This website includes more than 200 articles, investigations, book extracts, radio programmes and videos about drugs (policies and prohibition), harm reduction, the fight against AIDS, gender, prostitution…
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Category Archives: English
A Quiet Revolution : Drug Decriminalisation Policies in Practice Across the Globe
ARI ROSMARIN NIAMH EASTWOOD ‘A Quiet Revolution: Drug Decriminalisation Policies in Practice Across the Globe’ is the first report to support Release’s campaign ‘ Drugs – It’s Time for Better Laws ’. This campaign was launched in June 2011 and saw the organisation write to David Cameron, the British Prime Minister, calling for a review […]
Cliquer pour continuer la lectureExtrait / Excerpts : A Plague of Prisons
A Different Kind of Epidemic Here are some of the things we know about this new epidemic: • The population involved is diverse: men and women, adults and children, different social classes. • The onset was very rapid — in thirty-five years the population directly affected by this epidemic increased tenfold, from 250,000 in 1970 […]
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Vienna Declaration : a call for evidence-based drug policies
Evan Wood, Dan Werb, Michel Kazatchkine, Thomas Kerr, Catherine Hankins, Robin Gorna, David Nutt, Don Des Jarlais, Françoise Barré-Sinoussi, Julio Montaner, DOI: http://dx.doi.org/10.1016/S0140-6736(10)60958-0 Summary Full Text References © 2010 Elsevier Ltd. All rights reserved. There remain crucial areas in public health in which the gap between evidence and public policy persists, and […]
Cliquer pour continuer la lectureGood practice, good results. Maintenance treatment outcomes in France
Summary
In 2004, a public debate emerged on the misuse of, and trafficking in, prescribed drugs. Because of their positive outcomes, maintenance treatments were not officially questioned. A national evaluation showed that the decrease of 80% in fatal overdoses and of 67% in arrests for heroin use (1994-1999) were directly connected with treatment accessibility. This assessment resulted in a consensus among addiction and public health experts. These good results have not, however, been published by the mass media, and the general public still is unaware of them. Nor were the causes of these good results were not discussed among health professionals. They are not only due to the medications involved, but to good clinical practices. The first practitioners who started to prescribe maintenance treatment had followed extensive training, and were networking and building relationships of trust with their patients. Against the background of this public debate, a consensus conference on maintenance treatments organ- ized in 2004 recommended that the prescribing GPs should be better trained, and that they should be included in professional networks. Although these recommendations gave priority to the improvement of clinical practices, the authorities have decided to implement control measures over patients. These measures might make access to treatment more difficult, and they fail to sup- port the involvement of GPs and pharmacists. The effectiveness of substitution treatments could be affected.
Key Words: Maintenance treatment – Treatment accessibility – GPs training
Cliquer pour continuer la lectureThe institutional and historical context of introduction of opioid replacement therapy in France, and the situation of France in this field compared to other comparable countries
Summary
The main characteristics of opioid replacement therapy in France are: 1) the large number of patients, almost 100,000 ; 2) the use of high-dose buprenorphine ; 3) about eight out of ten patients are treated by GPs. The development of opioid replacement therapy is both very recent (1995, Marketing Authorisation) and very rapid. Although cases of misuse have been observed (injection, resale on the black market), a national evaluation showed that development of these treat- ments has been accompanied by an improvement of health and social integration (80 % reduction of fatal overdoses, reduction of syringe sharing, 67% reduction of arrests for heroin use between 1994 and 1999 – see INVS, 2001). These good results are due to a large access to care and Good Clinical Practice by a majority of practitioners. On the basis of follow- up studies, about two-thirds of patients obtain a benefit from these treatments. An improvement of current results would require adaptation of the management of poorly stabilized patients, with a broader access to care, including easier access to methadone. Erratic practices must be controlled by publi- shing good clinical practice guidelines, training of practitioners and improvement of the quality of the relationship with patients.
Cliquer pour continuer la lectureFrom Witches to Crack Moms ; Women, Drug Law, and Policy
From Witches to Crack Moms ; Women, Drug Law, and Policy. Susan C. Boyd, Carolina Academic Press, 2004 … Lire la suite
Cliquer pour continuer la lectureFrom prevention to care, a new approach to drug use
Peddro ; special edition, UNESCO and Unaids, pp. 76-78 The AIDS epidemic is gradually changing the public image of drug addicts. After a few hesitations as to how best to prevent the propagation of the virus, it was decided to appeal to people’s sense of responsibility rather than applying coercive measures. Preventive efforts are […]
Cliquer pour continuer la lectureAn evaluation study on share care methadone treatment between a specialized clinic and a network of General Practitioners
Heroin Add & Rel Clin Probl 2000 ; 2 (2): 29-33 Policy Initiatives
Summary
This article discusses recent changes in France from what has mainly been a repressively oriented drug policy towards accepting and supporting a variety of harm reduction measures. The introduction of harm reduction in the early nineties proved to be very successful in terms of harm reduction and is already a reality. Most officials, however, are still reluctant to support this implicit policy change openly, or work coherently for a reduction of current inconsistencies or admit the overwhelming success those changes have brought about, so the author is afraid of a serious backlash. The positive effects may be threatened if the public is not adequately informed about the new situation and its positive effects. The government may be unwilling to continue supporting harm reduction in the face of increasing public criticism based on ignorance and an inadequate conception of how to preserve public order in connection with illicit drugs.
Cliquer pour continuer la lecturePreliminary Observations In Substitution Treatment of Opioid Dependence
The International Center for Advencement of Addiction Treatment website
Summary
Considerable evidence indicates a gratifying reduction in the use of heroin in France, and major associated benefits to the general community. This improvement clearly seems related to the massive expansion of opiate-agonist based treatment; the fact that such expansion was possible (development within 4-5 years of the ability to accommodate some 80,000 users!) is itself an encouraging message to other countries (including the United States) seeking to control opiate addiction and its medical and social consequences. The overwhelming reliance on prescribing by generalist, community-based physicians (rather than specialized « programs ») seems to have been a sine qua non of the favorable French experience in recent years. And finally, disparate rules and regulations governing the use of the specific medications to treat heroin addiction preclude reliance on evidence-based medicine to guide the medical profession in its treatment of this illness.
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