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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.

Among the various approaches used to study behaviours of use and abuse of drugs, epidemiology is now being called upon to direct its attention to two other approaches. Firstly, it should provide a more global view of subject groups than the specific descriptions of a few specialized centres. Secondly, it should take part in studies assessing public health policies for drug addiction. In relation to procedures used by epidemiologists in other fields of health sciences, the distinctive features of drug addiction need limitations and adaptation of methods. In France, anonymity and free health care are guaranteed to all drug addicts who request them. The direct consequences of this legislation is the absence of a drug addict register, unlike in other countries, such as Great Britain. There are no either registers nor survey data base from which representative samples can be constructed. Moreover, since those definitions used are multicriteria definitions, the assessment of a case on a drug addiction scale is in practice usually highly subjective and associated with the particular orientations of a clinical team or of a school of thought, because the notion of dependence is not used in the same way. Since drug addiction develops beyond adolescence and has social and/or medical consequences, specialized or non-specialized public health services or prisons are the main areas of observation for epidemiologists. Surveys are conducted through teams specialized in the treatment of drug addicted volunteers. The anonymity of centres is guaranteed by the INSERM and the centres themselves guarantee the anonymity of subjects studied.(ABSTRACT TRUNCATED AT 250 WORDS)

In 1986, a national survey was carried out in France among 4846 drug abusers attending specialised agencies and treatment centres. Data are analysed and compared with the results of a previous study in 1972. Most French drug abusers are men (74%) ranged in age from 20 to 29 years (68%). Data suggest increasing problems with heroin (69%), cocaine (13%), solvents (5%), alcohol (26%) and multiple drug dependence. Women are younger, they have attempted suicide more often than men but have been incarcerated half as often. Concerning drug abuse trends, women appear to use increasingly sedatives in combination with other drugs. Partial data concerning HIV seropositivity reveal a rate of 48% among drug abusers having been tested.

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.

In France, drug abuse among the young population first appeared at the end of the sixties. Repressive and therapeutic measures were then combined and specific sanitary structures set up. The authors describe the historical and social backgrounds of this phenomenon and review the sources of relevant statistical information records of offenses against the drug law; statistics of special care centres; epidemiological studies on confirmed drug addicts. These sources are various and the approaches quite different. However, they reveal socio-demographic characteristics of French drug abusers and a typology of substances abused and identify different periods in drug career. These studies also allow identification and evaluation of risk factors of drug abuse by typological analysis and by psychometric tests. The authors outline the benefit of collaboration between researchers and clinicians: partial interviews of small addicted populations and national surveys provide complementary information. Systematic epidemiological studies would give global measures of changes in addiction.

An epidemiological survey was carried out among high school students of 3 French regions. Their use of drugs (alcohol, tobacco, psychotropic drugs, illicit drugs) was studied and four different subgroups of users were identified by classification. Moreover, cluster analysis applied to adolescent personality self-perception revealed 10 different personality types (5 for the boys; 5 for the girls). The correlations between personality self-perception and drug use allows to define groups at risk by the intersection of partitions.

An epidemiological survey was carried out among high school students of 3 French regions. Their use of drugs (alcohol, tobacco, psychotropic drugs, illicit drugs) was studied, as well as their self-perception of personality, relations inside and outside the family, school performance, and lifestyle. Different aspects of drinking were considered: regularity of intake, quantity absorbed, inebriation. The use of alcoholic drinks together with psychotropic substances was studied. A cluster analysis applied to adolescent personality self-perception revealed 10 different personality types (5 for the boys; 5 for the girls). The social, family, and relational characteristics of each personality type are described. The correlations between personality self-perception and liquor use allow us to define 3 profiles of heavy drinkers.