Launch of a Regional Roadmap for Combating Addiction: Challenges Related to Public Health, Safety, and Peace

Based on the guidelines set forth in the 2018–2022 National Action Plan Against Addiction, the 2018–2022 Regional Health Plan, and a shared regional assessment, the addiction roadmap is structured around seven priority areas:

1. Strengthening knowledge, coordination, and evaluation in the field of addiction

2. Informing, training, and communicating to raise awareness

3. Protecting and preventing addictive behaviors among young people

4. Preventing and reducing risks in party settings

5. Strengthening initiatives targeting vulnerable populations

6. Reducing exposure to substances

7. Continue to develop care for people with addictions, particularly in outpatient settings

The shared goal is, on the one hand, to prevent addiction with the aim of reducing crime, morbidity, and preventable premature mortality by promoting early intervention (which aligns with one of the objectives of the ten-year cancer control strategy, presented on February 4 by the President of the Republic: to reduce the number of preventable cancers by 60,000 per year) and, on the other hand, to streamline care pathways and prevent gaps in care by providing a range of services and better coordination of systems.

Strengthened Partnership: Everyone Is Involved

To achieve effective and sustainable results, this roadmap relies above all on a strengthened partnership among all relevant stakeholders, whether institutional or non-profit. Indeed, until now, many stakeholders have initiated actions in this area but very often in isolation, with limited resources and scope.

The primary objective of this roadmap is therefore to strengthen coordination among partners from all sectors in order to pool and optimize all actions carried out in the region, following the example of the joint leadership by the regional prefecture and the ARS with the support of Santé Publique France. This partnership is designed to cover the entire addiction continuum through prevention and harm reduction, treatment, and enforcement efforts, with the shared goal of promoting the well-being of all.

At both the regional and local levels, this roadmap will aim to give greater strength, coherence, and visibility to our public efforts in the fight against addiction.

Addiction: Issues of Public Health, Safety, and Peace

The issue of addiction is universal because it affects the entire population, across all ages and backgrounds. While its impact on health is well known, addiction can also significantly affect education, social integration, employment, and, more broadly, relationships with others. The use of psychoactive substances, such as alcohol or cannabis, also generates major public safety and public peace issues:

In terms of public health, in France, tobacco and alcohol are the two leading causes of preventable mortality: 75,000 tobacco-related deaths and 41,000 alcohol-related deaths per year. More than one-third of cancer deaths are linked to tobacco (45,000) and alcohol (16,000).

The Occitanie region is among those with the highest rates of daily tobacco, alcohol, and cannabis use:

• 30.3% of people aged 18–75 smoke daily, representing 1,200,000 smokers. This proportion is higher than in the rest of France (26.9%), with a prevalence significantly higher than in other regions among women but not among men*;

• 13% of people aged 18–75 consume alcohol every day in Occitanie (10% in France), with a significantly higher prevalence among men than among women. In Occitanie, the prevalence of weekly consumption did not differ from that of France for beer and spirits but was significantly higher for wine (33% versus 30% in France)*;

• young people in the Occitanie region exhibit a pattern of excessive consumption compared to young people in France (+19% for regular cannabis use) **.

In terms of public safety and peace, victims impaired by substance use are more vulnerable, and perpetrators, having lost their inhibitions, are more aggressive. These phenomena are accompanied by significant challenges regarding crime, trafficking, and insecurity, which have major repercussions on the daily lives of the entire population (theft, violence—including within the family—various nuisances, and road safety). For example, in 2020, in Haute-Garonne, alcohol and drug use was a factor in 47% of fatal accidents—nearly one in every two fatal accidents.

The health crisis marked the year 2020, creating a particularly difficult health, economic, and social context. While it is not yet possible to determine the immediate consequences of lockdown periods on the use of psychoactive substances, initial studies suggest a potential increase in consumption and risky behaviors, particularly due to the deterioration of mental health linked to the effects of the health crisis and its short- and medium-term economic and social impacts. For example, in the Coviprev study conducted by Santé publique France since the start of the first lockdown, approximately one-quarter of smokers reported in May 2020 that they had increased their tobacco use.