How can we prevent and reduce the risks associated with the use of illicit substances?
Health authorities are implementing public health measures to prevent drug use and reduce the risks associated with drug use.
Preventing Substance Use
The earlier drug use begins, the greater the risk of developing a long-term addiction. One of the key challenges is therefore to delay the onset of drug use. As a result, there are prevention programs targeting adolescents (in schools, for example), young people, and families to prevent the onset of drug use.
Several programs aim to strengthen children’s and young people’s skills to promote a range of health-promoting behaviors, particularly regarding addiction—such as the ability to say no, manage emotions, and communicate effectively. These are known as “psychosocial skills” or CPS.
Learn more:
As part of parenting support programs, practical guides have been developed to assist professionals in the health, social services, and education sectors who wish to undertake initiatives combining health promotion and parenting support.
Preventing addiction from taking hold
It is also about preventing addiction from taking hold among users and helping them stop using substances in cases of substance use disorder. To this end, early detection and brief intervention are useful tools for healthcare professionals. To support these efforts, the French National Authority for Health (HAS) has published a tool to aid in the early detection of alcohol, tobacco, and cannabis use, designed for physicians to help them discuss their patients’ substance use with them. More broadly, all use of psychoactive substances can be addressed during consultations.
Reducing the Risks and Harms Associated with Drug Use
In France, the first harm reduction interventions began in the 1990s as part of the effort to combat the HIV/AIDS epidemic among people who inject drugs. These efforts relied on the distribution of single-use equipment (syringes, crack pipes, snorting kits, injection and inhalation kits, etc.) and the provision of opioid substitution therapy.
The term HARM covers a range of pragmatic interventions targeting users who cannot stop injecting drugs. It has now expanded to include other substances
and modes of use. HARM interventions include:
access to safer consumption kits, particularly sterile syringes and needle exchange programs (NEPs),
access to opioid substitution therapy,
access to safe consumption sites and injection support services (development of safer consumption rooms – SCMR),
dissemination of information on risks and ways to reduce them when using drugs. It should be noted that this information may draw on the experiences of users themselves through the work of self-help associations for drug users.
Improve the reception, support, and care provided to clients and their families
Various types of specialized facilities provide medical, psychological, and social care to users anonymously and free of charge.
These centers provide anonymous and free services to substance users and their families and friends. Multidisciplinary teams (doctors, nurses, psychologists, social workers, etc.) work within the CSAPAs to provide comprehensive support to these individuals. This includes:
intake, information, and a comprehensive assessment of the individual’s situation or that of their loved ones,
reducing the risks and harms associated with the use of psychoactive substances,
medical, psychological, social, and educational support for patients. This includes diagnosis, healthcare services, access to social rights, and assistance with integration or reintegration.
CSAPAs are funded by the Health Insurance system and operated by associations or public health institutions. Some CSAPAs offer community-based consultations. They may provide outpatient care or offer residential treatment services.
Many CSAPAs organize support services for young substance users and their families and friends through Youth Substance Use Consultations (CJC). The goal of CJCs is the early identification of problematic substance use. They are primarily aimed at young substance users aged 12 to 25 and their families and friends. CJCs are generally held at CSAPAs but can also take place at Teen Centers or Youth Counseling Centers.
Learn more: View the list of Youth Consumer Consultations
CAARUDs provide services to people who use drugs who are not currently seeking treatment. Special attention is given to those in vulnerable situations. They offer unconditional support, hygiene services, nursing care, supplies, and advice to help reduce the risks and harms associated with their drug use. Depending on the location, the following may be available:
rapid diagnostic tests (TROD) for HIV, HCV, etc.,
substance testing,
medical consultations,
assistance with accessing rights or healthcare,
mobile services in the living and drug-use environments of people who use drugs.
Learn more: View the list of CAARUDs
Hospital units specializing in the care of people struggling with addiction have expanded significantly in recent years and are organized into three levels:
Level I units, known as community-based units, offer substance users outpatient consultations and simple, short-term inpatient detoxification. They also have liaison teams responsible for coordinating all the services involved in the hospitalization of people with addiction.
Level II units, known as referral units, complement the services of Level I units by providing care for so-called complex, longer-term inpatient detoxification. They may also organize follow-up care and rehabilitation stays to help patients regain balance and consolidate their recovery. This care is provided either on an inpatient basis or through day treatment programs.
Level III units, known as regional referral units, carry out research, training, and educational activities, as well as regional coordination.
Admission to hospital units is particularly recommended for individuals who have been weakened by previous detoxification attempts or who suffer from psychiatric or somatic comorbidities.
In relation to
Alcohol
thematic dossier
Alcohol is deeply rooted in French culture. Its consumption remains a major cause of death and illness in France.
Tobacco
thematic dossier
Despite a slight decrease compared to 2015, tobacco remains responsible for more than 68,000 premature deaths in 2023—accounting for 11% of total mortality—making it still the leading cause of...
Sexual health
thematic dossier
Santé publique France focuses in particular on four areas of sexual health: sexually transmitted infections, including HIV; contraception; combating discrimination; and violence.
