On April 14, 2025, the non-governmental organization Médecins du Monde, alongside other associations, filed two legal appeals against the French government for its "inaction" regarding the "haltes soins addictions" (HSA), commonly known as "salles de shoot" or drug consumption rooms. Established in 2016, the two existing HSAs in Paris and Strasbourg cater to the most vulnerable and marginalized individuals, providing them with a safe environment to consume drugs under medical supervision. The current experimentation phase of these facilities is set to conclude at the end of 2025, but concerns over their future have prompted Médecins du Monde to take action.
Céline Debaulieu, a representative of Médecins du Monde focusing on risk reduction, expressed the organization's frustration, stating, "We are launching two legal appeals against the State for its inaction and obstruction regarding the haltes soins addictions." The first appeal aims to ensure the continuation of these facilities beyond the experimental phase, while the second addresses a failed project in Marseille that was abruptly halted due to political intervention.
The second appeal specifically targets the refusal to open a new HSA in Marseille, which was validated by several health agencies, including the Regional Health Agency (ARS) and AP-HM. However, political decisions have thwarted these efforts. In February 2024, Sabrina Agresti-Roubache, the then Secretary of State for the City, celebrated the cancellation of the project, stating, "We successfully stopped the installation of a salle de shoot in Marseille." This political climate has left many advocates feeling that the government is prioritizing punitive measures over public health.
Adrian Peurey-Calazel, a lawyer with Médecins du Monde, emphasized the need for accountability, asserting, "There is an active obstruction from the State in opening new HSAs. The refusal to establish one in Marseille is a clear example of this." The organization argues that this obstruction not only violates public health commitments but also harms the health of drug users by denying them essential services.
According to the Observatoire français des drogues et des tendances addictives, the number of cocaine users in France has doubled between 2022 and 2023, highlighting the urgent need for effective harm reduction strategies. Médecins du Monde and supporting associations believe that HSAs have proven their effectiveness in reducing the risks associated with drug use. They provide critical services, including medical care, social support, and housing assistance, aimed at helping individuals reintegrate into society.
Frank, a former user who benefited from the HSA in Strasbourg, shared his story, stating, "At 15, I was placed in a foster home. By 19, I found myself homeless until the opening of the HSA, which allowed me to sort out my paperwork and regain a semblance of normalcy." His experience underscores the importance of these facilities as a gateway for marginalized individuals to access vital resources.
The appeals filed by Médecins du Monde are not just legal actions; they represent a broader call for the integration of HSAs into common law. Various reports, including those commissioned by the government, emphasize the necessity of making these facilities a permanent aspect of France's public health strategy. A government report from Autumn 2024 particularly noted the need for HSAs to be included in standard healthcare provisions.
Despite the political hurdles, advocates remain hopeful that the administrative court will rule favorably on the appeals, with a decision expected within 12 to 18 months. The first appeal, described by lawyer Me Vincent Brengarth as "historic," aims to address the systemic failures in public health policy surrounding drug use and addiction.
As the debate continues, the situation surrounding HSAs in France reflects a larger struggle between public health initiatives and political ideologies. Many advocates, including Catherine Delaurme, president of the Fédération addiction, argue that HSAs are essential for providing a safe space for marginalized individuals to consume drugs responsibly. She stated, "HSAs serve as a crucial entry point for the most vulnerable populations, allowing them to access necessary support services and reduce health risks."
The ongoing legal battles will be closely watched, as they could set a precedent for how France approaches drug addiction and public health in the future. The stakes are high, not only for those who rely on these services but also for the broader public health landscape in the country.
As the appeals unfold, the effectiveness of HSAs remains a focal point. International reports, including those from the European Union, have highlighted the positive impact of drug consumption rooms on community safety and health outcomes. Advocates argue that the integration of HSAs into the healthcare system is not just beneficial but necessary for addressing the rising tide of drug use and its associated challenges.
In summary, the actions taken by Médecins du Monde and its allies signify a critical moment in France's approach to drug addiction and public health. With the potential for significant legal and social implications, the outcome of the appeals could reshape the landscape of drug policy in France for years to come.