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Medscape
7 days ago
- Health
- Medscape
Craving management workshops and peer-led support are helping French prisons reframe addiction as a healthcare issue.
The most recent congress of the French association of healthcare professionals working in the prison service (ASPEP), held in Paris, revisited the issue of substance use disorders among incarcerated individuals. For many years, drug use in prisons was met with ambiguity — or even outright denial — by authorities. The prison administration maintained the somewhat simplistic belief that because drug use is illegal, it could not exist in a system where the law is meant to prevail. This perspective began to shift in the early 1980s, when concern over the transmission of HIV and hepatitis from injectable drug use prompted a more serious response. However, the focus at the time remained on controlling infectious disease risk rather than addressing addiction as a medical condition. That era has since passed. Today, prison authorities — working alongside healthcare professionals — acknowledge the reality of both drug use and addiction within correctional settings. A major step forward came in May 2024 with the publication of the first national statistical survey on substance use in French prisons: The ESSPRI study (Survey on Health and Substance Use in Prisons), led by the French Monitoring Centre for Drugs and Drug Addiction (OFDT). The study reflects a growing commitment among the medical community to objectively assess and address substance use behind bars. The survey was conducted between April and June 2023 and included approximately 1000 inmates aged 18 years or older. It assessed their use of psychoactive substances. The results — revisited at the March ASPEP congress — revealed significant levels of substance use: 63% of inmates reported daily tobacco use (compared with 25% of adult men in the general population) 26% reported using cannabis (vs 3% outside prison) 14% had used other illicit substances (including cocaine, crack, MDMA, and heroin) since being incarcerated Targeted Policy Recommendations By contrast, alcohol use within French prisons appears relatively low: Only 16% of inmates reported drinking alcohol while incarcerated. However, this is likely due to limited availability rather than a voluntary choice to abstain. Based on its findings, the OFDT identified three broad patterns of substance use among inmates: One third — primarily younger inmates — regularly use both tobacco and cannabis. One third use only tobacco. One third — often older inmates — do not use any psychoactive substances. The OFDT called for health policies that reflect these actual patterns of use. In particular, they recommended that prevention and treatment strategies within prisons focus more specifically on tobacco and cannabis, which are the most widely used substances. Transition After Release Across France, various initiatives have emerged to improve addiction care in correctional settings. However, program implementation remains fragmented, as most addiction services are organized independently by individual prison-based addiction treatment centers (known as CSAPAs). Despite this lack of coordination, some initiatives are particularly noteworthy. At the Bois-d'Arcy remand center in Yvelines, for example, CSAPA staff have introduced 'release kits' to support continuity of care for inmates with substance use disorders as they transition back into the community. This post-release period is a time of heightened vulnerability, marked by unstable living conditions and an increased risk of high-risk behaviors. In fact, post-release mortality — primarily due to suicide or overdose — is 3.6 times higher than during incarceration. The release kits, developed collaboratively with inmates and grounded in harm-reduction principles, are available in three versions tailored to individual needs: Basic kit: Includes key information, such as emergency contact numbers and referral options for addiction specialists. Kit for crack and cocaine users: Offers harm-reduction materials and substance-specific guidance to promote safer consumption practices. Kit for individuals who inject drugs: Contains sterile injection equipment and a dose of naloxone for emergency overdose reversal. Workshops to Address Craving At Baumettes Prison in Marseille, France, the local CSAPA has developed a program focused on managing craving — the intense urge to use substances experienced by individuals with addiction. Care is delivered through therapeutic workshops codesigned with inmates. These consist of four weekly group sessions facilitated by two healthcare professionals. Each group includes up to six participants and encourages open discussion of cravings and coping strategies, with a strong focus on shared experience and peer support. 'We explore how patients perceive their cravings and work to activate their psychosocial skills so they can draw on their own internal resources,' explained Camille Normandin, Elisa Carta, and Damien Mauillon during a presentation at the recent ASPEP congress. The workshops provide education on the physiological mechanisms underlying craving, while also helping participants develop personalized relapse prevention strategies. Inmates are encouraged to identify their own high-risk situations and develop tailored solutions to avoid giving in to urges. While pharmacologic substitution therapies are addressed, 'the real focus is on empowering inmates to draw on their own experiences and insights,' emphasized the CSAPA team from Baumettes. The ASPEP congress also served as a platform for healthcare professionals working in the prison system to call for better coordination of addiction services and, importantly, for more transparent and stable funding — which they described as inconsistent and difficult to track across facilities.
Malaysia Sun
01-06-2025
- Health
- Malaysia Sun
Calls for France to follow UK with generational tobacco ban
France recently banned single-use vapes and nicotine pouches as part of its plan to foster a tobacco-free generation. But, as the world marks the annual World No Tobacco Day on Saturday, a group of public health advocates and MPs want to go further by introducing a generational tobacco ban similar to the UK's. Smoking is no longer as fashionable in France as it was in the days ofSerge Gainsbourgchain-smoking Gitanes on TV. Yet it remains the country'sleading cause of preventable death, killing around 75,000 people a year. It is also linked to heart disease, strokes, type 2 diabetes, asthma, dementia and fertility issues. Over the past 30 years, France has cracked down on smoking banning advertising of tobacco products in 1991, smoking in public places in 2007 and sales to under-18s in 2009, and introducing plain packaging in 2017. These efforts have paid totheFrench Monitoring Centre for Drugs and Drug Addiction (OFDT), the number of regular smokers fell from 40 percent of adults in the mid-2010s to 23 percent in 2023 although this is still above the EU average. France becomes second European country to ban disposable e-cigarettes Only16 percentof 17-year-olds say they now smoke daily, down from 25 percent in 2017. Vaping, however, is on the rise, especially among teens, with around 6 percent using e-cigarettes daily. The recent bans on single-use vapes known as "puffs" and nicotine pouches are part of France'sNational Tobacco Control Planfor 2023-2027, which aims to reduce the adult smoking population to 20 percent by 2027, and teen smokers to 10 percent by 2028. The ultimate goal: a tobacco-free generation by 2032, with only 5 percent of under-18s smoking. Severing the link The best way to reach that goal is to prevent young people from starting smoking, says Professsor Loic Josseran, head of the Alliance Against Tobacco (ACT). "We know that 90 percent of smokers begin under the age of 18," he said. "The ban on sales to minors simply isn't enforced, there are no penalties and no controls." Losseren is calling for a UK-stylegenerational tobacco ban, which wouldprohibit sales of tobacco products to anyone born after 1 January, 2009 effectively raising the smoking age by one year each year until it applies to the whole population. The law, passed by the UK Parliament in March, is expected to take effect in January 2027. Earlier this week, ACT and France's public health agency (SPF) met with MPs to begin working on a similar initiative. Their proposal would make it illegal to sell tobacco including cigarettes, cigarillos and rolling tobacco to anyone born in 2014 or later, throughout their lives. "This measure, which may seem radical, is in fact an extension of the ban on sales to minors," Josseren argues. ACT says7 out of 10French people support the idea of a tobacco-free generation. It aims to place youngsters in a non-smoking, non-consuming environment severing contact with tobacco. "Since they won't have started smoking, they won't want to buy tobacco... We're not depriving them of anything, we're just offering them better health." He stressed that the measure targets sales, not consumption, and adult smokers will still be able to buy and consume tobacco. New Zealand was the first country to pass such a law in 2022, althoughit was scrapped by a subsequent coalition government in February 2024 to help fund tax cuts. Denmark, Malaysia and the American state of Nevada are also debating introducing similar legislation. 'Political courage' The UK law, initially proposed by the then-Conservative government and picked up by its Labour successor, earned broad cross-party backing, despite a few MPs on the right branding it an attack on personal freedom. In France, however, Josseran says gaining support "will need real political courage". So far, two MPs Nicolas Thierry from the Greens and Michel Lauzzana from the centre-right Ensemble coalition support the idea. Both were involved in the recent ban on puffs. But many remain hesitant. "A few are interested, but many are more concerned with the tobacco industry's arguments," Josseren says, noting that every MP has tobacconists in their constituency. "They fear they'll say: 'Be careful, if you bother me I'll tell everyone not to vote for you'." French tobacconists protest at anti-smoking law He acknowledges that a generational tobacco ban would eventually force tobacconists out of business. Meanwhile, he claims the industry is lobbying hard, pouring "several million euros into the National Assembly each year" to block public health laws. The industry is also diversifying. "We're seeing the creation of a nicotine market in which young people can choose between nicotine gum, beads, cigarettes, heated tobacco, chicha, vape..." He added: "It took us two years to ban puffs and already manufacturers are marketing new ways of delivering nicotine. That's why we need an umbrella law to prevent all these new forms coming on to the market." Environmental focus The tobacco industry defends its role in the French economy, citing job creation and tax revenues. Seventy-five percent of the price of a packet of cigarettes is tax an important source of income for the government, at a time when the state coffers are empty. Yet the OFDT says the financial equation weighs heavily against the state. While tobacco brings in around 13 billion per year, healthcare costs and losses in productivity due to early death or illness amount to 20 billion. The total cost of tobacco to French society in 2019 was estimated at 156 billion, including environmental damage and social impact. Cigarette butts, the plastic pollution that's hiding in plain sight Each of the 30 billion cigarette butts discarded annually in France pollutes up to 500 litres of water. Josseren calls it an "environmental horror" involving deforestation, land-grabbing, child labour and pesticide use. "It's an industry that plunders and crushes life everywhere it goes," he says. "The only thing it grows is profits." Anti-smoking campaigns now increasingly focus on tobacco's environmental footprint, which resonates more with young people than health warnings. "Saying that smoking isn't good, that we're going to die from smoking in 40 years' time, doesn't interest young people. I can't blame them," he said. "We have to explain that the environment is the real lever protecting the environment, respecting others. That can lead them to turn away from these products. That's our approach." Originally published on RFI
Yahoo
31-05-2025
- General
- Yahoo
Calls for France to follow UK with generational tobacco ban
France recently banned single-use vapes and nicotine pouches as part of its plan to foster a tobacco-free generation. But, as the world marks the annual World No Tobacco Day on Saturday, a group of public health advocates and MPs want to go further – by introducing a generational tobacco ban similar to the UK's. Smoking is no longer as fashionable in France as it was in the days of Serge Gainsbourg chain-smoking Gitanes on TV. Yet it remains the country's leading cause of preventable death, killing around 75,000 people a year. It is also linked to heart disease, strokes, type 2 diabetes, asthma, dementia and fertility issues. Over the past 30 years, France has cracked down on smoking – banning advertising of tobacco products in 1991, smoking in public places in 2007 and sales to under-18s in 2009, and introducing plain packaging in 2017. These efforts have paid off. According to the French Monitoring Centre for Drugs and Drug Addiction (OFDT), the number of regular smokers fell from 40 percent of adults in the mid-2010s to 23 percent in 2023 – although this is still above the EU average. France becomes second European country to ban disposable e-cigarettes Vaping, however, is on the rise, especially among teens, with around 6 percent using e-cigarettes daily. Read more on RFI EnglishRead also:France to ban smoking on beaches and close to schoolsEU moves to ban smoking and vaping in outdoor spacesCigarette butts, the plastic pollution that's hiding in plain sight
Daily Mail
06-05-2025
- Politics
- Daily Mail
Drug dealing 'cancer' has reached every corner of France with no 'safe places' left and even 'the slightest rural village has cocaine and cannabis, justice minister admits
France is suffering a ' cancer ' of drug dealing, with no 'safe places' left, the country's justice minister admitted as he positions himself for a presidential run. Gérald Darmanin said in a recent interview that even the 'smallest rural town' in France is now 'familiar with cocaine and cannabis'. 'Drugs, for example, have always existed, but today we can clearly see that in the smallest rural town, they know about cocaine, cannabis.' 'Beforehand, drugs were simply in big towns [and cities] or the metro,' he told Legend in an interview published on Sunday. 'What really strikes the French is that it has become widespread, metastasized,' he added. 'It's no longer just in the places where we were looking for the potential problem' he added, suggesting France has become 'more violent'. Darmanin voiced support for sweeping security measures to ensure a 'safe society' - a risky curtailing of personal liberties as he looks towards the 2027 presidential election. 'If you want a safe society, you need facial recognition, for example, which we don't have today.' 'It's thanks to AI applied to cameras that we are able to observe crowd movements, that we were able to observe strange behavior,' he added. The former Minister of the Interior said France 'thwarted three attacks during the Olympic Games', arresting an 18-year-old Russian national suspected of planning to commit an 'Islamist-inspired' attack in Saint Etienne. Illustrating his argument, Darmanin added: 'In Dubai, we see your face and we know your identity, what your criminal record is, if you are wanted.' Asked by interviewer Guillaume Pley why France had not adopted such measures, he referenced 'paranoia about technology' and 'civil liberties'. 'Unfortunately, Parliament has always opposed it until now. We must all evolve for the safety of the French,' he added in a post on X on Monday, after the interview aired. Not all agreed. Jean-Philippe Tanguy, deputy of the French National Assembly, jibed: 'Does the Minister of Justice know that he was Minister of the Interior for years?' 'Taking the French for fools by making so-called strong statements when the death toll is so low and catastrophic is still crazy,' he added. Cocaine use in France has nearly doubled in a matter of a few years, according to a recent study. An estimated 1.1 million people took the drug at least once in 2023 - up from 600,000 when the French Monitoring Centre for Drugs and Drug Addiction (OFDT) last published its report in 2022. France now ranks 7th in Europe for cocaine consumption. Ivana Obradovic, deputy director at OFDT, told Agence France-Presse (AFP) that part of the reason for the increase in drug use was 'the evolution of working conditions'. People were using cocaine to cope with intense workloads or tough working conditions, she said. Perception of drug purity, and the relative stability of price, may have also contributed to the change, she suggested. While prices have remained virtually unchanged, the purity of cocaine is said to be on the rise. Data from the EU's drug monitoring agency EMCDDA showed how a relative price of 100 in 2011 had fallen to 98 by 2021. A benchmark purity of 100 meanwhile climbed to 143 in the same period. The rise of drug gangs has seen violence flare up. Ten people were killed last year in such clashes. As many as 341 were injured, The Times reports. Darmanin, with President Emmanuel Macron's liberal Renaissance party, announced in late April that he would like to be president and was 'working' on a platform. Macron himself will be unable to run in 2027 after serving two consecutive terms. The 2024 election, called by Macron following the European Parliament elections last June, saw growing divisions in the French National Assembly. In the EP elections, Marine Le Pen's National Rally came out as the leading party, with 31.4 per cent of the vote. Rallying against the hard right, the left wing alliance New Popular Front won 188 seats in the legislative elections - short of a majority, but ahead of the 142 won by the National Rally. Ensemble, Macron's centrist coalition, lost, but took 161 seats, which was higher than pollsters predicted. 289 seats were needed for an overall majority in the 577-seat assembly. Separately, in his interview on Sunday, Darmanin apologised for the first time to Liverpool supporters for the policing operation at the 2022 Champions League final in Paris. Darmanin said 'we got the measures wrong' in the interview broadcast on YouTube. The final between Liverpool and Real Madrid at the Stade de France was overshadowed by a 37-minute delay to kick-off as fans struggled to access the entrances after being funnelled into overcrowded bottlenecks as they approached the stadium. Darmanin initially blamed Liverpool fans for the disorder and claimed many had turned up without tickets. Three years on, he admitted in the interview that the authorities had got it wrong. 'Yes, it was a failure,' said Darmanin. 'Because I hadn't checked what was happening properly, which was my mistake, and because I gave in to preconceived ideas. 'I apologise to Liverpool fans. Of course they were right to (feel angry).' Nervy police fired tear gas towards thousands of supporters locked behind metal fences on the perimeter of the stadium. Liverpool fans had to suffer a series of false claims in the aftermath of the chaos. European football's governing body UEFA initially tried to pin the blame on supporters arriving late despite thousands having been held for hours outside the stadium before kick-off. The French authorities then claimed an 'industrial-scale fraud' of fake tickets was the problem. A French Senate enquiry later concluded that poorly-executed security arrangements were the cause of the mayhem. An independent report found UEFA bore 'primary responsibility' for the failures which almost led to the match becoming a 'mass fatality catastrophe'. The report added it was 'remarkable' that no one was killed on the night of the final.
Local France
16-03-2025
- Local France
French customs seize 800kg of cocaine from truck
Officers seized the 826 kilogrammes of drugs on Saturday just off the autoroute leading to the city of Lyon and arrested the truck's Polish driver, the source said. The intercepted cargo is estimated to be worth around 24 million euros ($26 million), based on an average wholesale price of 30,000 euros (more than $32,000) per kilo. A gramme is usually sold for around 58 euros ($63). In total, French customs seized 53.5 tonnes of cocaine last year, more than double the quantity for the previous year. Cocaine use has nearly doubled in France, according to one study. Some 1.1 million people used cocaine at least once in 2023, the French Monitoring Centre for Drugs and Drug Addiction (OFDT) said in a report in January. The previous report, released in 2022, put the number of users at 600,000. The new figures put France in seventh place in Europe in terms of cocaine consumption.
