More than a million cocaine users: “We do not have the material and human resources to provide care”, stresses Hélène Donnadieu, addiction specialist

Hélène Donnadieu dirige l’unité d’addictologie du CHU de Montpellier. Midi Libre – ANNESI TIZIANA

According to a study by the French Observatory of Drugs and Addictive Trends (OFDT), published this Wednesday, January 15, cocaine consumption is exploding, with 1.1 million consumers. Work, partying, etc., all types of consumption and all backgrounds are concerned, notes Hélène Donnadieu, head of the addiction department at Montpellier University Hospital.

A figure that has almost doubled: from 2021 to 2023, cocaine consumption has exploded in France, from 600,000 to 1.1 million users, according to a study by the French Observatory for Drugs and Addictive Trends (OFDT), published this Wednesday, January 15, two days after Interior Minister Bruno Retailleau reported a record level of cocaine seized in France, 47 tons in 2024.

“Whether it is cocaine or ecstasy/MDMA, the wider distribution of psychostimulants represents one of the major trends of recent years”, underlines the report, which lists 750,000 users of ecstasy/MDMA.

“Our patient base is increasing sharply, without us having the means to provide good care”, says Hélène Donnadieu, head of the addiction department at Montpellier University Hospital, who explains that the situation is multifactorial: festive consumption, working conditions, easy access…

Are you surprised by the figures in the OFDT report on cocaine consumption, which affects 1.1 million French people ?

This is something that we also see in our reception facilities. For about five years, we have also seen an increase in requests for care for users of cocaine based, that is to say crack.

All modes of consumption are concerned, whether recreational or problematic, with extremely easy access to substances.

All environments are affected ?

I find it difficult to generalize, but this is not the prerogative of a community of marginalized drug users. Not at all. These are people who work, cocaine can also be used as a doping agent… there is cocaine in the workplace, obviously. And not just among business leaders.

“Everyman and Mrs.”

“Cocaine consumption has exploded for two or three years”, says a Montpellier resident, a privileged observer of drug trafficking sites in Hérault and Gard. 

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“Massive imports that have caused prices to fall”, from 120 &euros to 50 &euros in a few years, and “incentive offers from dealers" are not unrelated to this, he explains. “A customer who comes to get 60 euros of hashish is sometimes offered half a gram of coke,” reports the witness: “A potential new regular customer for the dealer. The trap will close. That's how it happens”
“Women in suits, young CSP++… ” he also describes the new consumer profile, “Mr. and Mrs. Everyman”, who increasingly choose to have their goods delivered to their home, by “18-25 year olds in small city cars, on scooters, on scooters, always punctual, never with bad plans, with a boss who checks if we are happy. They are sometimes with their girlfriend as a passenger, to go unnoticed”.
Served by a well-established communication on Snapchat or Telegram, clips presenting menus, the visuals, he says again, “reassure the forty-somethings” and sell dreams to young people.
“Everything is done to encourage consumption, it is sometimes even easier to find cocaine than weed”, laments the Héraultais, worried: “Unfortunately, I know people who consume it, and I can see how much their lives have changed, it is a serious public health problem”.

The average prices recorded by the OFDT, at 66 euros per gram, make it an accessible product ?

Yes. Either people have the means, or they manage to have the means, whether the consumption is recreational and occasional, or as part of an addiction, with all the social and financial consequences that this entails.

There is no “norm” in terms of consumption: it can be 0.5 grams in an evening, or five grams per day. When you consume base cocaine, you consume much more.

How does this translate into your active patient file? ?

There is a clear increase in the demand for care, in connection with cocaine, most often in poly consumption, with other substances.

“In addiction, there is never a cause that makes a consequence”

How do you explain this situation, it is linked to the current social malaise ?

There is never a single cause that makes a consequence in addiction. In terms of consumption, it is rather psychostimulant substances that are “in fashion”, even if I do not like this term in terms of consumption.

And then there is a rapidly expanding supply. The drug trafficking around cocaine means that there is a monumental supply, that it is extremely easy to obtain cocaine. Yes, the malaise has an impact, but on all addictions, and more on alcohol.

The world of rugby on the alert

“Alcohol and cocaine are widespread in rugby, there is no hiding it.  Cocaine kills, it is not festive at all. It's maybe 70 or 80% of clubs are dealing with it, it's become endemic in society. These subjects need to be addressed" : in December 2024, in Saint-André de Sangonis, Montpellier resident Florian Grill, who had just been re-elected to the French rugby federation, wants "to take the bull by the horns", because "when you have the figures for cocaine consumption, it's scary", relays Midi Libre.

To the point that the phenomenon leaves no club indifferent: “Rugby is often associated with cocaine, a subject that is increasingly being discussed, also in Villefranche”, confided, again in December, in Aveyron this time, in Centre Presse, elected official Frédéric Pourcel. “The scourge exists in rugby, we must not hide it. I was shocked seven years ago, when I discovered it”, continues Sébastien Marty, one of the co-presidents of the Villefranche XIII club. Since 2017, 16 rugby players, whether league or 15, have tested positive for cocaine according to official figures from the AFLD (French Anti-Doping Agency), recalls the Independent in a report published in October 2024.

Six months earlier, the regional daily followed the trial of "Momo" at the Carcassonne courthouse, who was sentenced to one year in prison for "small-scale trafficking of cannabis and cocaine". He notably delivered "the clubhouse of the rugby union team for the third halves".

Cocaine is an “old” drug…

Yes, it's not new, but what's new is that consumption is clearly increasing, with worrying health alerts.

Do you have enough means of care ?

No. We accept it. But we don't have the means to provide enough equipment to avoid the risks of infection, and we don't have the human resources to deal with the increase in the active queue for these specific requests, we have + 50% to + 60% additional requests for care related to cocaine.

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