected individuals.⁵ HIV prevalence in PWID dramatically decreased from 40% to 20% in 14 years from 1988 to 2002,^{2 6} with a prevalence in 2011 of 10%.⁷ An estimated 77% to 85% of opioid-dependent individuals in France are currently treated with OMT."

"Cannabis is by far the most widely used illicit substance in France. In 2010, among adults aged from 15 to 64 years, around a third (32.1%) admitted to having used cannabis during their lifetime. This experimentation affects more men than women (39.5% compared with 25%). 8.4% of 15-64 year-olds have used cannabis over the last 12 months (11.9% of men and 5.1% of women), whereas the overall proportion of users during the month is 4.6%.
"Although lifetime use went from 28.8% to 32.1% for all age groups between 2005 and 2010 (Table 2-2), cannabis use remains stable. The slight increase observed is linked to a 'stock' effect of former generations of smokers.
"Cannabis is mostly used by the younger generations with virtually negligible consumption in the over 50 year-olds.
"Thus 20.8% of 15-24 year-olds were implicated in cannabis use over the twelve-month period preceding the survey.
"In terms of gender distribution, among the proportion of people who have used cannabis at least once in their life, men in the 25 to 34 year-old age bracket (64.3%) are at highest with percentages decreasing thereafter to 13.1% amongst 55-64 year-olds (Figure 2.1.). In women, cannabis lifetime users represent 37.0% of 15-34 year-olds and only 7.3% of 55-64 year-olds.
"Amongst 15-34 year-olds, the stability of cannabis use hides some generational disparities: use over the last 12 months has increased in 20-24 year-old women (rising from 13.0% in 2005 to 16.4% in 2010), whereas the level of lifetime use is declining for girls aged 15-19 and males aged 15 to 24."

"Since the beginning of the 1990s, the availability of stimulants, cocaine or other synthetic drugs (ecstasy, amphetamines, etc.), has increased in France. The emergence and the related spread of the freebase form of cocaine 74, crack (whose use is nevertheless rare) occurred during the same decade.
"With 1.5 million lifetime users aged from 11 to 75 (i.e. 3% of the general population) and 400,000 users over the course of the year (0.8% of the general population), cocaine ranks second among the most widely consumed illicit substances, way behind cannabis and licit psychoactive substances. In 2010, 3.6% of 15-64 year-olds questioned by the Health Barometer had used it at least once in their lives and 0.9% had used it during the past year (Table 2-2). The significant increase in its diffusion is nevertheless very marked. It reflects the accessibility of a substance that was once limited to the well-off. For some years, increasingly wide circles of society have tried it or used it. Current use (during the year) and lifetime use affects around three times more men than women."

"The proportion of 15-64 year-olds who have used cocaine at least once has significantly increased three-fold in 15 years, from 1.2% in 1995 to 3.6% in 2010. It increased by a third between the last two Health Barometer surveys. Use in the previous year almost doubled between 2005 and 2010 among 15-64 year-olds, from 0.5% in 2005 to 0.9% in 2010 (Table 2.2), a statistically significant increase. First time use usually takes place at the average age of 23.1 years.
"The age bracket mostly affected by cocaine use is young adults, with use becoming less frequent with increasing age. The proportion of cocaine lifetime users is highest amongst 25-34 year-olds (7.7% of the total, 11.2% of men, 4.4% of women). Fewer members of older generations have used the product at least once during their lifetime.
"Similarly, use during the year primarily affects 15-24 year-olds (1.8% of the total, 2.6% of men, 1.0% of women) then decreases and becomes practically nil from the age of 55 onwards."

"Alcohol and tobacco consumption levels are by far those which cause the most serious extent of damage, either on the health or social level, or with regard to potential dependency."

"The number of drug-related offences has risen sharply over the last 30 years. Almost 90% of all reported drug-related offences in France are related to drug use or possession. The numbers of arrests for drug offences have increased consistently since the 80s. There is no evidence showing whether this evolution is due to an intensification of police activity, an increase in drug use and trafficking or a better performance of the data gathering systems (or other factors) (OCRTIS (Office central pour la répression du trafic illicite des stupéfiants) A paraître).
"Reasons for arrest
"The use of narcotics is the main reason for arrest, accounting for 143,640 arrests in 2011, i.e. 89% of arrests for drug-related offences in 2011. This percentage has increased since 1998. In 2011, 18,111 arrests were recorded for usage-dealing and trafficking, i.e. 11% of arrests for drug-related offences. Contrary to arrests for drug use, arrests for usage-dealing and trafficking have decreased compared to the previous year (- 20% for usage-dealing; - 17% for international trafficking; - 16% for local trafficking)."

"Cannabis remains the main substance involved in arrests for drug-related offences, regardless of the grounds for arrest, accounting for 90% of arrests for use and 70% of use-dealing and
trafficking cases in 2011.
"Way behind cannabis, heroin and cocaine are the main substances involved in drug-related arrests (accounting for 5.4% and 3.5% of usage-related arrests, respectively).
"We should point out the relative importance in France of the number of arrests related to the misuse of medicines (particularly HBD, aka Subutex®, but also unspecified substances, used in spite of the absence of any proof of a prescription), and those for hallucinogenic mushrooms."

"France continues to be a major transshipment point for drugs moving through Europe. Given France‘s shared borders with trafficking conduits such as Spain, Italy, and Belgium, France is a natural distribution point for drugs moving toward North America from Europe and the Middle East. France‘s overseas territories‘ presence in the Caribbean, its proximity to North Africa, and its participation in the Schengen open border system, contribute to its desirability as a transit point for drugs, including drugs originating in South America. France‘s own large domestic market of cannabis users is attractive to traffickers as well. Specifically, in descending order, cannabis/hashish originating in Morocco, cocaine from South America, heroin originating in Afghanistan and transiting through Turkey, Belgium, and the Netherlands, and ecstasy (MDMA) originating in the Netherlands and Germany, all find their way to France."

"Cannabis
"According to OCRTIS 214 the median price for herbal cannabis in 2011 was approximately €7.50 per gram and ranged from €5.80 to €10 per gram. This price is up compared with previous years (€6.50 in 2009 and €7.00 in 2010). According to the TREND price barometer, the median price for herbal cannabis is around €10 (Gandilhon et al. 2011). This upward phenomenon is explained by the fact that an increasing percentage of consumers appear to display a marked preference for high-quality products.
"The wholesale price, as measured by the police, stands at €3,000 per kilogram.
"For the OCRTIS, the median price of cannabis resin has remained stable. In 2011, it was still €5 per gram. This observation was confirmed by the TREND system, since the median price per gram is approximately €5. The wholesale price of cannabis resin for the same year was €2,000 per kilogram.
"Heroin
"According to the OCRTIS in 2011, the median price for a gram of brown heroin was approximately €35, down more than 10% compared with 2010. If this downward trend continues, this would indicate a certain trend reversal since the price per gram had been stable since 2007. Nevertheless, over the longer term, the trend is clearly downward since the price of a gram of heroin in the early 2000s was approximately €60. For 2011, the TREND system reported a stabilisation of the price at around €40.
"The wholesale price for brown heroin has also decreased to approximately €10,500 per kilogram.
"Misuse of substitution products
"Since 2008, the price per 8 mg tablet of HDB marketed as Subutex®, the only (or almost only) form available on the black market in major urban centres, rose slightly to €5.50-5.60 in 2011 compared with the €4 price of previous years (Cadet-Taïrou et al. 2010b). This price increase is believed to be related to difficulties in keeping the market supplied due to the strict prescription control measures put in place by health authorities.
"The price of a 60 ml vial of methadone ranges from €5 to approximately €20, depending on the location.
"Cocaine
"The price per gram of cocaine hydrochloride has remained stable for five years after having been halved compared to the late 1990s. In 2011, the median price according to the OCRTIS was approximately €60. However, TREND’s observation was different, reporting an upward trend with prices closer to €65 in cities and over €70 on the festive scene. Nevertheless, it is still too early to draw any conclusions from this observation.
"The wholesale price, which also remained stable, was €30,000 per kilogram."

"The number of problem drug users estimated at national level varies from 222,000 (multiplier applied to arrest data) to 340,000 (multivariate indicator method), corresponding to a prevalence of 5.5 per thousand and 8.4 per thousand, respectively, depending on the method employed. The multiplier method applied to treatment data gives an intermediate prevalence of 7.5 per thousand. Estimates based on arrest data are lower than the other two estimates, especially for those obtained with the multiplier method, with no cross-checking between confidence intervals. In 2006, the range of values adopted at national level, i.e. 210,000 to 250,000 users, corresponded to the overlap zone of confidence intervals calculated for each estimation method. Adoption of the same principle for the 2011 data led to disgard the multiplier method applied to arrests. The only estimates retained were based on treatment data and the multivariate indicator. A rather large range in values was thus obtained, namely 275,000 to 360,000 problem drug users. The upper and lower prevalence limits associated with these estimates are 7 per thousand and 9 per thousand. This result places France on an upper average ranking in terms of European Union statistics, with prevalences rounding similar levels to that observed in western European countries such as Italy, Spain and the UK, although markedly superior to Portugal and Germany."

"France has recorded national estimates of the number of problem drug users since the mid 1990s. The last estimate produced by the OFDT relates to 2011 data and follows on from earlier estimates in 1995, 1999 and 2006. The definition of problem drug use has, however, changed from one study to the next: in 1995, the inclusion criterion for this category was the use of opiates; in 1999, this criterion was extended to include cocaine. The definition proposed by the EMCDDA in 2004 was adopted for the 2006 and 2011 estimates: the concept of problem drug users includes users (between 15 and 64 years of age) of all drugs administered intravenously or regular users of opiates, cocaine or amphetamines. There is, however, a slight difference between the approach used in France and EMCDDA recommendations. In the studies conducted in 2006 and 2011, all patients who had consumed the aforementioned substances or administered drugs intravenously within 30 days prior to the study were considered to be problem drug users. The use of this inclusion criterion does not, however, indicate whether use has been ongoing for one year – a condition stated in the European protocol. The purpose of this criterion was probably to exclude “occasional” users. In practice, almost all recent users of these substances or of intravenous drugs seen in treatment and harm reduction centres are long-term users."

(Prevalence of HIV/AIDS in France 2010, by Transmission Method)) "The estimate of the number of new HIV patients since HIV reporting became mandatory in 2003 was 55,168 on 31 December 2010 137. Given reporting delays and under-reporting, in 2010 the number of positive notifications was estimated at 6,265, which is slightly lower than the two preceding years (6,341 in 2009 and 6,340 in 2008).
"In 2010, people infected through intravenous drug use represented no more than 1.13% (71/6,265) of these new cases of infection. The most frequent contamination route is heterosexual intercourse (57% of cases) followed by homosexual intercourse between men (40%) (Cazein et al. 2011). It is still too early to assess the impact of the recommendations (generalised screening and repeated screening amongst exposed populations) of the 2010-2014 French national HIV-AIDS and Sexually Transmitted Infection plan on HIV surveillance data. In 2008, the incidence of HIV amongst IDUs was estimated at 86 per 100,000 person-years [95% CI, 0-192] (Le Vu et al. 2010). (Table 6-1).
"The number of new AIDS cases amongst IDUs has fallen continuously since the mid-1990s. Whereas IDUs represented a quarter of the people diagnosed at the AIDS stage at that time, they represented only slightly fewer than 8% in 2008 and approximately 5% in 2010 (provisional data)."

"Data from the death registry reveal a constant increase in the number of drug-induced deaths from 2003 to 2008, and even until 2009 if we limit the age range to 15-49-year-olds, amongst whom the large majority of cases were due to overdose.
"DRAMES [Drug and Substance Abuse Related Deaths (ANSM)] provides information on the substances that are the main cause of deaths by overdose. In 2009, illegal drugs were the main cause, as the main product, of death in slightly more than half of the cases (53%), followed by substitution treatments in approximately 34% of cases and opioid medications (excluding substitution treatments) in almost 13% of cases. Overall, opioids were chiefly involved in 87% of cases and cocaine (alone or combined with other substances) in approximately 12%. The rise in the number of overdoses between 2006 and 2009 is explained by an increase in the number of deaths from heroin overdose (+ 44 cases) and methadone overdose (+ 27 cases)."

"We currently have relatively accurate information about the number of people receiving care in the specialist centres. The CSAPAs [National Treatment and Prevention Centre for Substance Abuse] are required to provide the administrative authorities with an annual activity report containing certain information about people received during the previous year (see Appendix IV-P). The response rate for these reports is close to 90% annually and almost 100% over a two-year period. Based on these reports, it is possible to estimate at approximately 96,000 the number of people who were seen in the outpatient CSAPA in 2008¹²⁸ for their problem with illegal drugs. This includes overlapping, although these should not make up more than 5% of the total. Compared to the outpatient CSAPA, very few people, slightly fewer than 2,000, appear to be accommodated in a residential treatment centre, some of whom are already included in the figures for the outpatient CSAPA. In fact, these centres send a large number of patients to the residential centres where they are then housed. The number of people seen for a problem with illegal drugs in 2008 in prison CSAPAs can be estimated at 5,000.
"The only national data available for primary care is for people receiving substitution treatment. In 2010, as was previously mentioned, approximately 145,000 people were refunded by social security for their substitution treatment. Some of these may also have been monitored jointly or in succession by a CSAPA during the year.
"As regards hospitals, national data obtained from the PMSI medicalised information system programme are available 129 specifying the number of hospital admissions in the departments of medicine, surgery and obstetrics with a primary diagnosis of behavioural disorders related to the use of psychoactive substances, excluding alcohol and tobacco (ICD 10 diagnosis: F11 to F16, F18 and F19). There were approximately 7,500 hospital admissions in 2011, 1,900 of which concerned opiate users, almost 2,200 sedatives and hypnotics, around 1,000 cannabis users and 1,600 polydrug users. It should be noted that this data does not include attendance at emergency departments or those monitored on an outpatient basis for hospital addictions clinics. Overlapping also exists between hospitalised patients and those seen in specialist centres or primary care."

"In 2011, almost half of new patients (48%) were treated in specialised treatment centres for problems associated with cannabis use. A majority (57%) of them stated using cannabis every day. The percentage of people treated for their cannabis use was much lower among women (35% vs. 51%). The proportion of people using it daily was slightly lower among men, but this difference was not very marked (57% vs. 61%).
"The proportion of first-time treatment patients stating that cannabis posed the biggest problem was higher than that recorded in all new patients (71% vs. 48%). The breakdown of the frequency of use was similar in the two groups. The large number of cannabis users among patients in treatment in France is partly the consequence of the large and still increasing number of arrests for cannabis use. In fact, some of the users who have been arrested were sent to treatment centres by the courts.
"After cannabis, opiates are the second product most often cited as causing the majority of problems: 41% of new patients fall into this category. Of these patients, 77% stated heroin, 5% methadone and 18% other opiates (primarily HDB) 131. Of these patients, heroin was most frequently used nasally (65%), but one in every five heroin users still injects. The monthly percentage of injectors is much higher (37%) amongst other opiate users. Among the opiate users, almost 80% consumed these substances on a daily basis and 11% took them regularly (i.e., several times a week).
"Women are treated less often than men for cannabis use. However, they are treated far more than men for their opiate use (50% vs. 38%), regardless of the type of opiate in question. They used the injection route slightly less often than men to consume heroin (22% vs. 24%), but as often for the other opiates.
"The percentage of first-time treatment patients listing opiates as the substance posing the most problems is far lower than that recorded for all new patients (20% vs. 41%). Distribution of frequency of use is similar in the two groups although there is a slightly higher proportion of daily use among first-treatment patients. This group administers fewer injections during the month (15% versus 21%)."

"In 2010, 135 CAARUDs [Support Centre for the Reduction of Drug-related Harms] existed throughout France. These are medico-social centres funded by the French social security system. They operate in various places with diverse methods. Of these, 95% offer a stationary reception service, 66% have street teams, 47% operate in squats, 40% have mobile teams, 39% work with teams on the party scene and 28% have developed prison activities. They largely contribute to distributing clean injection equipment (3.8 million syringes in 2008) and other prevention equipment (e.g., ancillary injection equipment, condoms).
"The major activities undertaken by these units are: providing assistance with hygiene and first aid care, offering health education promotion activities, helping people get access to social services, following-up on administrative and legal procedures and seeking out urgent accommodation.
"More specifically, the 2008 CAARUD activities pertaining to distributing prevention equipment were:
"• syringes: 2.3 M single syringes and 530,000 kits (2 syringes per kit, i.e. approximately 1 M syringes) handed over personally and 200,000 kits (2 syringes, i.e. 400,00 syringes) via distribution machines managed by CAARUD (see below);
"• small injection equipment: 1.1
"• condoms: 782,000, 91% of which were male condoms
"• gel: approximately 292,000 units."

(Syringe Distribution in France 2008) "From the different information sources, we can estimate that approximately 14 million syringes were sold or distributed to drug users in France in 2008. Comparing this number to the number of IV drug users (81,000 recent IV users) produces a ratio of approximately 170 syringes per user per year (Costes et al. 2009). This figure, which only represents an order of magnitude, may indicate rather high accessibility to syringes in France for IV drug users. The pharmacies play a key role and are involved in over two-thirds of the sale or distribution of syringes. However, a reliable evaluation of requirements together with an analysis of geographical disparities (accessibility of syringes in rural areas in particular) has yet to be carried out.
"No estimate has been completed since 2008 when 13.8 M syringes were estimated to be distributed or sold. Some data are, however, available for 2010. Almost 2.4 M Stéribox2® kits (kits containing sterile injection equipment) were distributed in pharmacies in 2010, which corresponds to 4.7 M syringes (2 syringes per kit) based on InVS SIAMOIS data. The distribution of Stéribox2® in pharmacies has thus been stable since the early 2000s. Dispensing machines outside CAARUD distributed 1.1 M syringes in 2010 based on the data provided by the Safe Association – a figure that has increased compared to 2007."

""Providing assistance in gaining access to OST [Opioid Substitution Treatment] and general care is one of the CAARUD’s [Support Centre for the Reduction of Drug-related Harms] primary missions:
"• 83% of the CAARUDs reported that they had set up access to OST (referral or monitoring)
"• of all of their activities involving access to hygiene and first aid, the most common procedures (35%) were body care, followed by nursing care (26%);
"• 84.7% of CAARUDs developed health education promotion activities, 75% of which were individual interviews and group sessions focussing on the risks related to substances and to modes of contamination.
"The CAARUDs saw 48,000 people in 2008. The new patient intakes per structure stands at an average of approximately 200 subjects, although in reality the figures varied greatly: 41 centres saw fewer than 200 people whereas 11 CAARUDs saw more than 1,000 155 (Chalumeau 2010).
"The role of the CSAPAs [National Treatment and Prevention Centre for Substance Abuse] in reducing risks, which is one of their missions, cannot be quantified in the absence of data."

"For the last ten years, the Observatoire français des drogues et des toxicomanies (OFDT, or the French Monitoring Centre for Drugs and Drug Addiction) has repeatedly worked on estimating the social cost of licit and illicit drugs. The first study (Kopp et al. 1998) dates back to the 1990s and examined the possible calculation methods. The initial estimates were presented in the Kopp and Fénoglio report (Kopp et al. 2000) on Le coût social des drogues (the social cost of drugs). This initial work estimated the annual costs of the illicit drugs to society to be €2,035.24 million. Regular estimates have been carried out since then. There are two reasons for the need to continually re-estimate these figures: the appearance of new data that were initially unavailable (e.g. treatments for certain diseases) and the need to consider new calculation methods. Hence, the 2006 study assessed the social cost of illegal drugs to be €2,824.44 million in 2003 (Kopp et al. 2004). Compared to the 2000 estimate, the social cost of illicit drugs was only multiplied by a factor of approximately 1.39."

Laws & Policies

"The 2011 national strategies of the governmental policy are set forth by the 2008-2011 government action plan against drugs and drug addiction. The forward-looking 2011 report by the MILDT (Mission interministérielle de lutte contre la drogue et la toxicomanie, or the French Interministerial Mission for the Fight Against Drugs and Drug Addiction) revealed that nearly all of the government’s objectives had been achieved. Furthermore, between 2011 and 2012, three other national plans integrated and reinforced the health measures set forth in the 2008-2011 drugs plan: the 2009-2012 'hepatitis' plan, the 2009-2013 'cancer plan' and the new 2010-2012 'detainee' plan supervised by the French Ministry of Health and Sports with the participation of the French Ministry of Justice.
"Public expenditure on implementing the governmental drug policy and French national health insurance in 2010 was approximately €1,510 M. This estimate does not take into account expenditure attributable to prison administrative services or major hospital or primary care costs. These expense categories have been estimated within the scope of previous studies. Kopp and Fénoglio estimated the costs of treatment attributable to drug-related health problems at €21.58 billion in 2003; prison expenditures were estimated at €219.79 million (Kopp and Fénoglio, 2006b). After inflation, these estimates would have accounted for €26.66 billion and €0.25 billion in 2010 respectively. If we consider these latest categories of expenditure up-dated after inflation, public spending attributable to the drug and addiction prevention policy is somewhere close to €28 billion in 2010 (licit and illicit drugs). This estimate accounts roughly for 1.5 percent of the GDP in 2010 (GDP accounts for €1,931.4 billion in 2010) but also for 6.6 percent of the State’s budget which accounts for a spending of €435.37 per habitant."

"The initial interministerial anti-drug plan dates back to 1983. The 2008-2011 'Government Action Plan Against Drugs and Drug Addiction' includes almost 200 measures for prevention, enforcement, health/social care, research, observation, training and international cooperation. Priority is given to preventing people from taking drugs from the get-go, since the age of first-time use is younger and younger. This targets young people and those close to them (such as parents and educators).
"The Plan mentions several priorities for enforcing the law: alcohol abuse among the youngest users, drug related offences and/or tobacco use in public establishments, cannabis trafficking, seizure and court-ordered confiscation.
"It provides for new treatment and social integration modalities, particularly for minors, pregnant women or parents of young children, cocaine or crack users and newly-released convicts. The plan aims to increase housing capacity for addicts in vulnerable conditions.
"Finally, with respect to international policy, the 2008-2011 plan has three major objectives:
"• reinforcing (within a multilateral, European and bilateral framework) actions deployed at every stage along the trafficking routes (particularly in western Africa and the Mediterranean) in order to choke off the cannabis and cocaine supply sources in Europe and heroin outlets in central Europe and the Balkans;
"• setting up of increasing numbers of agreements with the countries concerned in order to simplify international action against the diversion of chemical precursors (particularly in Afghanistan);
"• and finally, boosting Mediterranean cooperation to coordinate the fight against drugs in the Mediterranean area.
"The 2012 electoral calendar postponed the adoption of the 2012-2015 'Government Action Plan Against Drugs and Drug Addiction'.
"The preceding plan (2004-2008) was inspired by a policy that mainly targeted young people and prevention, with a particular focus on 'halting the spread of cannabis' among adolescents and young adults. Without abandoning these efforts, the 2008-2011 Plan emphasises enforcing the law through targeted communication campaigns. The government plan can also be seen as a continuation of the French Ministry of Health’s 2007-2011 Plan for the treatment and prevention of addictions, adopted in November 2006 42, which seeks to structure and enhance the availability of existing facilities and programmes (hospitals, health/social care centres and in primary care settings)."

"A drug user is an individual who consumes a narcotic substance. The legal authorities often liken the possession of small quantities of narcotics to use. They also equate the cultivation of cannabis to use when the substance is intended for personal consumption.
"Any drug related offence exposes a person to being arrested by the police, a gendarme or a customs officer and will, in principle, be referred to the judicial system. Offences are examined on a case-by-case basis by the public prosecutor who, based on the principle of the 'opportunité des poursuites' (appropriateness of proceedings), may decide to take legal action against the offender, to simply close the case or to propose other measures as an alternative to legal proceedings. This principle enables judicial responses to be adapted to each individual situation by providing a progressive response in accordance with the seriousness of the acts committed. It also explains the differences in penal practices employed by the courts."

"The harm reduction policy for drug users is the responsibility of the government (article L3121-3 of the French Public Health Code modified by the law of 13 August 2004 - art. 71 35). This harm reduction policy seeks to prevent the spread of infection, death by intravenous drug overdose and the social and psychological damage caused by narcotics use. The law of 9 August 2004 36, which established CAARUDs [Support Centre for the Reduction of Drug-related Harms], states that, along with other schemes, CAARUDs should be used to contribute to the harm reduction policy (article L3121-5 of the Public Health Code). CAARUDs are open to both individuals and groups, provide personalised advice and information to drug users, offer support to help drug users obtain access to treatment (which includes assistance with hygiene and access to basic emergency care), make referrals to specialised or general treatment systems, encourage screening for transmissible infections, help users gain access to entitlements, housing and professional integration or rehabilitation, provide equipment to prevent infection, and intervene locally outside the centre to establish contact with users. CAARUDs³⁷ provide social mediation to ensure good integration in their neighbourhood and prevent the public disturbances related to drug use. Their coordination with other organisations has been stipulated in a circular.³⁸"

"Since May 1987³⁹, the unrestricted sale of syringes has been authorised in retail pharmacies, pharmacies located inside healthcare establishments and establishments that focus exclusively on selling medical, surgical and dental equipment or that have a specialised department for such equipment. Since March 1995⁴⁰, these may be issued free of charge by any non-profit association carrying out AIDS prevention or harm reduction activities among drug users; these associations must meet the French Ministry of Health requirements described in the decree (article D. 3121-27 of the French Public Health Code). Providing syringes and needles to minors is only authorised by prescription (art. D.3121-28 of the French Public Health Code). However, neither pharmacies nor associations are legally bound to ask users to provide their identity or age since the 1987 suspension of the provisions of the 1972 decree.
"It is not legal to arrest someone on the sole charge of narcotics use in immediate proximity to a harm reduction or syringe exchange structure (for example, pharmacy SEPs). Furthermore, simply carrying a syringe is not sufficient evidence to justify an arrest.
"A national harm reduction standard for drug users has been prepared (art. D. 3121-33 of the Public Health Code) and approved via the decree of 14 April 2005⁴¹. Among other things, this stipulates that all participants, health professionals, social workers or members of associations, in addition to any persons to whom these activities are addressed, must be protected from accusations concerning drugs use or the incitation to use drugs during their work."

"Use or possession of illegal drugs is a criminal offence in France. The law itself does not distinguish between possession for personal use or for trafficking, nor by type of substance. However, the prosecutor will opt for a charge relating to use or traffic that is based on the quantity of the drug found and the context of the case. An offender charged with personal use faces a maximum prison sentence of one year and a fine of up to EUR 3,750, though prosecution may be waived. Alternatives to prosecution may include voluntary payment of a fine or non-remunerated work useful to society. Prosecutors may also prioritise treatment approaches for small-time offenders, both those related to personal drug use or other minor crimes. A circular to prosecutors in 2005 stated that any legal action before the magistrates courts must remain exceptional, but a new circular of 9 May 2008 defined a new ‘rapid and graduated’ policy. Addicts would continue to receive the therapeutic injunction, directing them to treatment. Users in aggravating circumstances, such as drivers or those in educational establishments, as well as recidivists, might be imprisoned. Users in simple cases may receive a caution, but this should usually be accompanied by a request for a compulsory drug awareness course introduced in March 2007, for which the non-addicted offender may have to pay up to EUR 450.
"Drug trafficking is punishable with imprisonment of up to 10 years, or up to life in prison in case of particularly serious offences, and a fine of up to EUR 7,600,000."

"Law enforcement measures against narcotics use are more severe in certain cases, such as when this use affects road safety.
"The law of 3 February 2003 17 introduced a new offence concerning any driver whose blood test reveals the presence of narcotics. These drivers risk a sentence of two years’ imprisonment and a €4,500 fine, and drivers who simultaneously use narcotics and alcohol risk up to three years' imprisonment and a €9,000 fine. The law of 18 June 1999 18 and its application decree (of 27 August 2001) 19 introduced mandatory drug use screening for drivers involved in a road accident that was immediately fatal or for drivers suspected of narcotics use who were involved in an accident that caused bodily harm. Since the 2011 adoption of the LOPPSI 2 law 20 (loi d’orientation et de programmation pour la performance de la sécurité intérieure, which covers French law enforcement activities), and its application circular of 28 March 2011, narcotics screening has become mandatory following road accidents that cause bodily harm, whether such accidents are fatal or not. Moreover, the circular 21 of 28 March 2011 on reinforcing the fight against unsafe road conditions enables, upon requisition of a French public prosecutor, random narcotics controls on all drivers (art. L.235-2 of the French Traffic Code, modified by article 83 of LOPPSI)."

"Since the adoption of law 2011-1862 of 13 December 2011 44, the French Code of Penal Procedure has enabled public prosecutors to institute simplified proceedings for narcotics use offences. However, the public prosecutor must ensure that the alleged offences for which an accused is being held in custody are simple and have been established by police investigation, and that, given the minor nature of the offences, it does not seem necessary to order a sentence of imprisonment or a fine of up to €3,750 (fine stipulated in article L.3421-1 of the French Public Health Code). In the event of a simplified procedure, the arrested person may be ordered to pay a fine of up to €1,875 in compliance with article 495-1 of the French Code of Penal Procedure. If the judge presiding over the case deems that imprisonment should be ordered, the judge refers the case to the public prosecutor.
"In addition to applicable punishments, lawmakers also came to a decision on the new policy for carrying out sentences applicable to cours d'appel (courts of appeal) and tribunaux de grande instance (high courts). Law 2012-409 of 27 March 2012 45 thereby establishes a new strategic framework for law enforcement jurisdictions. This law has three main objectives:
"• To ensure swiftness in executing the sentences that are handed down, particularly for prison sentences;
"• To reinforce efforts to prevent recidivism;
"• To improve how delinquent minors are handled."

"The 16 February 2012⁴⁹ circular established new criminal policy strategies to be adopted by the judicial authorities. While reiterating the need to consider investigative elements that suggest simple use or narcotics addiction and the principle of proportionality with respect to the seriousness of the alleged offence, the February 2012 circular emphasises the need for systematic penal responses and increasingly effective judicial measures. Jurisdictions are encouraged to implement primarily educational measures for initial simple use offences. Examples of these measures include drug awareness training course and health/social strategies for addicted users (drug treatment order). Responses to minors should be limited to educational and health measures. The circular also encourages courts and courts of appeal to develop partnerships with associations to ensure the efficacy of educational and health/social measures."

"In polls before 1999, the majority view which appeared to be defined is that prosecutions and legal penalties should be imposed on consumers of heroin and of cocaine (85% in favour), of cannabis (70%) or of alcohol (approx. 50%). However, polling of such opinions is very sensitive to the way in which questions are put: three quarters of interviewees in this way, were not in favour of the idea that drug addicts should be punished. Likewise, if the person and his individual freedom are emphasised rather than the legal aspects of the question of utilisation, then one third of interviewees, as in 1999, will be induced to express their consent for the proposal according to which the prohibition of smoking cannabis is an infringement of the right for free utilisation of one's own body."