The city of Marseilles decided to open its first drug consumption room. Read our interview with Beatrice Strambul, who has been in the forefront of the harm reduction movement in France since the 1990s.
Drugreporter: What is your personal story, how did you get involved in harm reduction?
Beatrice Stambul: I joined Médecins du Monde (MDM) in 1990 and got involved for my first mission in Romania (I am a Romanian speaker). I spent one year in Transylvania as a psychiatrist dealing with “abandoned” children in institutions. Back in France, I was eager to continue my involvement in a medical NGO whose values I shared. I heard about a needle exchange project in Marseilles that I joined. I wrote the program without any knowledge of what harm reduction was, but I rapidly learned by doing, mostly with users themselves. I am proud to say that in 1994, I was the first person in charge in MDM to employ a drug user as a member of staff. This new approach changed my way of seeing my job, and alongside this volunteer activity I opened a methadone clinic in my hospital. Through MDM, I opened the first needle exchange bus in the Russian Federation (St Petersburg) and later opened the first methadone centres in Kachin State (Myanmar). Through the French Harm Reduction Association, where I served as president for 3 years, I became a harm reduction activist.
Marseilles has a bad reputation as a city of crime and drug trafficking. Do you think this image is accurate or more like a media hype?
Both. The “romanticised” memories of the French Connection are still very present. Marseilles is a city that bears a heavy stigma of drug trafficking and drug use. There is a complex reality of a poor and cosmopolitan town, a harbour, with a mix of many different ethnic communities, that gives a highly publicised picture of a place where illegal goods are a normal part of our local life. None of it is untrue, but the situation is far from unique in the rest of France, just less publicised.
Where are the main hotspots of drug use in the city?
Marseilles is a city with no suburbs. During the 14th century, all the villages around the centre were included in the conurbation. Today, the northern districts are large, poor, ugly housing complexes, mostly inhabited by French people of foreign origin (North Africa, Comoros Islands, gypsies, etc.). Many of these places are dealing and consuming sites, and of course in the city centre there is the railway station, and some hotspots known by drug users, that may move with police action.
Harm reductionists in France often report an increase in crack/cocaine use. Is this the case in Marseilles too?
Cocaine is highly available (heroin is scarce). It is, with our clients, mostly injected. Now and then we test cocaine which is practically pure (90% has been found now and then). Crack cocaine is not sold as such. Users buy cocaine and base it themselves (usually with ammonia). We provide them with sodium bicarbonate if needed. 1g of average cocaine can be around €150/200
A new drug consumption room is to be opened soon in the city. How did you convince city leaders about the need to open one?
Marseille has had the same mayor (right wing) for 23 years. To govern such a city, you have to be pragmatic. Somehow, HR programs as well as the fight against HIV/AIDS actions have always been supported by local authorities. When we proposed a safe consumption room 8 years ago, the mayor said yes, then the right wing of his party talked him into refusing. So, he said no, and the Ministry of Health would not go against the mayor. For years a couple of crazy obstinate people, including me and the vice mayor in charge of health, kept the project alive and the mayor finally said yes again. He signed the letter yesterday, the project is written. We found an incredible site (the former morgue of a very central hospital!). We need 1 million euros, and off we go. ASUD MARS SAY YEAH, a self-support organisation of which I am president, will implement the program in coordination with all other HR organisations. We had a meeting with the general director of Regional Health Agency on the 3rd of June. It went very well, he asked us to make some minor corrections in our proposal and the city will support it. The process is slow but we remain optimistic!
In Paris there was lots of resistance against the consumption room, coming from the local neighbourhood. Do you expect this is too? How can you prevent conflicts?
Yes, there are hostile petitions, deadly tweets from the extreme right and negative media articles. ASUD has been evicted from our drop-in centre twice, following petitions organised by our neighbours. The vice-mayor offered another association, involved in street and squat work, a full-time remuneration for a street worker whose job would be to operate around the site. We of course shall organise meetings of all sorts. A protocol has been written to be signed by the general attorney, police authorities, the Prefet, and other representative of the law called “protocol of public tranquility”, meant to watch and report all situations and assess them.
Not so long time ago there was a lot of talk about decriminalisation of drug use in France. But now I don’t hear much about it. Is it still happening?
None of that. Not even the decriminalisation of cannabis. The government just issued the silliest of laws transforming the penalty for cannabis use into a fine. Inapplicable. Otherwise we remain one of the most repressive states in western Europe when it comes to drug use. Having worked in prison I can assure you of that.
Interview by Peter Sarosi
Photo: Istvan Gabor Takacs
