Report: France

Drug users to have secure site in Paris

Drug users in France will soon have a state-sanctioned place where they can use heroin, crack and other intravenous drugs, after the government approved a pilot site in Paris. The City Council had already voted to allow a secure injection site to be opened in the city, a controversial measure, which social workers say should help to reduce the number of drug users in the streets.


 "We want a place where people can come and use drugs, but also to be able to speak with a doctor," explains Celine Debeaulieu, who is in charge of opening France's first supervised injection site. She works for Gaïa Paris, which runs drug treatment and harm reduction programmes in the city. Gaïa already provides a mobile needle exchange service, which is currently focused on the area around the Gare du Nord train station, the epicentre of the Paris drug trade.

A large van is parked on a small side street. Inside it's like a pharmacy; a social worker stands behind a counter offering an array of needles and other material used to inject drugs.

"We deliver material for all drugs that can be injected, like cocaine, heroine, crack," says José Matos, who manages the staff that collects used needles and hands out the sterile material for free to about 70 people every day.

Providing syringes might seem like it’s just encouraging drug use, but it’s at the base of harm reduction, a way of dealing with drug users, to reduce the spread of infectious diseases.

"If we don't deliver syringes they will still inject and they will share syringes and they will get infected. When we deliver a syringe, we explain how to use it and how to prevent the risks," explains Matos.

"In the 1980s, around 40 per cent of injecting drug users were HIV positive. With harm reduction, today we are around 10 percent. And we also do social work. Most of the people that we see are homeless, and social work is also a way to prevent them from going down too far."

Bilal, 19, says he visits the needle exchange van from the suburbs several times a week for materials, but also for the HIV and hepatitis tests they provide.

"I come for needles, tourniquets and alcohol swabs," he says after taking a blue plastic bag full of syringes and alcohol swabs. " I am in good health. I don't have hepatitis, I don't have AIDS or anything."

He and others can get material from the van, but they can't shoot up there. But Celine Debeaulieu says that will soon change. She explains how the injection site, called salle de consommation, or consumption room, will work:

'You'll have to show the drug you will use and the quantity. Someone will give you all the sterile materials, and you will have a space to inject your drug," she explains.

There will be a time limit, and hygiene will be strictly enforced. Far from a crack den, it will feel more like a doctor's office.

"It's a medical and social centre, which will propose medical and social services," she says.

Such spaces already exist in Europe - in Switzerland, Germany, the Netherlands and Spain. But while the government is behind the idea, opposition politicians question what they say is state-sanctioned drug use.

Local residents around the train station are worried it will only attract more drug users to the area. But Debeaulieu says that based on experiences in other countries, the situation should actually improve.

"All the evaluations of consumption rooms show that the public benefit is really clear... because drug users had a place where they could come and use drugs. It's fewer people in the street, fewer people who might leave used syringes, and less chance that a kid can find the used syringes," she explains.

José Matos, who has been running the needle exchange programme for seven years, says there is a real need for a clean, safe place for drug users.

"I have seen people injecting in very bad conditions: in parking lots or in public toilets. And I have been also to a consumption room in Switzerland. And I think it's really better, because it's at least clean. We will be able to see how people inject, and try to change their way of doing it, to make it better."

Gaïa has yet to find a space for the injection site, but hopes to find one and open by the summer, to welcome 150 to 200 people a day

The site is part of the idea of harm reduction, which addresses drug use realistically, with a focus not so much on treatment (though Gaïa does have a methadone substitution programme) as on health.

"The reality is that people will use drugs, whether we are here or not," says Debeaulieu.

"In a perfect world it would be better that people don't use drugs. But in the real world, people are using drugs. So for harm reduction, let's just be pragmatic, and at least propose tools to help people remain in as good health as they can be."

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