What’s the drug/opioid epidemic look like in France?

Part of the reason buprenorphine (Suboxone, etc.) is being pushed in the U.S. is because France tried this experiment first.

France approved buprenorphine in 1996, and in 2010, reported “a five-fold reduction in overdose deaths and a sixty-fold drop in the number of active injection drug users.”  (As in the U.S., figures are always 2 or 3 years behind the current year.)  (France has free needle exchanges and similar progressive programs.)  But just like Dr. Kolodny’s corporation, Phoenix House, France began by offering “treatment” instead of jail to victims of the drug war, including the use of buprenorphine to treat substance abuse and addiction.  So, shall we see how France is doing?

Selected excerpts from:  http://www.emcdda.europa.eu/publications/country-overviews/fr

The number of drug-induced deaths showed a constant increase between 2003 and 2010, and were mainly attributed to deaths due to heroin and methadone overdoses. In 2011, based on the General Mortality Register, 340 drug-induced deaths were recorded, a reduction from the 392 cases reported in 2010. In 2011 the majority of victims were male (249 cases). The mean age of the deceased was 45.7 years (significantly higher for females than for males). Toxicological data available from the Special Mortality Register (SR) indicates that opioids prevail, mainly methadone or buprenorphine, alone or in combination with other psychoactive substance. Opioids were involved in more than three-quarters of deaths recorded in the SR.

Since 1995 opioid substitution treatment (OST) has constituted the main form of treatment for opiate users, and has been integrated into a total therapeutic strategy for drug dependence, including for drug users in prison. Methadone and HDB [buprenorphine] are used for OST, though HDB, introduced in 1996, is still the most widely prescribed substitution substance. In rare cases, morphine sulphate is provided as substitution. Several directives regulate the dose, place of delivery and duration of OST.

France is a transit area for illicit drugs smuggled to the Netherlands, Belgium, the United Kingdom and Italy. As in most European Union countries, cannabis is the most widely available and accessible of all illicit substances… In 2010 a total of 157,341 drug-law offences were reported, of which 87.5 % were cannabis-related, 6.8 % heroin-related and 4.1 % cocaine-related.

Among all treatment clients, 44 % reported cannabis as their primary drug, followed by 43 % for opioids and 6 % for cocaine. Among new treatment clients, 63 % reported cannabis as their primary drug, followed by 27 % for opioids (mainly heroin) and 4 % for cocaine.

The high number and proportion of cannabis users among treatment demand clients in France is related to several factors — the establishment some years ago of specialised consultation centres for young users, mainly cannabis users, and of CSAPAs, and the fact that cannabis also remains the main drug in court-ordered treatment cases.

Following a period of policy development, France’s new Government Plan for Combating Drugs and Addictive Behaviours 2013–17 was launched on 19 September 2013. It takes a comprehensive and global approach towards illicit and licit drugs (narcotics, alcohol, tobacco, psychotropic medicines and new synthetic products) and other forms of addictions (gambling, gaming, doping)… The prevention of drug, alcohol or psychotropic use in the workplace, incorporating the use of screening, has been a priority for occupational physicians since 2012… Moreover, since 2005 some 300 youth addiction outpatient clinics (CJCs) have been opened throughout France to carry out ‘early intervention’.

Funny how the drug war has created similar victims all over the world. The strategy that France and Phoenix House are using — offering “treatment” instead of jail, especially for young people — doesn’t appear to be working.  At least for the victims, who are forever labeled as drug addicts. And all the cannabis users (who may have a potential addiction rate of about 3%) are now introduced to a bunch of people with serious drug problems. Drugs don’t have the stigma for young people that they do for older folks, so I imagine there’s a good-sized underground drug market for people who suffer from addiction — and for a large number of people who don’t, or didn’t before they were forced into these programs.

Governments in both countries introduced buprenorphine, which increased access and use of this drug — which, coincidentally, also increased the instances of abuse and overdoses involving buprenorphine.  And in France, along with methadone, buprenorphine is the opioid that’s causing the most damage.

Because general practitioners in the U.S. don’t want to treat drug addicts, sales of buprenorphine are small compared to France (which is how this drug is mostly distributed in that country). But, thanks to Dr. Kolodny, pretty soon, when it comes to buprenorphine, America will look worse than France.

The good news is that it looks like French citizens have turned to cannabis, when they are able to, and that legalizing medical cannabis in that country would really help.

Since Dr. Kolodny last worked in Brooklyn, NY, tomorrow we’ll look into what damage the drug war is doing in that state. Sound like fun?


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