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The main objective of the present study is to determine the prevalence of lifetime use and use in the past 30 days of narcotics in French seamen and to assess factors correlated with positive urine test in seamen as a whole. A stratified survey conducted in 19 French ports collected 1,928 self-administered questionnaires on cigarette, alcohol and narcotics consumption. Seafarers were randomly selected and interviewed during their annual seafaring aptitude consultation. Only the 1847 male respondents were included in analysis. Nearly half of the seamen had tried cannabis at some point in their life, and 16% were users in the past 30 days. Lifetime use of certain other illegal drugs (cocaine, heroin, hallucinogenic mushrooms, poppers and ecstasy) was non-negligible, but cocaine and heroin were the only ones showing exceptional prevalence of consumption over the previous 30 days. Lifetime use of drugs was non-negligible among seamen. Prevalence of recent cannabis use was elevated. Recent consumption as indicated by positive urine test correlated with age group, family situation, occupational category, geographical area, young age of first alcohol consumption and experimentation with other drugs., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

The collaborative, anonymous, case-control study was intended to determine the prevalence of opiates, cocaine metabolites, cannabinoids and amphetamines in the urine of drivers injured in road accidents and to compare these values with those of non-accident subjects ("patients") in France. Recruitment was performed nationwide in the emergency departments of five hospitals and comprised 296 "drivers" aged 18 to 35 and 278 non-traumatic "patients" in the same age range. Females represented 28.4% of "drivers" and 44.2% of "patients." Screening for drugs in urine was performed by fluorescence polarization immunoassays in each center. Each positive result was verified using gas chromatography-mass spectrometry (GC-MS), in a single laboratory. Statistical analysis comprised single-step logistic regression and simultaneously took account of confounding factors and the final differences in prevalence values between the two populations or different subgroups. Cannabinoids were found in 13.9% of drivers (16.0% of males and 8.3% of females, p < 0.05) and 7.5% of patients (12.3% of males, 1.6% of females, p < 0.0001); only in females was this prevalence higher in injured drivers than in patients (p < 0.05). Opiates were present in 10.5% of drivers' and 10.4% of patients' urine samples (NS), and were more frequent in urine samples positive for cannabinoids, in drivers (p < 0.01) as well as in patients (p < 0.001). The prevalence of cocaine metabolites in drivers and patients was 1.0 and 1.1% and that of amphetamines 1.4 and 2.5%, respectively. No causal relationship between drugs and accidents should be inferred from this retrospective study. Nevertheless, the high prevalence of cannabis and opiate (licit or illicit) use in young people, whether injured drivers or patients, has potential implications for road traffic safety in France. Cocaine and amphetamines did not appear to be a major problem, unlike the experience in other countries.

Although the phenomenon of drug abuse in France is well delimited, it constitutes a public health problem. The way it spreads is sometimes 'epidemic' in sub-groups especially exposed. The somtic or relational consequences are short-term and it concerns more and more adolescents or young adults. Two main research axes have been developed: studies in the general population, adolescents or adults, in order to know the general context of licit and illicit psychotropic use in France, and specific studies in detoxification centers in order to describe the characteristics of drug addicts and to evaluate their requirements. Results of some recent surveys can illustrate these axes. Total abstinence is exceptional. Psychotropic drug abuse is deeply established in traditional French social customs. Most subjects had a narrow relation with psychoactive drugs. The variety as well as quantity of products allow everyone to adopt a style of consumption. Globally, alcohol consumption has decreased. Moderate consumers seem to be those who especially confine their drinking to daily wine consumption. On the other hand, the consumption of aperitifs and other drinks in on the increase. The dissociation of alcohol consumption from meals enhances drunkness. Nicotine-poisoning in men had a parallel evolution and has increased in women. Psychotropic drugs (tranquillizers and hypnotics) are specially used by aged women on medical prescription. For the study of drug abuse, data is collected in specialised centers and prisons regarding socio-demographic variables, intoxication profile and medical and social consequences. For both the general and addict population, epidemiological research, especially typological analysis, allows to identify some sub-groups at risk of drug addiction.