French teknivals: harm reduction at the cocktail party

Rave parties are the latest fashion aournd the world, and that is also true of France. Party goers are attracted to techno music, but there is something else attracting them to the  festivals, and that is the freedom to use drugs. The use of psychoactive drugs – especially synthetic drugs- has been disseminated in raves around the world. One groundbreaking initiative however, has emerged in French rave parties: the adoption of harm reduction practices that inform drug users of the risks they are running and try to prevent further damage.

The most famous raves take place in northern France, close to the border with Belgium, which in turn, is close to the Netherlands where it is much easier to buy drugs. Rave festivals, called teknivals, on both sides of the border last from 3 to 4 days, and some will bring together over 40 thousand people.

Harm Reduction kiosks

Duprez notes the “painstaking” work of the NGO Médicins du Monde (Doctors of the world). Doctors set up harm reduction stands (known as “reduction des risques”) at the rave parties as part of what they call the “Rave Mission”.

The NGO approach to drug users is fourfold: to approach drug users and make contact with them since no other organizations get that far; to allow drug users to interact with them freely; to make it possible for that connection to be made through a social and medical organization free of prejudice; and finally, not to censure to drug use; that is evident in rave parties. The health based intervention of the NGO in rave parties emerged out of a demand that came from rave goers themselves, since no other organization would approach the teknivals. Médicins du Monde is also known for its high mobility. Their teams move constantly, and are multi-disciplinary, composed of doctors, nurses, pharmacists, psychologists and educators, they can be professionals or volunteers, and have been present at teknivals since 1997.

According to the NGO’s website, the types of emergencies faced most often are cuts, burns, head and stomach ache, exhaustion and hypoglycemia. These ailments fall under the responsibility of firemen, the Red Cross and the Medical Emergency services in attendance near the raves. “Our role, therefore, is to focus on being close to users, in making a connection and raising their awareness of the risks involved. They feel free to talk frankly about drug use,” says the website.

To prevent dehydration for example, one of the main consequences of using ecstasy, the NGO provides a hydration kiosk that sprays water on users so they can lower their body temperature and distribute water for free. This free distribution of water has run into problems when a water selling company felt it affected its business. Despite difficulties, the NGO has continued its presence at the raves, distributing fliers that explain what drugs are made of and their effects, and most importantly, having users enter into conversation with specialists about related topics such as the spread of the HIV/AIDs virus.

There are other organizations on both the French and the Belgian side working with harm reduction in raves, but Médicins du Monde is the most significant one. “Is it also treated with some mistrust by the French middle class, that is still very conservative and skeptical of the efficacy of harm reduction practices,” said Duprez. According to Duprez, NGO doctors have strained relations with their colleagues, with professional councils and with the government – since some of their initiatives are still illegal – although they are able to carry out their work due to their good reputation that they have garnered throughout their careers.

Even in illegal raves – that are held very frequently – harm reduction agencies are able to set up their stands, offering safe use kits  with the necessary equipment to inhale cocaine (sniff kits) or inject heroin (shoot kits) and test the purity of ecstasy tablets or cocaine powder. According to the Médicins du Monde site this type of kit is also illegal, posing yet another challenge to the work of the organization.

Abstinence only propounded by psychoanalysts

Duprez (photo) points out that harm reduction has been a late-comer in drug policy in France, and it is still restricted to non-official venues, such as NGOs. He blames abstinence only and zero tolerance policies adopted inspired in the USA with pushing illicit drug use into hiding, and creating an “underground” world, “and with it, with unsafe drug use, HIV came to Paris” said Duprez.

Duprez believes that psychoanalysts and psychiatrists lobbied the government against substitution therapies for heroin use in the height of its use, leading to the adoption of substitution therapies for the first time in 1995, during Bernard Kouchner’s tenure as Minister of Health.

Harm reduction still timid in France

Duprez takes that as the turning point that defeated abstinence only as drug policy and opened the door to substitution therapy and harm reduction.
 
Back when he first began his research, Duprez believed that harm reduction was basically hypocritical and actually facilitated risks. Today, after his field work at the rave parties, and although the initiatives are still few and far between, he is certain of the role of harm reduction: “If the choice you have is between zero information and some information, whatever information it may be, some information is the best option,” said Duprez.

In the researcher’s view, harm reduction policies are still only tentative in France, ten years after their initial emergence. “Many doctors agree that they are still underappreciated and rejected by their colleagues. There are those who do not even want to touch the topic for fear of how it will impact their careers,” said Duprez. Duprez adds that the harm reduction needs the support of the State, “France is currently going through a very conservative period, take the Sarkozy government as an example, he belongs to the extreme-right, “said Duprez, adding that:” The government does not finance or even consider harm reduction, that is why risk management ends up relegated to the area that overlaps between NGOs and State institutions.” 

Criminalizing poor drug users

Prior to his study of recreational drug use and harm reduction policies in France, Duprez analyzed police investigations and criminal justice proceedings. In his view there is a close relation between the world of drugs and poverty, since only those who are poor and cannot afford to pay the fees are imprisoned, judged and sentenced. Duprez believes the French penal system is prey to contradiction: “Drugs use is today much more of a question of public security than public health. We are very far from decriminalizing drugs. For now and for the foreseeable future, petty drug users and drug sellers will be the preferred targets of the police.

 Translated by Lis Horta Moriconi