International - France

Basic Data

(Prevalence of Drug Use) "Among illicit drugs, cannabis remains the predominant substance by far, with an estimated 13.2 million lifetime users (who used it at least once during their life). Close to one million people regularly use it in France. The use of cocaine, the second most used illicit substance, is well below this and affects around ten times fewer people, including those who have used these substances at least once in their life or at least once in the previous year."

(Prevalence of Drug Use by Youth) "The HBSC [Health Behavior of School-Aged Children], ESPAD [European School Survey Project on Alcohol and Other Drugs] and ESCAPAD [Survey on Health and Use on Call-Up and Preparation for Defence Day] (See appendix IV-K) surveys show similar results: cannabis appears to be the most illicit substance used among adolescents and, particularly, among boys. 28% of 15-year-olds stated having already used it at least once during their lifetime (2006) and 42% of 17-year-olds. Use in the month affects 1 in 4 young people aged 17 and 15% of 15-year-olds.
"With the exception of cannabis, lifetime use of illegal or misused drugs remains rare. Among 15-year-olds, the most common substances are solvents and products to inhale (5% of people who have used it at least once during their life). These are followed by cocaine and crack (3%), amphetamines and “medicines for getting high”, all around 2% and, finally, heroin and LSD, which do not exceed the 1% mark.
"More 17-year-olds have used at least once during their life illicit products and other products: poppers (13.7%), inhalants (5.5%), hallucinogenic mushrooms (3.5%) and cocaine (3.3%). Reported lifetime use is low for GHB (0.4% of 17-year-olds), crack and heroin (1.1%) and amphetamines (2.2%). Thus, there seems to be a renewed interest for stimulants in some marginal groups of the adolescent population, even if the fashion for ecstasy seems to have passed away."

(Prevalence of Cannabis Use) "Cannabis is by far the most consumed illicit product in France. In 2010, among adults aged from 15 to 64, around a third (32%) stated having used cannabis at least once during their lifetime. This lifetime use affects more men than women (40% compared with 25%). Current use (in the past 12 months) affects 8% of 15- to 64-year-olds (12% of men and 5% of women), although the proportion of users during the month reaches 5% overall.
"Although lifetime use went up from 29% to 32% for all age groups between 2005 and 2010 (Table 2-2), cannabis use remains stable. Indeed, other forms of use also being stable, the slight increase observed is mechanical, linked to a “stock” effect of former generations of smokers. This stability hides some generational disparities: current use (particularly regular use) is increasing for women aged 20 to 25 (from 39% in 2005 to 44% in 2010), although the level of lifetime use is declining for girls aged 15 to 19 and for men aged 15 to 25. The proportion of lifetime users of cannabis is at a maximum in men aged 26 to 34 (64%) and then decreases to 13% for those aged between 55 and 64. In women, the number of people who have used cannabis at least once during their life represents around 37% of 15- to 34-year-olds and only 7% of 55- to 64-year-olds. Current use of cannabis particularly affects the youngest (21% of 15- to 25-year-olds). It then decreases with age. It is almost zero for 55- to 64-year-olds (Figure 2-1)."

(Prevalence of Cocaine Use) "Since the beginning of the 1990s, the availability of stimulants, cocaine or other synthetic drugs (ecstasy, amphetamines, etc.), has increased in France. The emergence and the related spread of the freebase form of cocaine⁸⁴ and crack (whose use is nevertheless rare) occurred during the same decade.
"With 1.5 million people who have used it at least once during their life aged from 11 to 75 (i.e. 3% of the general population) and 400,000 users over the course of the year (0.8% of the general population), cocaine ranks second among the most consumed illicit products, way behind cannabis and licit psychoactive substances. In 2010, 3.6% of 15- to 64-year-olds questioned by the Health Barometer had used it at least once in their lives and 0.9% had used it over the course of the previous year (Table 2-2). The increase in its diffusion is nevertheless very marked. It reflects the accessibility of a substance that was once limited to the well-off. For some years, increasingly wide circles of society have experimented with it or used it. Current use (during the year), like lifetime use, affects around three times more men than women."

(Prevalence of Cocaine Use and Trends by Age) "The proportion of people who have used cocaine at least once during their life is highest among 26- to 34-year-olds (8% of the general population, 11% of men, 4% of women). This proportion decreases in previous generations. Among 15- to 64-year-olds, encountering it occurs, on average, at 22.5 years old.
"Use during the year primarily affects 15- to 25-year-olds (1.9% of the general population, 2.8% of men, 1.1% of women) then decreases and becomes practically nil as of age 55.
"The proportion of 15- to 64-year-olds who have used cocaine at least once during their life increased three-fold in 15 years, from 1.2% in 1995 to 3.6% in 2010. It increased by a third between the last two Barometer surveys. Use in the previous year almost doubled between 2005 and 2010 among 15- to 64-year-olds, from 0.5% in 2005 to 0.9% in 2010 (Table 2.2)."

(Alcohol and Tobacco More Damaging) "Alcohol and tobacco consumption levels are by far those which cause the most serious extent of damage, either on the health or social level, or with regard to potential dependency."

(Drug Arrests) "The number of drug offences skyrocketed over the last 30 years (cf. Graph 9-1). Almost 90% of all reported drug offences in France are related to drug use or possession for use. Police reports recording drug offences have increased consistently since the 1980’s. This evolution can be attributed to increased police activity but also possibly to an increase in drug use and trafficking and a better performance of the data gathering systems (or other factors that we may not even guess) {Ocrtis 2009}.
"Reasons for arrest
The “one-off” (or simple) use of narcotics remains the main reason for arrest, accounting for a total of 135,417 in 2010, i.e. 86% of all arrests for drug-related offences in that year. This proportion has risen slightly since 1998. In 2010, 11,277 arrests for use-resale were recorded, the second leading reason for arrest, i.e. 7.2 % of all arrests for drug-related offences.
"The 10,889 arrests for drug trafficking recorded in 2010 can be split up into two categories, i.e. arrests for international trafficking and arrests for local trafficking, accounting for 7% of all arrests for drug-related offences."

(Drug Arrests by Substance) "In 2010, cannabis remained the main substance involved in the arrests for drug-related offences, regardless of the grounds for arrest. Cannabis accounts for 90.4 % of arrests for drug use and 69.9% of use-resale and trafficking cases.
"After cannabis, heroin and cocaine are the main substances involved in the drug-related arrests. Arrests for heroin use are more frequent than those for cocaine use (5.4% vs. 2.9 %) with a similar picture for arrests for use-resale and trafficking: heroin (n=3,382) accounted for 15.4% of all arrests for use-resale/trafficking whereas cocaine accounted for just 11.2%.
"We should point out the relative importance in France of the number of arrests related to the misuse of medicines (particularly Subutex® but also unspecified substances, used in spite of the absence of any proof of a prescription), and those for hallucinogenic mushrooms."

(Transshipment of Drugs) "France continues to be a major transshipment point for drugs moving through Europe. Given France‘s shared borders with trafficking conduits such as Spain, Italy, and Belgium, France is a natural distribution point for drugs moving toward North America from Europe and the Middle East. France‘s overseas territories‘ presence in the Caribbean, its proximity to North Africa, and its participation in the Schengen open border system, contribute to its desirability as a transit point for drugs, including drugs originating in South America. France‘s own large domestic market of cannabis users is attractive to traffickers as well. Specifically, in descending order, cannabis/hashish originating in Morocco, cocaine from South America, heroin originating in Afghanistan and transiting through Turkey, Belgium, and the Netherlands, and ecstasy (MDMA) originating in the Netherlands and Germany, all find their way to France."

(Price of Selected Drugs)
"Cannabis
"According to OCRTIS¹⁶⁶ the median price for herbal cannabis in 2010 was approximately 7 euros, and ranged from 5 to 10 euros per gram. This price is slightly up compared to previous years. This phenomenon is explained by the fact that an increasing percentage of consumers appear to display a marked preference for high-quality products. The wholesale price of herbal cannabis, as measured by the police, stands at 3,500 euros per kilogram.
"The median price of cannabis resin has remained stable. In 2009, this stood at 5 euros per gram. The wholesale price for the same year was 1,950 euros per kilogram.
"Heroin
In 2010, the median price per gram of brown heroin was approximately 40 euros and has remained at around this level since 2006 after having fallen sharply since the late 1990s when its price hovered around the 70 euro level. The wholesale price for brown heroin has also remained unchanged at around 12,000 euros per kilogram.
"High-dose buprenorphine
"Since 2008, the price per 8 mg tablet of HDB marketed as Subutex®, the only (or almost only) form available on the black market in major urban centres, rose slightly to 5.5-5.6 euros in 2008 and 2009 compared to 4 euros in previous years {Cadet-Taïrou et al. 2010b}. This price increase is believed to be related to difficulties in keeping the market supplied due to the strict prescription control measures put in place by health authorities.
"Cocaine
"The price per gram of cocaine hydrochloride has remained stable for five years after having been halved compared to the late 1990s. In 2010, the median price was approximately 60 euros per gram. The wholesale price, which also remained stable, was 30,000 euros per kilogram."

(Prevalence of Problem Drug Use) "It is believed that there were somewhere between 210,000 and 250,000 problem drug users in France in 2006, i.e. a prevalence level of between 5.4 and 6.4 per 1000 inhabitants aged 15 to 64 years old, placing France in the average for the European Union. Half of these drug users are involved in a medical substitution treatment for opioids. Indeed, it is also estimated that approximately 120,000 people used opioid substitution drugs during the first half of 2007. When examining the various surveys to establish the proportion of heroin users and applying this to the number of problem users, the number of active heroin users (i.e. those who took the drug during the last month) is estimated at almost 75,000. The same approach when applied to intravenous drug users gives a figure of 81,000 people taking intravenous drugs during the month gone by and 145,000 over the course of their lifetime."

(Reasons for Growth in Estimated Number of Problem Drug Users) "Increasing from 160,000 in 1993 to 230,000 in 2006, the raw data could lead us to believe that we are seeing a major increase in this phenomenon. However, this impression is deceptive for at least two reasons. The first is that the methods and, above all, the purpose of the estimates have changed. We have moved away from the notion of "heroin addicts" (1993) to that of "problem users of opioids" (1995) and subsequently to the definition of "problem users of opioids or cocaine" (1999) and finally to that of "users of drugs by intravenous means or regular users of opioids, cocaine or amphetamines" (2006). Thus, the subject of these estimates has widened over time. The second reason is the scope of the confidence intervals applicable to the central estimates. Just like the confidence intervals obtained with the application of the capture/recapture method (which is central to all of the methods used), we have noted in the estimates calculated for 2005-2006 that the national estimates ranged from 144,000 to 367,000. For these reasons, it is difficult to issue a clear opinion on the apparent increase in estimates. We should simply underline the fact that an increase in the number of problem drug users would appear to be possible. Indeed, other information sources point firstly to "an ageing of this population group" which is less often subject to high mortality levels following the increase in the availability of substitution treatments in the late 1990s, and secondly a certain "renewal" of this population group, due to the circulation of stimulants, the appearance of new opioid users and changes on the festive scene."

(Prevalence of HIV/AIDS by Transmission Method)) "Since the introduction of mandatory HIV reporting in March 2003, 32,594 people have been found to be HIV positive. Taking reporting time delays and under-reporting into consideration, the number of reports of seropositivity in 2008 was estimated to be 6,500, a relatively stable figure compared to the previous year (6,400 in 2007), in line with the general downward trend compared to previous years (7,000 in 2006 and 7,500 in 2005).
"In 2010, people infected through injecting drug use (IDUs) represented no more than 1.5% of these new cases of infection (Table 6-1). The most common mode of transmission is heterosexual intercourse (43.4 % of cases), with more women infected than men (66% of cases) and followed by homosexual intercourse (23 % of cases or 37 % of infections in men).
"The number of new AIDS cases among IDUs has fallen continuously since the mid-1990s. Whereas IDUs accounted for a quarter of the people diagnosed at the AIDS stage at that time, they represented only slightly fewer than 8% in 2008 and approximately 5% in 2010 (provisional data)."

(Drug-Related Mortality) "According to data from the General Mortality Register, the continuous upward trend observed since 2003 seems to come to a halt, with a lesser number of cases (-9) recorded in 2009. Although this apparent break is belied when age is restricted to admittedly active users' ranges, in order to exclude false positives (deaths induces by the misuse of prescribed opioids painkillers), in which case a slight increase is observed. This figure is confirmed by data from the forensic laboratories, showing an even sharper rise. Plausible explanations of the rise in the number of drug induced deaths are: increasing availability and purity (heroin in particular); lowering prices (cocaine); emerging new types of poly-substance users, steering clear of treatment centres or low threshold facilities and unaware of harm reduction practices; harmful and riskier uses for fear of being arrested {Cadet-Taïrou et al. 2010b}. It should be underlined that women represented almost one fifth (19%) of the deaths recorded in 2000 and a little less than 15% only in 2009.
"Illegal drugs were the main substances responsible in slightly more than half of the cases (53%) in 2009, substitution treatments in approximately 34% of cases and opiates (excluding substitution) in almost 13% of cases. Overall, opiates were the main cause in 87% of deaths, and cocaine, either alone or combined with other substances, in approximately 12%. The increasing number of overdoses between 2006 and 2009 is explained by an increase in the number of deaths from heroin (+ 44 cases) and methadone (+ 27 cases) overdoses."

[Note: The GMR reported 374 deaths related to drugs in 2008 and 365 deaths in 2009.]

(Number of Clients in Treatment) "Based on these activity reports, it is possible to estimate at approximately 96,000 the number of people who were seen in outpatient CSAPAs [Addictology Treatment, Support and Prevention Centres] in 2008 for their illegal drug problem. This includes overlapping, although these should not make up more than 5% of the total. Compared to the outpatient CSAPA, very few people, slightly fewer than 2,000, appear to be accommodated in a residential treatment centre, some of whom are already included in the figures for the outpatient CSAPA. A large proportion of patients accommodated in the residential centres were in fact referred there by an outpatient CSAPA. The number of people seen for a problem with illegal drugs in 2008 in the prison CSAPAs can be estimated at 5,300.
"The only national data available for primary care is for people receiving substitution treatment. In 2010, approximately 145,000 people were reimbursed for their substitution treatment by the Social Security organisations. Some of these people are also included in the figures for people having benefited from a CSAPA services in 2010."

(Primary Drug Reported by Clients Entering Treatment) "Almost half of the new patients (46%) sought help from the specialised treatment centres in 2010 for problems related to cannabis use. A majority (58%) of them stated using cannabis every day. The percentage of people treated for their cannabis use was much lower among women (32% vs. 49%). The proportion of people using it daily was slightly lower among women, but this difference was not very marked (58% vs. 62%).
"The proportion of first treatment patients stating cannabis as their primary drug (i.e., the substance causing the most problems) was higher than for all new patients, reaching two-thirds. The breakdown of the frequency of use was similar in the two groups. The large number of cannabis users among patients in treatment in France is partly the consequence of the large and still increasing number of arrests for cannabis use. A portion of the arrested users was referred to treatment centres by the courts.
"Opiates were identified as the primary drug by 43% of patients. Of these patients, 80% stated heroin, 4% methadone and 16% other opiates (primarily HDB)¹¹⁸. Of these patients, heroin was most frequently sniffed (62%), but one of every five heroin users still injects. The percentage of injectors was much higher (40%) among users of other opiates, a category comprised mainly of HDB. Among the opiate users, almost 80% consumed these substances on a daily basis and 11 % took them regularly (i.e., several times a week)."

(Syringe Exchange Availability and Activity) "In 2010, 135 CAARUDs [Harm reduction support centres for drug users] existed throughout France. These are medico-social centres funded by the French social security system. They operate in various places with diverse methods. Of these, 95% offer a stationary reception service (“drop-in”), 66% have street teams, 47% operate in squats, 40% have mobile teams, 39% work with teams on the party scene and 28% have developed prison activities. They largely contribute to distributing clean injection equipment (3.8 million syringes in 2008) and other preventative equipment (e.g., ancillary injection equipment, condoms).
"The major activities undertaken by these units are: providing assistance with hygiene and first aid care, offering health education promotion activities, helping people get access to social services, following-up on administrative and legal procedures and seeking out urgent accommodations.
"More specifically, the 2008 CAARUD activities pertaining to distributing preventative equipment were:
"• Syringes: 2.3 M syringe units and 530,000 kits (2 syringes per kit) handed over personally to individual users, 200,000 kits (2 syringes per kit) distributed via dispensing machines managed by the centre;
"• Small injection equipment: 1.1 M filters and the same number of “cookers”, 1.7 M water vials, 2 M alcohol wipes;
"• Condoms: 782,000, 91% of which were male condoms;
"• Gel: approximately 292,000 units."

(Syringe Distribution) "From the different information sources, we can estimate that approximately 14 million syringes were sold or distributed to drug users in France in 2008. Comparing this number to the number of IV drug users (81,000 recent IV users) produces a ratio of approximately 170 syringes per user per year {Costes et al. 2009}. This figure, which only represents an order of magnitude, may indicate high accessibility to syringes in France for IV drug users. However, this figure is difficult to interpret firstly because there is no reliable assessment of needs and, secondly, because of the likely geographical differences (particularly in rural areas). Pharmacies play a central role in providing this equipment.
"Following a significant increase up to the late 1990s, syringe sales to drug users in pharmacies have fallen markedly since. This significant drop is only partially offset by the increase in the distribution of injection equipment by the CAARUDs. The CAARUD centres currently only represent less than a quarter of all syringes sold or distributed to drug users."

(Syringe Exchange and Opiate Substitution Treatment (OST)) "Providing assistance in gaining access to OST and general care is one of the CAARUD’s primary missions:
"• 83% of the CAARUDs reported that they had set up access to OST (referral or monitoring);
"• Of all of their activities involving access to hygiene and first aid, the most common procedures (35%) were body care, followed by nursing care (26%);
"• 84.7% of CAARUDs developed health education promotion activities, 75% of which were individual interviews and group sessions focussing on the risks related to substances and to modes of contamination.
"The CAARUDs saw 48,000 people in 2008, with an average of approximately 200 subjects seen at least once during the reference period, although in reality the figures varied greatly: 41 centres saw fewer than 200 people whereas 11 CAARUDs saw more than 1,000 139 {Chalumeau 2010}.
"The role of CSAPAs in harm reduction, one of their missions, cannot be specified because there is insufficient data due to the newness of the system."

(Social Costs of Drugs) "At the initiative of the French Monitoring Centre for Drugs and Drug Addiction, the social cost of legal and illegal drugs has been regularly published for around ten years. The first study {Kopp et al. 1998} dates back to the 1990s and examined the possible calculation methods. The initial estimates were presented in the Kopp and Fenoglio report {Kopp et al. 2000} on the social cost of drugs. This initial work estimated the annual costs to society to be € 2,035.24 M. Regular estimates have been carried out since then. There are two reasons for the need to continually re-estimate these figures: the appearance of new data that were initially unavailable (e.g., treatments for certain diseases) and the need to consider new calculation methods suggested after public debate on previous results. Subsequently, Kopp and Fenoglio⁸² {Kopp et al. 2004} assessed the social cost of illegal drugs to be € 2,333.54 M in 2004. A new estimate in 2005 gave a social cost of € 2,824.44 M {Kopp et al. 2006}⁸³."

(1997 - France - new drug-related AIDS cases) "The number of new drug-related AIDS cases fell sharply in 1996 and 1997. However, the same was true of all cases irrespective of the cause of infection, and the trend is linked to the effectiveness of tritherapy treatments introduced in 1996. When it comes to assessing the impact of syringe accessibility, it is more relevant to observe trends in the rates of HIV positivity among intravenous drug users. This is not monitored statistically in France, unlike new cases of AIDS. However, a number of surveys have shown a decline in seroconversion and the prevalence of HIV in those who inject drugs."

Laws & Policies

(Policy Overview) "The national governmental policy strategies that were implemented in 2010 are defined by the 2008-2011 'Fighting Drugs and Drug Addiction’ Government Action Plan. In June 2011, the Mission interministérielle de lutte contre la drogue et la toxicomanie (MILDT or the Interministerial Mission for the fight against drugs and drug addiction) announced that nearly all of the 193 planned actions had been carried out. Three other national plans follow from this: the 2009-2012 “hepatitis” plan, the 2009-2013 “cancer plan” and the new 2010-2012 “detainee” plan, the latter being carried out by the French Ministry of Health and Sports with the participation of the French Ministry of Justice. The public health measures stipulated in these different plans reinforce the health section of the 2008-2011 governmental plan.
"Nationally, the strategies of the government plan are broken down into inter-ministerial local plans, production of which is the responsibility of the “départment project leader” The local département monitoring committee, which is responsible for coordination, seeks consistency with the specific plans in the département (such as cohesion contracts, town contracts, public health programmes and regional medico-social schemes). The département project leader mobilises the local stakeholders to apply national prevention or anti-drug trafficking strategies. In health policy, the département project leader liaises with the regional project leader, who is the special contact of the Agence régionale de santé (ARS, or Regional Health Agency) which, since the adoption of the HPST law in July 2009, has become a sort of “one-stop-shop” for the national healthcare offering."

(Principle of Appropriateness of Proceedings) "A narcotic user is an individual who consumes a narcotic substance. The legal authorities often linken the possession of small quantities of narcotics to use. They also often equate growing cannabis for personal use or using drugs for doping (seeking higher professional, intellectual or athletic performance) with use.
"Any offence involving the use of narcotic substances may result in arrest (by the police, the gendarmerie or the Customs Department), and will normally be referred to the legal system. Offences are examined on a case-by-case basis by a French public prosecutor who, based on the principle of the “opportunité des poursuites” (appropriateness of proceedings), may decide to take legal action against the offender, to simply close the case or to propose other measures as an alternative to legal proceedings. This principle of “opportunité des poursuites” allows for a response carefully tailored to each individual situation by gradually increasing the penal response along with the severity of the criminal acts. This also explains the wide disparity in penal responses given by the courts."

(Harm Reduction Policy) "The harm reduction policy for drug users is the responsibility of the state (article L3121-3 of the French Public Health Code modified by law n° 2004-809 of August 13, 2004 - art. 71). This harm reduction policy seeks to prevent the spread of infectious diseases and death by overdose because of intravenous injection and the social and psychological damage caused by the use of drugs classified as narcotics (article L3121-4 of the French Public Health Code modified by law n° 2004-809 of August 13, 2004 - art. 71). The law of August 9, 2004 which set up the “Harm reduction support centres for drug users” (CAARUDs) states that along with the numerous other schemes and measures, CAARUDs should be used to further improve the harm reduction policy (article L3121-5 of the Public Health Code). Thus, the “Harm reduction and support centres for drug users”¹² receive both individuals and groups, in addition to providing tailored advice and information for drug users. They also provide support for drug users in obtaining access to treatment, which includes hygiene systems and access to basic emergency care, referral to specialised or general treatment systems, encouragement to undergo screening for transmissible infections, support for users in exercising their rights and gaining access to housing and professional reintegration, the availability of infection prevention equipment, and localised intervention outside the centre with a view to establishing contact with users. CAARUDs provide social mediation to ensure good integration in their neighbourhood and prevent the public disturbances related to drug use. Their coordination with other organisations has been stipulated in a circular¹³."

(Syringe Exchange and Harm Reduction Worker Policies) "Since May 198714, the unrestricted sale of syringes has been authorised in retail pharmacies, pharmacies located inside healthcare establishments and establishments that focus exclusively on selling medical, surgical and dental equipment or that have a specialised department for such equipment. Since March 199515, these may be issued free of charge by any non-profit association carrying out AIDS prevention or harm reduction activities among drug users, meeting the requirements described in the decree from the Minister of Health (article D. 3121-27 of the French Public Health Code). Providing syringes and needles to minors is only authorised by prescription (art. D.3121-28 of the French Public Health Code). However, neither pharmacies nor associations are legally bound to ask users to provide their identity or age since the 1987 suspension of the provisions of the 1972 decree.
"It is not legal to arrest someone on the sole charge of narcotics use in immediate proximity to a harm reduction or syringe exchange structure (for example, pharmacy Syringes exchange programmes, SEPs). Furthermore, simply carrying a syringe is not sufficient evidence to justify an arrest.
"A national harm reduction standard for drug users has been prepared (art. D. 3121-33 of the French Public Health Code) and approved via decree n° 2005-347 of April 14, 2005. Among other things, this stipulates that all participants, health professionals, social workers or members of associations, in addition to any persons to whom these activities are addressed, must be protected from accusations concerning the use or the incitation to use drugs during their work."

(Possession and Trafficking) "Use or possession of illegal drugs is a criminal offence in France. The law itself does not distinguish between possession for personal use or for trafficking, nor by type of substance. However, the prosecutor will opt for a charge relating to use or traffic that is based on the quantity of the drug found and the context of the case. An offender charged with personal use faces a maximum prison sentence of one year and a fine of up to EUR 3,750, though prosecution may be waived. Alternatives to prosecution may include voluntary payment of a fine or non-remunerated work useful to society. Prosecutors may also prioritise treatment approaches for small-time offenders, both those related to personal drug use or other minor crimes. A circular to prosecutors in 2005 stated that any legal action before the magistrates courts must remain exceptional, but a new circular of 9 May 2008 defined a new ‘rapid and graduated’ policy. Addicts would continue to receive the therapeutic injunction, directing them to treatment. Users in aggravating circumstances, such as drivers or those in educational establishments, as well as recidivists, might be imprisoned. Users in simple cases may receive a caution, but this should usually be accompanied by a request for a compulsory drug awareness course introduced in March 2007, for which the non-addicted offender may have to pay up to EUR 450.
"Drug trafficking is punishable with imprisonment of up to 10 years, or up to life in prison in case of particularly serious offences, and a fine of up to EUR 7,600,000."

(Driving Under the Influence) "In the fight against narcotics use, the authorities may adopt a more severe stance in certain cases, such as when this use affects road safety.
"The law of February 3, 2003 introduced a new offence concerning any driver whose blood test reveals the presence of narcotics. These drivers risk a sentence of two years’ imprisonment and a € 4,500 fine, and drivers who simultaneously use narcotics and alcohol risk up to three years' imprisonment and a € 9,000 fine. The law of June 18, 1999 and its application decree of August 27, 2001 introduced mandatory drug use screening for drivers involved in a road accident that was immediately fatal or for drivers suspected of having used narcotics who were involved in an accident that caused bodily harm. Since the adoption of the LOPPSI 2 law (on the orientation and programming for performance of domestic security)⁹ and its application circular¹⁰ (March 28, 2011), narcotics screening has become mandatory following road accidents that cause bodily harm, whether fatal or not. Moreover, the circular of March 28, 2011 on reinforcing the fight against unsafe road conditions enables, upon requisition of a French public prosecutor, random narcotics controls on all drivers (art. L.235-2 of the French Highway Code, modified by article 83 of LOPPSI)."

(Treatment Alternatives for Criminal Offenders) "The strategies of the criminal anti-drug policy have been redefined in various circulars issued by the French Ministry of Justice since the early 1970s. Depending on the period, some focus on improving care, while others emphasise more effective repression of use. As an example, the circular of June 17, 1999 called upon French public prosecutors to "develop more diverse legal responses" to deal with arrested drug users at all stages of the criminal proceedings, with prison sentences being reserved for extreme cases and used as a last resort. Subsequently, health alternatives to prosecution were strongly encouraged and better executed: including court-ordered treatments for dependent drug users, a caution for occasional users (particularly users of cannabis), or dismissal of the case with referral to an addictology health/social care centre for other types of drug-related behaviours.
"The "delinquency prevention law" of March 5, 2007 further reinforced the range of law enforcement measures available for use against drug users. Firstly, this law enabled judges to deal with narcotics offences using a simplified, “fast-track” procedure in order to provide a systematic penal response to narcotics use. It introduced a new, ad hoc sanction: a drug awareness-building training session focusing on the dangers of the use of narcotics products (up to a maximum of €450, equivalent to the cost of a class 3 fine). Provided for in articles L 131-35-1, R131-46 and R131-47 of the French Penal Code in application of decree n ° 2007-1388 of September 26, 2007, the aim of this measure is to make offenders fully aware of the danger and harm generated by the use of narcotics as well as the social impact of such behaviour. The training session may be proposed by the authorities as an alternative to legal proceedings and penal agreements. An obligation to complete the course may also be included in the ruling as an additional measure. It applies to all adults and to minors over the age of 13⁷."

(Public Views on Criminalization of Drugs) "In polls before 1999, the majority view which appeared to be defined is that prosecutions and legal penalties should be imposed on consumers of heroin and of cocaine (85% in favour), of cannabis (70%) or of alcohol (approx. 50%). However, polling of such opinions is very sensitive to the way in which questions are put: three quarters of interviewees in this way, were not in favour of the idea that drug addicts should be punished. Likewise, if the person and his individual freedom are emphasised rather than the legal aspects of the question of utilisation, then one third of interviewees, as in 1999, will be induced to express their consent for the proposal according to which the prohibition of smoking cannabis is an infringement of the right for free utilisation of one's own body."