1. Drug consumption rooms: welfare state and social acceptance in France

France has for a long time being reluctant to implement drug consumption rooms (DCRs). Since 2016, two DCRs have been implemented in Paris and Strasbourg. In this paper we will analyze how DCRs have the potential to change the political environment for public health and public order, because they can affect the distribution of responsibility for harm reduction, by collectivizing responsibility for harm reduction.

The paper is based on an ethnographic-based research conducted in Paris about PWIDs, residents, politicians, harm reduction providers, police officers’ experiences, attitudes and opinions of DCRs. The methodology includes ethnographic observations, semi-directive interviews (N=160) and media analysis.

In France, DCRs were first envisioned in a public health perspective to protect PWIDs from infectious diseases with less attention being paid to their social rehabilitation, due to a prohibitionist model that still considers PWIDs as deviants. DCRs implementation has been delayed due to the reluctance of some residents’ collectives to welcome a DCR in their living area. The local level provided the starting point for implementing a DCR through strong alliances between Parisian politicians, harm reduction activists and PWIDs, but nothing was possible without a political shift at the national level that bolstered changes in French laws and public funding by the State. Our survey shows that in France, the repressive aspect of drug policy has not prevented the creation of DCRs, the humanitarian imperative of protecting the most vulnerable members of society linked to the Welfare State being deemed more important than the repressive objectives of the war on drugs.

Difficulties in cohabitation with local residents can sometimes make public authorities hesitate to implement DCRs, due to the NIMBY phenomenon. However, DCRs have the potential to become an instrument for civic cohabitation as well as contributing to the destigmatization and health of PWIDs.