 Good morning, I'm Peter Sharuschi and this is stories from the front lines drug reporters live video series with activists and professionals working in the field of harm reduction. Today, we will speak about the situation in in France with two professionals. Lauren Collar from federal addiction and and Etienne Norman, the head of the carwood dropping center in the city of to lose. Hello guys, how are you. Yes, I think you're sorry you are muted. Etienne you are mute muted yourself. So it's perfect. I'm okay. Good. Yeah, we are good. Lauren, do you hear us because yes. Okay, good. So both of you are here. So can you explain us what is the situation right now in France with the with COVID epidemic is the lockdown measures now easing. What about the number of those infected so do you see the light in the end of the tunnel. I don't know because there is a problem I think we've learned it's more that have a national vision. But I can answer for to lose because I'm from France and to lose is on the source of friends. It's a part of friends that is not the most COVID influence that there is not a lot of epidemic cases. We have a we had most of the problem in the North, East and we've had the group of Paris land. Of course, in all of the group all over the country, but actually they say that we are going to open all after the tour join. So to see the light it can be, but we don't know because as you know, as in all the country, maybe there is a second one. I think that what's happened was more to to to to to to make an invitation to for the poor people from precarious and so on because there is a lot of services in in our, not in our addiction and in a social part that was close. So we can speak about that after but I don't know if I answer to all the question. Yeah, thank you very much. We are trying to get back Lauren who has connection problems we hope that she can join us soon. Before that before she can join us back at here and can you explain us how this crisis affected people who use drugs in in in your city. Can you talk a bit about that. Okay, my it was a it was especially it was a big problem at the beginning with the the confinement I don't know in English if we can speak about the confinement it exists. Yes, confinement. Yeah, yes. Okay, confinement. So it was a big problem because the people make the choice of of being in confinement but they don't make the choice of stopping their using some of them that are more important users. They don't have the choice so they don't have an economic resources from the street. Because we've all the confinement there is nobody inside the street so we don't have problem with the, the, the, the furniture use of heating and so on but we have a lot of problem relating to alcohol tobacco drugs. In the legal part, there was a lot of center of urgency that they call us with a lot of pressure from the people that they were inside, because people start to be without alcohol and without tobacco and as they decide to make confinement straight. They start to have problem with people that they were intention. So we start to our action in it was more to reduce the harm reduction action from the center because we can't have the collective part. So we make a drive and so on drive to give the material we go on outreach we develop because in my center we have a program for harm addiction program of metadone. That is in a, in a, in a part really, really simple to access and we start to, to have a lot of people that try to, to have a metadone because at the beginning there was a problem with the prescription, the prescription, the doctor and so on and the access. And there was problem from the street to access to metadone or to some products or period. After we decide to make outreach to go to the squad and to people that live all over the street and all over the department to see what's happened to them. Of course we have another program that is a program of harm reduction by distancy. I don't know the name in English, but it's like it's like the people they can send mail SMS message from their phone and we have always a person that is behind the screen or behind the phone and they can have an exchange rating to their life, to their using and I can have their, their material, all over there inside the Occitan, Occitan part. But it's, we have a program of that that is all over the France. In each big land we have that kind of program. And we were thinking that the people they are going to, to come to that kind of program and in fact now because they, they did some of them come and some of them they are like, okay, I don't know, this is new. I'm not sure that I can ask to, to a screen to give me some advice or to give me some, to send me some material. But at the beginning there was another problem and it was a big effect relating to the people that they don't know they would, they don't have the good information and a lot of them that they were alone inside straight car or squat and that they don't have the information they, they start to, to be stressful because they have control of police relating to authorization to go and come back. And of course we have a, we, in Toulouse, we, we work a little bit with the policy. So I start to prepare a special authorization for them to go to the, to my center or to, or to, to, to go to have metadone. In fact, the policy, they pass, they say, oh, so you are open, what's happened? And I say, okay, there is a problem for that people you make some control. And of course they are in the streets or start to make some control, they need to have health care and so on. So that's, that part start to be okay because after the users association, start to make a special authorization for the people from the street and users. And people come to have a lot of material during 15 or four months to, to have a limit to the moving. And that, that was the, the beginning with a lot of anxious, they, a lot of them were anxious because they, they start to have the price of cannabis that is growing up. And they don't have money from the street or from the, the illegal resources and they start to, to, to be without a product. And of course, did all the product were there, the price of cannabis is growing up the cocaine start to be like, because there was, there was in Toulouse and a lot of time in France, there was a stock. So that we don't have a problem with the cocaine, but we have a problem with in a couple of land, we have a problem with heroin that they don't have it in Toulouse. It's not a lot of a, it's not a city with a lot of heroin. So I don't, we don't, we don't saw that. I don't know. I'm going to, to, to think, but the adaptation was really, really thing to help the other dispositive urgency and that they have people inside that they don't know how to do with the legacy drugs like tobacco and alcohol. And we start to give them some advice. We've, we've advised from a federation addition and we've modus bimendi that we work to, to, to, to have a, not that to, to have a practice to, to, to give them some advice and to, to explain to advice to each question. And we say that our work was more to, to start to have, I don't know, it's like a kid. I don't know it's okay. Okay. Okay. To give them all the resources to decide to decide for the people that they were there. So this kind of resources was relating to the, to the money. And I'm a director of a center. Can I buy alcohol or tobacco? Yes, of course, there is that law that allowed, allowed you to buy it and to give to the people. The spirit was that the people, and as I say, as I say to them all the time, the people must be without difficulty, psychics and physics. We are not going to pay you the, the, the, the difference. The high. We're going to buy your high. The highway, because it's not live at, we are not in an open highway, but we are going to give you all the things you need to be cool and to, to, to assure your confinement. That was our spirit in France. That's very interesting. And I see that Lauren could rejoin us. Lauren, can you confirm that this, this was also representative to the whole country, or this, this progressive attitude happening in the other parts of France. Well, the situation as it can described it for the bit that I heard was really reflected everywhere in every area in France. We have differences between regions obviously in terms of the quality of product that is consumed or the, the facility or the availability of resources but the situation as it stands during the lockdown is really similar in terms of the question of accessing resources inside housing centers. And it has been really, well, a sad opportunity, but an opportunity still to, to make progress in terms of legislation in terms of explaining the need for harm reduction and for less criminalization. The cream would be nice really in France, but we are not there yet, but to have less criminalization of drug use and way better access to harm reduction and, you know, on not no judgment facility as we say in French. So, the housing centers have been improving a lot of their practices all over France I know for instance that in Normandy, an arm reduction center who couldn't be open during the lockdown because of the lack of space to welcome people in a very secure way they went and became an outreach team. So they are only out reaching now, and they have been building very strong partnerships with the home with the housing outreach team also and so now they're working hand in hand and they have the housing team has been really understanding even better and seeing the positive effects of welcoming use as much as we can here in France. So it's been really leading a great progress also in terms of public stakeholders understanding the need for arm reduction for better arm reduction. And for instance on the OST access, the question of changing the prescription was done nationwide so everybody in France now is supposed to have access to a renewal proposition of OST methadone actually in pharmacy up to 28 days without having to go to the doctor now. So one of the main challenge with the lifting of the lockdown sorry I'm going to be short I promise. One of the main challenge is to make sure that we have this these measures that are going on and keep keep on going after the crisis period so that's taking a lot of effort now to make sure that it's not only it's not only during the crisis period and era but it can change for the long term. Yeah, thanks. Etienne mentioned that they experienced rising cannabis prices in Toulouse. What did you experience in other parts of France that was also the case did you make any survey on how the drug market is changing now? Well the French branch of the MCDDA so the French MCDDA has been really looking at that and we have been collaborating with them obviously to make sure that we access the shorter way and the quicker, the better, the to monitor the level of prices, especially on cannabis but also on other products. So Etienne mentioned that for cocaine we don't have the same level of difficulty in accessing cocaine but the question of cannabis is a really particular one also because of the lockdown and the question of young users in France it's a bit tricky because there have been confined they have been under lockdown with their family and without the possibility to have the same access to cannabis so the question of the family is discovering how much the user needs or needs or wants to have access to cannabis and well it has been really difficult for some families and some users so we have dedicated teams inside the network who have been really actively reaching out to young people to make sure that they don't get in too much trouble regarding their use and the question also of the absence of the black market or not the absence completely but the reduction, drastic reduction of the black market has also been and Etienne mentioned it has also had consequences in terms of financial resources for people and for people who use and sell drugs also so they have been faced with the challenge but now with the French monitoring center we have seen a start of an increase in terms of quality of bad quality cannabis and of course it's something that we were expected expecting so the French monitoring center on drug and drug addiction have been publishing reports that are available online and I know that they have been also included in the MCDDA's reports they have worked really closely with the transporter survey and we have been promoting that obviously in our network both of you mentioned shortly the police and we know that France is not the most liberal country when it comes to drug laws and law enforcement what are your experiences with the police attitudes during this crisis do they show some restraint not to arrest so many people or is it the same strict law enforcement going on in France both of you I can start and then I'll give the floor to Etienne if you want to tell us how it is on the field so what we've seen is that the police is obviously more present in the streets but also they have a priority in terms of making sure that the lockdown is respected so now with the lifting of the lockdown we're going to see how it's changing but what we've seen on the national level and in some region more than others obviously is that the police has been more progressive in terms of orientation to the armaduction facilities also because the priority is really not to arrest people because we don't have magistrates the justice is not well it has been posed also and the prisons have been clearing out a number of detainees so it's really not fashionable to put people in jail which is a good news for us obviously and it's not I mean this is something this is also something that we want to see after the crisis to be maintained in the long run is that the police have been more and more pushing people to access health care and to make sure that they are inside housing centres and not out in the streets or even worse to how not in the police stations so that's what we've been seeing and we've been promoting that for the European forum on urban security also who has been really helpful in terms of accessing down the city halls and the police at national and local level it and if you want to tell us how it is for you I don't know what can I say more I just want to tell you that in fact the police they start to be more cool and they start to be more cool they don't they were really strict with the confinement for all the people in Toulouse here I live in the camp of Toulouse and I was with a drone and helicopter around me when I was with my dog so but with all the people was like that so it was a little bit stressful and I give a lot of functions so people they were anxious with the product with the lack of product with the police and with all the control so but when they start to arrive to some of the control of police they start to realise that the police they just want to see the authorization and they don't they don't take care of their effect of the states that they have and they let them go it was not because we know you know we don't have users only inside the street we have users inside the land we have users that work we have users that they were inside and they sell some product inside the poor part of our city and there that that was a little bit different because when I was with my motorbike to go to the street to that kind of land all the police were there they make a lot of control to that poor neighborhood and that was not good for the traffic and for the economy and so for that there was a little bit there was some some problem relating to deal there was a into losing but I saw that there was some problem in Paris or some problem in Marseille so we know that that kind of that kind of economy that kind of market is not it's not easy to make a communication with them but the thing is that the police were there all the time when I was passing to the roundabout and to the point and they was there on the street and making some control and that was not really cool after there was the part of Ramadan that arrived and they start not to be there like that we are like that in France we are not we say that we are not racist but we have some actor that is like a racist relating to poor and to some people a few years ago there was a kind of discussion about France going to decriminalize drug use and then then this discussion was stopped or I don't I didn't hear about it anymore so can you tell us like what is what is what is going on now is there any chance that the drug use will be decriminalized in France well I can take this one maybe so I hope that at some day it will be decriminalized obviously but yeah so it's some it's a subject that is rising and then getting buried again and then rising again because of the civil society efforts obviously so we've been really mobilized with also our partners obviously in France to push for that debate and it has been on the table in the last two years maybe because of a new measure that has been pushed by the current government to make to transform the the penalty for drug use from a prison sentence to a fine but to a financial sanction but now it's yeah you can have what went on the floor and what was accepted in law is that you can have you still have exactly the same section in terms of prison time and and obligation of care and so on but on top of that you can also have a financial fine if the police who arrest you wishes to go quickly and don't go to the justice system so you don't access the justice system you just have to pay fine so that was the debate maybe that you were referring to Peter because it's one of the most recent debate about drug the drug policy that we had in France but this is of course this is not what we promote and this is something that we went strongly against because it's just like adding up to the sanctions available to the police for drug use and this is really not something that has been proven effective and it's not proven effective anywhere and it's not based on any evidence obviously and it has been it will create even more difficulties so I'm sorry that I don't really have a good news on that front French drug policy the good news is however that there is a debate going on about the possible legalization and regulation of the cannabis market but it's not currently productive, productive, productive anything it's the base the base of that is a report that was asked by the government to the parliamentaries to the to the National Assembly really to make sure that we have covered every possibility in terms of organizing the regulation market for cannabis if and whenever we would eventually want to legalize this market that's where we are at but evidently with the current crisis things have been posed and stopped but it will take take place again it will start again next week so we are in relations with the with some deputies some member of parliament on that specific report but we don't have any clue right now currently regarding the production that has been that will that will be published afterwards so this is one and well two of the main actualities and news regarding that issue also we've been promoting the latest reports of the global commission on drug policy who has been really so helpful and plenty of great ideas and also in relation obviously with the arm reduction surveys and so on that will definitely and continue to prove that the cream is effective in terms of access to care and human rights for people who use drugs we've been doing that for so long now in France but we are keep going we are keep but we keep pushing that because it's where it should go but the ideology in France is really really strong as I'm sure that you know the question of legal highs and not illegal highs are so like you know divided so you can't have a proper think about the regulation of the alcohol market and you can't have a proper think about the regulation of the cannabis or heroin market so it's really difficult but we keep going and we have good faith because on the other hand some news show that we have been closer than ever to a proper debate and an evidence based debate in the national assembly. It's something that is getting track in the public opinion. So, yeah, we can't be 100% confident but we have good hope to have a proper debate sometime in the near future. Yeah, you mentioned legal highs and new psychoactive substances. How prevalent is that in France? Do you see that it's rising or who is using these substances? For example, Etienne, do your clients use new psychoactive drugs? You're muted. Excuse me. I didn't hear the end of the question. Excuse me. Yeah, the question was that, you know, Lauren mentioned about legal highs and these new psychoactive substances and I was asking you if you experience that the use of these drugs is prevalent among your clients? Is it rising among your clients or what can you tell about that? The people that they use are speed or amphetamine or cocaine that they were inside the space, they start to have a growing limitation of their consume of alcohol. For example, some of them that they don't have cannabis they start to try the CBD. That was a lot. But there was not a lot of people that make that kind of switch. A lot of people that are from the street that they don't have the resources from the market, people give them from the street. They start to use products like medicaments and so on. But it was not a lot of people that made that kind of switch. What I was repairing all over the France was the same that there was some people that start to stop or reduce their consume because of that confinement. They don't have the same solicitation. They don't have the same craving. Some of them start to stock to have all the product, all the confinement. Some of them they switch. Some of them they try to reduce or stop. So it was not a movement. It's like a case per case. We have to look to all the people that they come and try to understand what's happened to them. I just want to complete part that my colleagues Lauren say is relating to human rights. It was relating to the jail because we were directly with that kind of problem. We were looking to Italy because they were the first country with that kind of problem. And we were at the beginning on the starting block like okay what is going to happen for the people there. If they cut the relation that they have and they don't make a zoom or go to meeting or a relation by internet is going to be a big shit for the people that they are inside the jail. Of course they did. They did that and so it was a big shit and the status to to to to the we you know in France we have we are we are in a legal part we have the right of using alcohol or tobacco. But in jail. It's a part of France that you can't use alcohol. It's a part of friends that it's forbidden to use alcohol and for that we make some some resources kit with some advice to the to the we have our partner with Federation addiction with the International Observatory of Jail and some some of our actor that that they were there because because they say that the hydro hydro alcohol Jail Jail was forbidden because people they they they they they can use it for for being high. So we say that the problem is not of that and that the problem that it's not allowed to forbid that but as in French right. The pen in the series they are they are they are allowed to decide what they want inside the day. You know our system it's like you are director of a jail you have the right of making right inside. And it's you that are the boss. So like that we can't we don't have the we can make some paper we can make a press some declaration in place. But we don't have a changing relating to jail with people that are there. So of course for me what I saw inside the media it was that the movement was getting down. But we have a lot of people that were there. That we know that they have some problem of anxiousness and so on and that they don't have the possibility of going to see a doctor or to have a medicine. So that was a big shit for them. And some of a lot of people from the jail they were going out because the of course the government decided to for the end of the of for the people that they are next to the end of the people that they don't have a bigger big problem of justice that they can go out from the jail. Like that we have less people inside and we can have more Jason. It was a little bit like that. Okay. So, another, let's say recent development in France was that few years ago. In some cities, you introduced the drug consumption rooms. What happened with those rooms during during the lockdown measures? Are they still open? Did they change any any how the rules? Yeah, what can I say, because I'm not in a consumption room so I just call my colleagues from Paris and they say that there was a lot of people that they come they change a little bit the rules. Because they have the distancy and and the wash and so on. So but the people that were coming were the it was increased because there is a lot of people that they were not as the park in Paris. They were closed all the day there was the street and so on but there was a lot of park and people that they're on the street and as they use drugs inside the park they come so they come more to the consumption room. And it was not easy, because there was a lot of people with a little part of time and we can't open the construction room with all the bank. So it was a little bit stressful. They work a lot. They work, they work a lot in Paris, they start to develop program relating to housing housing housing social. Like, they start to put people inside the hotel and to follow them. And to like that they can use drugs properly inside the hotel and they can be a little bit protect for some of them. But I know that they work a lot with people from the 115. It is the urgency for housing people in to lose we work with that with the 115 and we decided to open camping and to open camp to the people that they want to go there. And of course we like in Perpignan like Oliver the friend some of the harm addiction center they start to buy a solar shower for the people that they are on the street because they don't have access to the to the water. That that was the most incredible part because at the beginning we saw that the that the toilet public toilet they were close that the water was close. So we didn't understand why they do did that. Of course I speak about to lose but I saw that there is some some of the country of the city that that make the same. And we have to to to work a lot with with the public services to try to open the point of water that we don't arrive to that so we buy some solar shower and so on to give to people. And of course we need water to put in solar shower so it was not easy. But we have people that have relation with the neighbor on the street and so on so we start to have some, some, some help from the civil people. If if I can just make one and one or two addition yeah okay thank you. So yeah for the DCRs said we have two DCRs in France one in Strasbourg one in Paris so well I'm not going to add really much more of what has been said already but one of the things that have been challenged with during the lockdown is one of the main things that have been proving difficult for our induction drop ins and so on is the question of the continuity of the activity. So it was really, really crucial crucial that they could remain open because people definitely need that kind of settings and places because it was a bit challenging because, for instance, it's the little things you know it's not the clinical approach it's more of the operational challenge. For instance the question of the children of staff who couldn't be in school. So people had to be work to work remotely but when you work on a daily basis in a DCR you can't work remotely obviously so how to manage that is that has been really important for the managers of the DCRs to make sure that they have found they found solutions to to to compromise between the needs of the private life of the staff and the needs of the professionals on the field who had to be there so they have been strongly reacting and strongly involved and mobilized in I mean people have been working like crazy during the lockdown we have to take that into account. We have been reinforced teams to make sure that people have are are are that we know where people are in terms of maintaining a relation and not having them hide away and not not accessing any more reduction. So that's the, that's one of the challenge. One of the other challenge was also the question of making sure that people don't disappear also from the housing and social care, not only the strictly used related harm reduction but also the access to health and to social caring and care and so that was really key to to push for in all the droppings and what we've seen on the ground is the question of to what point do we meet new people and to what point do we want to outreach and to find to make sure that we find the relation with people who have been disappearing during the lockdown have been housed somewhere we don't know where we're not being able to move around as much as they used to so. So yeah and this year's have been really key in making sure that we that people get what they need to help, even during this very difficult period that have been pushed on us. What do you think does this crisis make people to show more solidarity. I mean, as general as French society, because now probably the worst of this crisis is just coming still in the future like you know economic crisis. And there will be needed, need the so lot of solidarity will be needed. Is it optimistic or pessimist when it comes to the future. It's a difficult one. That's really difficult to say at this stage. We are still digesting the the very difficult times that have been proving on the ground and yeah I think one of the main challenges that is yet to come is the question of the economical impact of that period. So if you want to take this one first maybe. Yeah, thank you. You are the best. As, as you say it's a difficult question because we saw a lot of solidarity. I saw my neighbor that give that start to make some mask from people from the street they give tobacco. They give me money alcohol and so on. It was funny because they, they don't even care of the people but they did some of them sort of the of the neighborhood they ask us where is Frank where is the other one because we saw them all days. Of course we don't know actually because I'm, as you say, Lauren, there is the part of the economical part that is that is going up that make us deciding to open all the friends and and to make the day confinement. So we were thinking that maybe it's going to change a little bit on the way of life in France and we are not sure actually that the that that kind of effect is going to continue. Because, as you know, if there is more people that are poor because they lost their job and in to lose, for example, we have a bus, but we know that, you know, in the border was the same and some of the economical part of the country, for the land of to lose, it's going to be a big sheet. And so, when there is a lot of people that lost their job, of course, in a psychological social way, they are going to push down the people that are more part of the than them and to start to be in the good level. So if you use your time to help the drug addicts and the people from the street, why you don't use your time to your neighbor that is going to lost their job and so on. So it's going to be like that, I think, but I'm not sure because I'm not, I'm not pretty, pretty, too, so pretty, I'm not, I'm not a God. I'm not God. So I can't, I can't, I can see what what is going to happen. And we have some hypothesis like that. And of course, for, for arm reduction, our work was really good because we work a lot together. We work a lot. And we produce a lot of things relating to the people that don't use arm reduction in their program and actually some of them they start to change. So I hope that that kind of effect is going to stay. I know that there is some people from the part of housing that they say, oh, it's really cool now because they accept that I can that I can drink the accept that I can use drugs they accept that I'm, I'm not in a way of drinking because, in fact, a lot of the housing agency, they say, oh, I give you an house, but if I give you an Aussie that you don't choose drugs, I'm a little bit kind of making caricature, but it's a little bit like that. So that kind of solidarity and that kind of human rights is is going to I think stay. And that's really cool for us and for them. Yeah, yeah, thank you. So I'm going to be more optimistic than you at the end. So it's, you know, it's, I think it's the first time might be the first time. Yeah, I think solidarity comes in terms of crisis more than ever. So that's something that we can see, even even if, even if the social and economical impact is yet to be measured. And we have to monitor that very closely. But the progress that we've seen in terms of accepting arm reduction. I mean, it's really sad to see that we always need a health crisis to to make progress on that front to make that much progress on that front. But now it has been proven effective. And something like access to OST is really more easy in pharmacies, for instance, for instance, or what you what we've been saying about the outreach team or the question of a virtual outreach. Also the question of the online forums, the question of the postal programs to access arm reduction materials and so on. This is something that no one is going to put in debates ever again, I think. I mean, I'm not a God either. But I think that that's, it has been proven so effective during this crisis that we might have said that in stone at some point, hopefully. And the other thing, and then I'm going to end on that for that question is the question of the reform of the health services, because I don't think that we can't, I don't think we can consider hospitals and centers as regular private sector, you know, for profit organizations as we used to start to do, meaning that the government. Well, not only this one actually, unfortunately, have been really pushing for reform for more liberal liberal economical management of hospitals and so on. And that is something that they might not do as much. So we can have more room for clinical approaches for training professionals in hospitals and so on. So that might be another form of solidarity that we can push from the institutional point of view. Yeah. And I think these are really nice concluding words as well because our time is approaching its end. And I hope that you will be right so we can use this as an opportunity also in France but all over Europe, Lauren is a chairperson of the civil society forum on drugs and it will be also interesting to see what will happen in the European maybe at another time we can discuss that. So, Lauren and ATN thank you so much for being with us today. And thank you for all those who are watching us on Facebook. Next week on Monday we will speak with professionals from the UK, Matt Saliswell from European network of people use drugs and the neat Eastwood from the release of London based human rights NGO. So please join us on Monday for PM. And thank you again for our French guests and good luck with your work. Goodbye.