Proceedings of the Special Committee on
Illegal Drugs

Issue 7 - Evidence - Morning Session

The Special Senate Committee on Illegal Drugs met today at 9:09 a.m. to reassess Canada's anti-drug legislation and policies.

Senator Pierre Claude Nolin (Chairman) in the Chair.

[Translation]

The Chairman: I will now call to order this public hearing of the Senate Special Committee on Illegal Drugs. I am very pleased to welcome you to our proceedings today. I would like to take this opportunity to welcome those who travelled to be here at our meeting in Ottawa as well as those who are listening to us on the radio, on television or via the Committee's Internet site. I would like to inform people with access to the Internet that they can now watch us. We are continuing the experiment we began last June. Digital cameras are filming our debates, which are then retransmitted through a video signal. This is a first for a committee of the Canadian Parliament.

The committee is made up of five senators. Without further ado, I would like to introduce them. The Honourable Colin Kenny from Ontario is the vice-chairman of the committee. The Honourable Tommy Banks represents Alberta. The Honourable Shirley Maheu represents Quebec. We also have the Honourable Terry Stratton, who represents Manitoba. With us this morning as an observer is the Honourable Jean Lapointe, from Quebec. My name is Pierre Claude Nolin and I am also from Quebec. Dr. Daniel Sansfaçon is our research director.

The first version of the Special Senate Committee on Illegal Drugs was created during the last Parliament. On April 11, 2000, the Senate voted unanimously to establish the first special committee on drugs. I was appointed chairman.

On October 16, 2000, after a great deal of preparatory work, we held our first public hearing. With the calling of the general election last October, the 36th Parliament came to an end, and with it, the work of our committee.

In February 2001, as soon as the 37th Parliament began its work, the Senate began studying the motion to re-establish the committee and on March 15 unanimously approved the continuation of the committee's work, with a slightly changed mandate.

[English]

The Senate Special Committee on Illegal Drugs has received a mandate to study and to report on the Canadian policies concerning cannabis in its context and to study the efficiency, means and controls used to implement those policies. In addition to its initial mandate, the committee must examine the official policies adopted by other countries. The Canadian international treaty responsibilities regarding the conventions on illegal drugs, to which Canada is signatory, will also be examined.

The committee will also study the social and health effects of the Canadian drug policies on cannabis and the potential effects of alternative policies.

[Translation]

Finally, the committee must table its final report by the end of August, 2002. In order to meet properly the mandate we have been given, the committee has adopted an action plan based on three major points. The first is knowledge. In order to meet this challenge, we will hear from an impressive array of experts from Canada and abroad, and from university, police, legal, medical, social and government backgrounds. The hearings will be held chiefly in Ottawa, and if necessary, occasionally outside the capital. The second focus is sharing the knowledge. In my view, this is definitely the most noble aspect of our work.

The committee wants Canadians throughout the country to become better informed and share the information we assemble. Our challenge will be to plan and organize a system that guarantees access to and the distribution of this knowledge. We would also like to hear what people think about this knowledge. To this end, in the spring of 2002 we will be holding public hearings in various locations throughout Canada.

Finally, our third objective is to review very closely the guidelines which should form the basis of a public policy on drugs in Canada.

[English]

Before I introduce you to the distinguished experts of today's hearing, let me inform you that the Senate has ordered that all the proceedings of the committee registered during the Thirty-sixth Parliament be included as an integral part of our proceedings.

I also wish to inform you that the committee maintains an up-to-date Web site. The sight is accessible through the parliamentary Website at www.parl.gc.ca. All the committee's proceedings are posted there, including the briefs and the appropriate support documentation of our expert witnesses. We also keep up to date more than 150 links to other related sites.

[Translation]

Let me say a few words about the committee room in which we are meeting today. This room, known as the Aboriginal Peoples' room, was set up in 1996 to pay tribute to the first peoples to occupy North America, and who are still actively involved in the development of Canada. Four of our Senate colleagues are proud and worthy representatives of these peoples.

Today we will be examining French public policy on illegal drugs. We will be hearing from three eminent French experts to assist us in our work today. Our first witness this morning will be Ms Nicole Maestracci, a jurist, and President of the Mission interministérielle de lutte contre la drogue et la toxicomanie (Interministerial Mission on Anti-drug and Addiction Activities).

After this morning's break, our next witness will be Mr. Jean- Michel Coste, a demographer, sociologist and Director of the Observatoire français des drogues et des toxicomanies (French Monitoring Centre for Drugs and Drug Addictions). Finally, this afternoon, we will have with us Mr. Michel Kokoreff, a sociologist and lecturer at the University of Lille and at the Institut d'études politiques de Paris (Institute of Political Studies in Paris).

Ms Nicole Maestracci was a lawyer until 1977, before becoming a magistrate in 1979. She has held a number of positions, including that of juvenile court judge in Melun, from 1979 to 1983, and was a sentencing judge in Seine-Saint-Denis from 1992 to 1996. She was the director of the penitentiary administration branch of the Department of Justice, the officer responsible for alternate sentences from 1984 to 1987 and later a technical adviser in the Office of the Keeper of the Seals from 1988 to 1990. Counsel at the Paris Appeal Court since 1996, she was appointed president of the Interministerial Mission on Anti-Drug and Addiction Activities in June 1998.

Welcome, Ms Maestracci, we thank you very much for accepting our invitation and we thank you for your interest in our work. Our procedure is very simple. We give you about 20 to 30 minutes to make your remarks, and then we proceed to a question and answer period. I would like to ask you now whether we may write to you after your testimony to ask you some questions should we fail to ask them while you are here. Naturally, we would hope to get an answer to these questions.

If, after your testimony, you decide that you would like to send us some additional information, we would be most interested in receiving it.

Ms Nicole Maestracci, President, Mission interministérielle de lutte à la drogue et à la toxicomanie (Interministerial Mission on Anti-Drug and Addiction Activities): Thank you for inviting me to appear before you to speak about the policy in France, the background of that policy and also the difficulties we encountered in implementing a policy, which may still be imperfect, but which is probably more consistent than it was in the past.

I think we could provide some background documents, some in English and some in French, on the policy in France, so that you can have access to some written material. In addition, we have an Internet site which provides all the information about the French policy. The address is: www.drogues.gouv.fr. It provides most of the information we have on the French policy.

In light of your request, I thought I would speak a little about the background of the French policy and tell you why we decided to adopt a new policy in France.

I would say that before the end of the 1960s, we had no illegal drug problem in France, or at least it was not seen as a problem. We had a fairly old piece of legislation, dating back to 1916, which had been passed during the 1914-1918 war, because there was a major debate about the use of illegal drugs by soldiers during the Great War. The legislation prohibited drug use, but provided for relatively moderate criminal penalties, and then till the end of the 1960s, as in most countries, we had no problem with illegal drugs. In any case, we were not aware of it, and drug use had not led to any identifiable social problems.

It was not until the end of the 1960s, as was the case in many western countries, that there was an explosion of marijuana and heroin use. This led Parliament to pass legislation in 1970. The act is quite interesting, because it is one of the pieces of legislation that arose out of the social defence movement in criminal law. It sought to combine a repressive, criminal approach with a public health approach.

One of the key provisions of the act was the "therapeutic injunction," which meant that drug users might not be penalized if they agreed to get treatment. At the same time, the legislation was quite repressive, because it provided for one year in prison just for drug use.

In France, on the one hand there is a system whereby the crown attorney decides whether or not to lay charges. In addition, there are the penalties set out in the Criminal Code, which are merely a maximum, and the judge is free to impose a much lighter sentence. Nevertheless, a penalty of one year in prison was established for drug users, and a fairly harsh penalty for drug trafficking became even harsher in the successive amendments to the act.

So we have an act which was very controversial, but it worked more or less until the end of the 1990s. I should make it clear that the repressive aspect of the legislation was enforced very quickly and very harshly. The public health approach was enforced less well, because we had to wait until 1985, about 15 years after it was passed, for the therapeutic injunctions to be available - that is a procedure whereby people could be referred for treatment by the court. This was a very imperfect tool. This is why the legislation was and is still seen in France as focusing much more on repression than on public health. This is also why there has been a significant debate about the act in France.

Around the end of the 1980s and beginning of the 1990s, we reached the AIDS years, which disrupted our concept of public health and treatment for drug addicts. Let me tell you about the situation at that time. On one hand, there was a treatment option very much focused on heroin addicts - France had 150,000 heroin addicts - while many other users were really not treated by the system. In addition, the treatment system focused very much on psychoanalytical care, which had to be requested by the individuals in question. Individuals who did not make this request did not receive treatment.

What was the result of such an option, which did produce some interesting results? The most marginalized users and the ones in the most trouble were not receiving treatment. During the AIDS years, when many drug users had AIDS as well, they ended up in hospital without ever receiving treatment beforehand by the health care system or by a doctor.

We realized that the treatment option that we were so proud of, that we thought was effective, was not meeting the needs of the most marginalized users. They are the ones that represent public health and safety problems.

The second problem was that our legislative system was seen as very repressive. It was heavily criticized for preventing the establishment of the genuine health policy that would provide treatment for drug users, preferring rather to impose penalties. If users receive penalties and can be stopped for questioning by the police, they do not go to treatment centres. They do not use clean needles and they do not go to risk prevention centres.

The third problem has to do with French society, which got into an extremely emotional debate on these matters. Like many debates in France, the issue of drugs was seen as a moral problem to some extent, and thus gave rise to extremely ideological and passionate debates, with people going to extremes on both sides of the issue. People took extremely categorical stands, which were not always based on genuine scientific knowledge. This tendency toward very emotional debates was fed by the fact that for a very long time, there had been very little reliable scientific information available. There were no regular epidemiological surveys or reliable scientific data. This allowed for many very contradictory and ideological interpretations.

The other problem with this type of policy was inter- departmental coordination. In other words, each department had its own drug policy, even though the government had established, as early as 1982, an interministerial mission for anti-drug and addiction activities. Initially, it had very few resources, it was just a committee of experts, and had no authority in the area of interdepartmental coordination. As a result, there was a sort of schizophrenia in the public policy approach. For example, in the case of the most serious heroin addicts, the Minister of Health asked all départements to establish needle-exchange programs, and at the same time, the police were stopping drug users for questioning if they had a needle in their pocket. No one was managing this contradiction, and ultimately, the users paid the price. That led us to question our interdepartmental coordination.

At the time, the AIDS epidemic had caused a major debate within addiction care services. A number of specialists stuck to the old position and thought that the system had worked well in the past and that we should continue to use a system that treats only those users who agree to treatment and who agree to refrain from drug use. Other addiction workers and specialists said that we could not let people die, that we needed harm reduction policies and we had to deal with users even if they did not intend to give up drug use completely. This meant an approach involving needle exchange programs, drug replacement therapy and reception centres for users who would continue to use drugs. This led to a major split among addiction care workers and this led us to question the relevance of our policy.

We come now to the period around the end of the 1990s. During these years, France had introduced a number of harm reduction tools. It had opened a number of reception centres for very marginalized drug users. With difficulty, we had begun developing replacement drug treatments, because there was a conflict between specialists regarding replacement therapies. We really began developing them beginning in 1996, and we established needle-exchange programs.

This development was the work of the Department of Health alone. The other departments did not feel involved in the implementation of this policy. I think that it is an extremely important matter.

Around 1998, a number of reports reached the government regarding our anti-drug policy. The reports were quite critical, for the reasons I have outlined. When I was appointed to my position, the Prime Minister asked me to suggest some reorganization, while making it clear that they were not prepared to change the legislation. Nor were they prepared to disrupt the entire system that was in place. Essentially, we had to reorganize the approach and ensure that it worked, without suggesting that we were taking a totally different approach from that taken to date.

I then based myself on the observations that I just talked about. At the Observatoire - and Jean-Michel Coste will provide you with more details - we started accumulating some epidemiological data which would show that consumption behaviours had changed a great deal, particularly among young people who very rarely used one substance, tending instead to use several different substances, both legal and illegal, either very occasionally or more regularly. Consequently, prevention and care policies which differed according to the substances used were no longer relevant, at least not as far as young people were concerned.

Furthermore, we knew, as a result of some scientific studies, that both legal and illegal drugs acted on the nervous system in similar fashion and that there was no public health reason for having such different policies as we had had in the past.

Finally, in France in particular, we had a significant alcohol problem which had been largely underestimated. We had a much more significant care program for drug users, who were relatively few in number, if you want to talk only about problem users, and a very insignificant and not very effective program for alcohol users, particularly for problem users or alcoholics.

Bearing all of these aspects in mind, I made a proposal to the government, further to all the scientific reports, to broaden the jurisdiction of my mission and to expand the plan that was going to be adopted by the government to include all psychoactive substances, namely, illegal drugs, alcohol and tobacco, diverted drugs - which is becoming an extremely important problem - and doping substances beyond their use in high-performance sport.

Obviously, this changed the nature of the work to be done. This led to a very significant debate in France, not on illegal drugs, but on alcohol. The fact that alcohol was included in the plan resulted in a great deal of resistance in the wine-growing regions - which have a lot of clout in France - and in the alcohol industry. This led to a political debate that went on for eight or nine months because what we call the "alcohol lobby" in France has a great deal of weight and power to change decisions.

It is interesting to note that although we thought the debate would focus on illegal drugs and on the new approaches that we would propose with respect to these drugs, in actual fact, the debate was much more about alcohol than about illegal drugs. With the new plan, we were trying to build reliable scientific information because it seemed to me that this was the only way to tone down the debate. I did not want to turn this into a political issue, in the ideological sense, but to ensure that our work was based on reasonable arguments.

My second concern in preparing the report was to be able to observe new consumption trends and new products in circulation so that we could respond very quickly. Furthermore, I wanted to be able to be in a position where the necessary political decisions could be made and where people working in prevention could be informed as quickly as possible.

The third objective was to share a common culture, and to share this common culture not only with the general public. In this sector, it seems to me that we cannot adopt a policy that has not won the approval of all citizens, namely, a policy where the public is not on board, and then expect all of the professionals to share this common cause. And here I refer to non-specialized professionals. In France, we had a small nucleus of very competent specialists and non-specialized professionals, namely doctors, teachers, police officers and judges who had very little knowledge about these often very contradictory issues. Everyone had to share common objectives and recall that a policy to fight drugs is first and foremost a policy aimed at protecting public health. Although a police officer and a doctor do not do the same job, their ultimate objective should be the same and we tried to work based on this premise.

After, the plan can be broken down several different ways. I will underscore a few points that I feel are essential, including the development of knowledge. You referred to objectives that I fully agree with, namely, knowledge, the sharing of knowledge and the principles used for establishing a policy. Naturally, we tried to do this work. Improving knowledge means having an organization that is at arm's length from the government, that has a certain autonomy, and whose findings will be indisputable. The Observatoire was established as the result of a 1993 plan, namely, before this new policy which was implemented a short while later. There was a great deal of resistance and it is still hard for people to accept the idea of having an independent organization which will provide information as it is and state: "You can agree or disagree, but this is the scientific reality." We developed this Observatoire by conducting epidemiological studies on a regular basis. Knowledge and the convergence of all the statistical data existing in each department - data which is not necessarily very compatible - must serve as a focal point for the European Monitoring Group for Drugs and Drug Addiction. We felt it was important to have a European organization that would collect all of this data. At the Observatoire, we broadened our scope to include research on alcohol, tobacco and other products. Today, we have a clearing-house that enables us to have some reliable data on these issues as well as a network of scientific experts from all disciplines, from sociologists to neurobiologists, that we can consult whenever a specific problem arises. This is an absolutely essential aspect for carrying out public policy.

In France, we had a significant debate on domestic security. This debate resulted in ideological positions being taken, in part because in the past, we had no independent organization gathering and analyzing current data, such as the data that can be provided by scientists.

The second thing is to share knowledge. This is indispensable. In France, we had many conferences on drug addiction, but they were reserved for a tiny world of specialists, always the same, who travelled regularly throughout France. Generally speaking, the same thing occurred in Europe.

We tried to draft some documentation that was intended for the general public and that pertained to two very important ideas. The general public is prepared to read and to understand a certain amount of scientific data. For a long time, it was believed that they would not be able to understand it because it was too scientific and technical. We prepared, for example, a booklet called "Savoir plus, risquer moins" (Know more, risk less) which provides certain facts about substances and the epidemiological studies. When we prepared this book, everyone told us: "It is too complicated, people will not read it," et cetera. We sold the small booklet for 10 francs in newspaper stands. Newspaper stands were easily accessible and it was easy for people to buy the books. In three days, we had no copies left. A million copies were sold in seven weeks.

This demonstrates that when you give people information, they use it, and that there is a significant demand for information in the general public. Educators in the French suburbs who do specialized prevention work told me that young people who generally did not read very many books had read this booklet from cover to cover. This shows that we were mistaken there as well and that people are not satisfied with posters dictating what they should or should not do. They need some explanation as to why such and such a behaviour is dangerous or not. Of course, this alone will not make their behaviour change, but it is an indispensable prerequisite. We did all this work, although it still needs to be improved because this is a job that will take a long time. It will take from five to ten years to raise the knowledge level of the general populace and ensure that this issue becomes an issue of public health or a social issue like any other. The work has begun. One very interesting point is that when we broadened this policy to include alcohol and tobacco, everybody said that French opinion would not agree to this given the place that wine had in French society and in France's cultural habits. A long political debate took place. Once the decision was made, the French bought in to this idea completely. They were able to distinguish between occasional use and problem use.

The fact that we were talking about alcohol, tobacco and medication at the same time as we were talking about drugs no doubt made everyone feel closer to the situation because everyone had the experience of consuming a product, be it legal or illegal. This was an important aspect that did not result in our saying that all of the products should come under the same legislative regime, but it resulted in our telling everyone: "Be careful, if you use, no psychoactive product is harmless." Then it becomes a matter of measuring and managing risks and that is front line prevention. The improvement of knowledge and communication are, in my opinion, two essential aspects in implementing the policy. We must also ensure that everybody has the same culture and the same knowledge pertaining to these issues. Consequently, each and every one of us, to some extent, plays a role in front line prevention. This is indispensable as far as I am concerned.

There is a great deal of work to be done in the area of prevention because we were lagging far behind in France in this sector. Perhaps this is less the case in Canada. Our educational establishments had no framework for implementing prevention programs. We had associations, doctors, police officers who visited the schools and often gave contradictory messages or did not intervene in a coherent manner.

We tried to implement prevention plans in each department to ensure that all adolescents of a certain age were given programs that were coherent and based on reliable scientific knowledge. This work began in December 1999, after the plan was adopted. In examining the work undertaken in other European countries that are ahead of us, I know that it will take about 10 years before we have any real prevention programs in our schools.

We also radically changed the approach we took in the health care sector. We had a fairly well-developed program for heroin addicts, but we had nothing for the other problem users, such as synthetic drug users or cocaine addicts.

We did not have very much for alcohol and tobacco. As for the problem of prescription drug dependency, in particular addiction to vasodyazepine, we had practically nothing. We tried to build capacity in front line medicine, in health care clinics and to detect problem users. If we do not develop our ability to detect, the people will not consult us until they are already sick, and this is particularly true for alcohol. On average, the people in our detox centres are about 40 years old. Until they reach the age of 40, the people are not necessarily ill, they do not have any symptoms, and therefore they will not consult us.

One of the objectives was to ensure that front line doctors ask simple questions that enable them to diagnose a problem at an early stage and suggest treatment. Initially, we worked much more as a network with front line general practitioners and treatment centres that call upon specialized treatment centres for alcohol and drug abuse, so that each department has a certain number of referral centres that can also initiate substitute treatment programs, particularly methadone programs. And then, we provide hospital services for the most serious cases or those requiring more specialized assistance.

We have set up some networks, a hospital town, that enable us to meet this requirement, and, in all likelihood, improve our ability to take charge of situations that are extremely varied in nature. We have made quite good progress in developing substitute treatments and today nearly 80,000 people are under such treatment in France. Of this number, 70,000 are using subitex, high dose Buprénorphine which is unique to France since it is not currently marketed in other countries and 10,000 heroin users are on methadone. This has all been achieved very quickly and, in part, is initiated by the local doctor.

I will conclude on the issue of co-ordination between the enforcement system and the health and social system to try to improve the way that drug users may understand our penalty system. To make our penalty system more effective, we encouraged all of the Republic's attorneys to enter into an agreement with directors of health and social programs, namely the individuals who manage the treatment programs.

We did this with a very clear objective in mind: All individuals who are stopped by the police for illegal drug use or for offences committed while under the influence of alcohol can now be referred to the service responsible for health and social care.

We have come a long way with this program and today 93 out of 100 departments have initiated such agreements. As a result, even though the individual stopped by the police may not have any criminal charges brought against him, he will be directed to a health and social treatment program. Furthermore, even if this person is charged criminally, he can still benefit from this health and social treatment. Consequently, we have a penalty that is in keeping with the offence committed and the seriousness of this offence, but at the same time health and social treatment come into play as soon as problem consumption has been detected.

Accompanying this approach to drug use and crimes related to drug use, we have also developed tools to fight against trafficking, particularly trafficking at the local level. The expansion of small trafficking networks in France is a big problem, a problem which moreover concerns not only the illegal drugs themselves but the resulting parallel economy.

Our systems to fight trafficking and our police organization were not very effective in dealing with small trafficking networks. We try to focus more on the lifestyle of these individuals rather than taking the conventional approach using informers, surveillance and information which did not prove to be very helpful for this type of offence.

Once again, we tried to come up with a balanced policy for fighting local trafficking. When I talk about local trafficking, obviously I am not trying to minimize all of the efforts made to fight international trafficking. However, I would say that we had already focused quite intensively on this aspect whereas we really did not know what to do about local trafficking. This was very important politically because young people could not understand why they were being pulled over by the police for using cannabis whereas their pusher remained quietly at home and was not called upon by the police. It was very important, therefore, to reset the pendulum and to state that pushing drugs was more serious than using them.

Just a word to conclude on my mission, and that is national and local coordination. In France, as you know, despite the fact that we have decentralized legislation, we are still a very centralized country with what I would call a Napoleonic administration whose departments tended to work in a very vertical fashion. Anything that is horizontal has a difficult time operating.

The mission I am in charge of reports to the Prime Minister. There are 43 officials working in the mission. Meaning that we have on staff a doctor, a pharmacist, a police commissioner, a judge, a police officer, a customs officer, and I am certainly forgetting some. By doing this, we have been able to develop within the mission a culture that is common to all departments.

Whenever necessary and for any aspect that comes under its responsibility, the mission can bring together all of the departments in an interministerial committee, which in its expanded version includes 19 ministerial departments. Since alcohol now comes under our purview, we have representatives from the Department of Agriculture, the Department of Education, the Department of Health, the Department of Justice, the Department of the Interior, etc. We can therefore have meetings involving the full contingent or a more restricted contingent.

When there is disagreement on a given subject, we go into arbitration, which involves the Prime Minister or the Cabinet of the Prime Minister. In each department, we have created an interministerial committee whose work at the local level mirrors my own at the national level. This committee is headed by the prefect. May I remind you that France is divided into departments.

That is how we co-ordinate our system. I think it works better now than it did in the past, but it is not perfect, because - I repeat - we now have a certain amount of reliable data and various departments view us as a reference organization which can help them implement their own policies more efficiently.

In France today, there is an ongoing debate on the issue of drugs, cannabis and law reform. In the coming years, I feel that the issue of the decriminalization of pot will be much less in the fore-front than the issue of how to deal with new drugs that come into the marketplace. I am referring to both synthetic drugs and drugs not used for their intended purpose, but also to the huge potential for trafficking drugs over the Internet. I think we are entering into a new era. One of my concerns is that we do not address the problems of this age based on the knowledge we have on previous times. All our data indicate that the line between that which is authorized and forbidden, legal and illegal, will become even more fine and that every country will be asking itself whether it makes sense to prohibit drug use. Do we need prohibition systems or, on the contrary, do we need to think of regulatory systems which do not entail total legalization or authorization, or prohibition or illegality, as we have seen that this approach does not work anywhere.

I would be pleased to answer any written or oral questions you may have.

The Chairman: Ms Maestracci, I will risk the first question. The various reports we have read, including reports published before the creation of l'Observatoire, have revealed - I am coming back to the issue of youth - a lack of co-ordination between prevention programs, and limited accessibility. I have some figures regarding the possibility for students of joining certain prevention programs. Can you tell us what has been done to address this weakness? Can you tell us what programs have been put in place?

Ms Maestracci: First, when we discovered this problem, we realized that it was happening elsewhere as well. For instance, in France, very little sexual education was being provided and we did not have an organized prevention program in schools. So we asked each prefect, in every department, to develop a prevention program.

This meant we had to find out just who was invited to speak to students in schools about drugs, drinking, smoking and other issues and then to monitor the program which was implemented and to develop new prevention programs with numbered outcomes for every department for, I would say, all the young people we wanted to reach.

As for the targeted age group, we had so much catching up to do that we chose to target teenagers. I am convinced that we should target kids who are much younger and develop programs for primary school children, as well as having programs for university students. But we could not do everything at once. So we began by targeting teenagers. We asked the prefects to calculate the number of teenagers in their area and to aim for implementing a minimum number of prevention programs given by trained personnel.

First, we asked them to identify prevention personnel and then we asked them to train them. We put in place local training programs for prevention workers. And we also asked them to make an inventory of prevention tools, be they written documents or videos shown in schools. In Paris, we created a commission to test prevention tools, which involved many experts on prevention, to determine which were the most appropriate tools for this age group and for use in a school environment.

At that point, we were still not in a position to say what types of prevention programs should be implemented. We decided to start building on existing resources because we knew that we could not design programs from scratch or suddenly make prevention professionals appear in every school. We had to start with what was already there, while emphasizing on the fact that prevention could not be carried out based only on good faith, but that these professionals needed a certain amount of training and a certain number of proven tools.

Other European countries did the same, that is, they had a very scattered approach and a lack of consistent, overarching policies. Even countries which today have more regular prevention policies, which have been in place for some time now, needed about 10 years to reach this point and had to go through several stages. You could say that we are at the awareness stage and that we have a certain number of proven prevention tools.

I do not know if we are going to get to the second stage, because it is more complex. Should each school have access to or employ true prevention professionals, who are called preventologists in Northern European countries? Or, on the other hand, should we provide more training to a certain number of doctors and teachers to carry out this work? The issue has not been resolved in France. But we will have to make a decision because prevention experts have differing opinions on the matter.

The Chairman: Madam Maestracci, what you have just said has answered what would have been my supplementary question, which is: who are these workers, given the difficult relationship between prohibition and prevention, or the socio-health approach? Is there not a danger that these people still believe in the myths of the past? Are you not afraid that some of these workers will put out a biased message to young people?

Ms Maestracci: Of course. But I find there is less danger of that. However, there is no doubt that it still exists. In France, most prevention initiatives were taken by the police and these initiatives do not at all reflect the new methods of prevention. For instance, there was a time, which is coming to an end, where the police visited classrooms with a suitcase full of products. Every country did this. We had decided that the police had a role to play in school, but their role is to teach kids about the law or about citizenship. They have no business providing public health information. So, the various players have to co-ordinate their roles.

In fact, we had many non-governmental organizations, such as associations to help alcoholics and drug addicts, and public health associations. However, none of these organizations worked together. So we also had to train and inform these people. And if it is true that the police had little training in matters of public health, it is also true that educators or those types of association had very little training in matters regarding the law. All kinds of contradictory and false information was being put out. It was an uphill battle. However, I was heartened by the fact that every country which tried to put into place prevention programs faced the same problems we did. At the same time, I realize this is a long-term effort. It is something which needs to be constantly updated. If we have good intervention personnel, they will tell us about changes which are happening and so we will be able to constantly update our approach.

I think several prevention models were proposed. In particular, people said that there would be no point in talking about the substances and giving out very technical information. If you are going to do prevention, you have to start with what young people are going through, you have to find out why they are doing drugs and you have to help socially and psychologically. In fact, our public health approach was inspired by Canada. Today, we realize that those things cannot be achieved if you do not also have a certain amount of technical knowledge. Even if it is only to air out the issue, that is, to provide information about the substances. But, of course, you cannot build a drug prevention program on that kind of foundation. You cannot talk to a young person about this issue without having enough information to address these issues. Otherwise, you are just not credible. That is an important point. If you are not credible, nobody is going to listen to you.

On the other hand, we are not always in a position to tell the truth. In France, there were some people working in the field of prevention who had a hard time because they did not receive proper training or were not told to tell it like it is. For instance, the police in France were very embarrassed when information was released regarding only pot. For a long time, it was believed that pot was extremely dangerous and could cause a person to become addicted to hard drugs and so on. People were content to believe that type of message. But that kind of message loses its credibility when scientific research around the world disproves it.

When the truth starts to come out, it complicates the situation, because the truth is neither black nor white, it is grey, it is not cut and dried. So people working in the field of prevention must walk a fine line. These people also had a hard time dealing with legal issues. In their view, if a law was passed, you could not talk about decriminalization. They could really not tell the police that despite a law being passed, they would still have to talk to young people about the way laws are enacted and how they come into being. Since laws change, the public also has to learn that it has the right to respond to a proposed new law. Because of this, prevention workers must be very skilled at what they do.

Senator Maheu: When you said that each department had its own policy, that piqued my interest. If ministers do not consult with each other, does that mean that even if the Minister of Health, for instance, says that there is a huge drug addiction problem among young people, that the Minister of Justice will not do anything about it? Knowing how the French would react, I find that strange.

Ms Maestracci: It is always difficult to judge something in retrospect. In my view, the moral and ideological weight of the issue of drugs - it was so taboo to talk about this in France that it was like a question of good versus evil - was such that when a harm reduction policy was being implemented, the Department of Health, rightly or wrongly, decided that if it wanted to do something, it would have to do so without anybody knowing.

I clearly recall a heart-to-heart conversation. When I was on the staff of the Minister of Justice, we had started to set up the very first needle exchange programs. I remember a member of the Health Minister's staff called me to say that if I called a couple of State prosecutors, they would put up with a needle exchange program in their region without prosecuting users. These prosecutors thought - and it made sense, given the attitudes in France - that if they launched an interdepartmental or public debate on the issue, it would never end, as these issues had never been discussed in France. So if the program was to go ahead, it would have to be done quietly. In fact, it was really hard to just set up the safe injection sites for the most marginalized users. The sites were slowly set up - they are called "boutiques" in France - without the knowledge of the people in the affected neighbourhoods. This gave rise to much heated debate about safety, and all kinds of associations were created in support of or against these sites.

All this could have been avoided if the government of the time had explained why these harm reduction programs were being implemented. After all, the government grasped the importance of creating AIDS approach for drug addiction? Perhaps because the issue of drug addiction was more of a political hot potato. It is true that French policy was deficient in that regard.

The fact that the Department of Health decided to do things in secret was wrong and maybe things would have moved ahead faster if the issue had been debated publicly. We have just reached a consensus in France - we had to include it in a bulletin - telling the police not to arrest people with clean needles on them anymore. People are just beginning to come around to the idea.

You cannot ask the police to implement recommendations if they do not understand their purpose. The process was not explained clearly enough. We are still in the process of creating a common culture. I hope this will help with further changes which will no doubt have to be made to our policy.

Senator Maheu: Canada must also create education programs targeted at every level. You have encouraged dialogue on every issue at once: drugs, tobacco and alcohol. Since the wine and spirits industry is so huge in France, do you foresee any resistance on the part of teenagers, or any other type of problem, regarding drinking?

Ms Maestracci: To reinforce what you said, we did not have many illegal drug prevention programs, but we had even fewer programs for drinking and smoking, which affect many more people. This shows you that, for various reasons, it is a lot harder to talk about these things than about illegal drugs. Further, we do not have the full picture of drug use among youth. We know more today on the issue of illegal drugs, especially since we put in place a program which traces drug use and new products. With regard to drinking, we basically had a good idea of the profile of alcoholics, which was that of a person who had been drinking for 20 or 25 years and had then gone to get help. It is a well-known problem in France. Then you have a huge population of people who drink to excess, but who are not yet alcoholics or who may never become alcoholics, because they just get drunk periodically. These people have largely been ignored.

That is why it has been difficult to implement prevention programs. The people who talked about prevention in schools came from anti-alcohol associations or AA-type organizations of which there are many in France. These types of organizations help alcoholics. They talk about alcohol dependency in schools, although what they have to say is not necessarily the thing teenagers need to hear, because, for their part, teenagers drink and drive or get drunk every Saturday night, but they are still far from becoming alcoholics.

It will be interesting to see how the issue evolves in France and if it will yield results in the long term. Research has shown that France, along with Portugal, has the highest rate of alcohol consumption in Europe. However, a European study carried out among 16-year-olds in schools has revealed that French students of that age are far from the heaviest drinkers in their peer group in Europe. It may be a generational thing. Sixteen year olds do not drink like their parents. They are, however, the greatest smokers of pot.

We could hypothesize that there is a direct correlation, that is, if you use a lot of one substance, you use less of another, or could it be the opposite, if you use a lot of one substance, chances are that you will use everything? We do not have answers to these questions right now, but we were surprised to find that young, 16-year-old French men were no longer Europe's major consumers. Ten years ago, this same study would have yielded very different results.

Senator Maheu: Are studies being done to determine why young people use marijuana rather than alcohol?

Ms Maestracci: Perhaps you will have more information from the two experts that you will be hearing, but we are still at the stage of formulating hypotheses. If we take a look at marijuana consumption in European countries, there is another factor that enters into the picture.

For instance, in countries like Great Britain, which for a very long time had a level of marijuana consumption that was much higher than other European countries, a threshold effect eventually comes into play, as though consumption levels could not increase indefinitely. There is a marketplace threshold - if I can call it that - or a ceiling that cannot be exceeded.

For the time being, all of these factors are but hypotheses, since most of the studies do not go back far enough to allow us to draw clear conclusions concerning consumption habits. We must also remember that we will not find something that we are not looking for. For example, we discovered that the use of doping substances was quite widespread among young amateur athletes when the doping scandal erupted during the 1998 Tour de France. Since the question had never been asked in epidemiological studies, we were not aware of this and, therefore, it did not exist.

We must keep in mind that we have relatively little historical data available on the trends in marijuana consumption in France. It has certainly increased, but we must be cautious about identifying the extent of the increase because until now we have not had accurate enough studies detailing the number of regular and less regular consumers.

I would therefore be very cautious on this subject but, at the same time, I think it is interesting to ask questions about one type of drug being a substitute for another. Does consuming more of one drug mean consuming less of another? Personally, I was very surprised to learn about the situation in some countries, such as Iran, for example, where alcohol is not consumed - at least, not officially, although there is a black market - but where there are 1,500,000 heroin addicts.

It is important that we ask this kind of question. In the book entitled Savoir plus, risquer moins that we distributed, we began by saying that there is no drug-free society. Once we agree that there is no drug-free society, we must then realize that minimizing the dangers involved in living with drugs will no doubt require eliminating the most dangerous drugs.

It is absolutely essential that we ask ourselves these questions and that we set up monitoring systems that will enable us to identify major trends in drug use. If the same study is conducted in ten years, marijuana may no longer be the issue it is today. The advances being made in the chemical and medical drug industries are such that these products will be at the centre of our concern in the coming years. So, we should not focus on the wrong issues either.

[English]

Senator Banks: I hope you will pardon my asking you questions in English. I also hope that whatever you determine in France does not impede your supply of excellent wine to the world, and to me in particular.

That leads to a question to which you referred in your response to Senator Maheu. If we could find a completely objective person - and I do not think any such thing exists; maybe those 16-year-olds to whom you referred are objective or a Martian coming down to look at what we all do - that objective person would look at the abuse that some of our public makes of alcohol on the one hand and tobacco on another hand, abuses that are clearly extremely harmful not only to society at large but to the user. My question for the moment is limited specifically to cannabis. That objective person would look at the abuse of cannabis, if that is the word, and say, "This appears, on the face of it, anecdotally at least, when the use is moderate, even to the point of impairment and intoxication, to be less harmful to the user and to society than the other two, and yet here we have legality with respect to the production but also with respect to the sale of liquor, and we give it to people in churches on Sunday mornings. We have the legality of tobacco, the harmful effects of which are unmistakable and irrefutable. Yet we have, for reasons I think you have referred to essentially as moralistic ones, made cannabis illegal."

Aside from the moral argument, one of the arguments that is made by people who believe it ought to continue to be illegal is that it is a gateway drug, that it leads in some views, inexorably, to the use of other more potent, difficult and harmful drugs. What is your opinion, in all of the information have you obtained and the questions you have asked of everyone, as to that question? Is the use of cannabis a gateway to the use of more harmful drugs?

[Translation]

Ms Maestracci: As for the last question, it is clear - all of the studies show this - that cannabis is no more a gateway to more dangerous drugs than tobacco, alcohol or other behaviour that puts a person at risk.

It is true that all users of more dangerous drugs began with marijuana, but they also started out using alcohol, tobacco or other products.

However, only a tiny proportion of those who use marijuana will go on to take harder drugs. We have contrasting information on cannabis because it is certainly not the most dangerous of all the products we have mentioned, since we know that it does not have any irreversible harmful effects.

Still, there is a small number of problem users who consume marijuana from morning to night and who will experience some health or social problems. Furthermore, one of the problems encountered in all the countries is, in fact, how to identify these problem users and draw conclusions.

Basically, one of the points made in the French plan is that what makes the product intrinsically dangerous is the behaviour associated with its use. In other words, whether or not a small or large amount is consumed, whether the product is taken before driving or in certain circumstances will determine whether users pose more of a danger to themselves or to others.

Everyone agrees with this point, yet no one is quite sure how to draw conclusions, either in terms of legal implications or policies. How does one draft legislation so that it takes into consideration only problem users?

All of the countries are confronted with this situation. Many European nations have introduced the concept of problem users into their legislation, without always being able to define it clearly.

The difficult thing about cannabis is that we must not go too far in the other direction. The fact that cannabis is the least dangerous of all the drugs we have mentioned does not mean that there will not be a given number of users who pose very serious problems. Using marijuana does not necessarily lead to hard drugs; however, it can lead to major difficulties for young people if they consume marijuana from morning to night.

Secondly, do we want to have only criminal consequences or should we instead develop or enhance educational and health measures? These are the questions that we must ask about the use of cannabis, which is certainly the most complex case.

The Chairman: I want to let you know that the questions submitted to you in writing and your answers to these questions will also be posted on our Internet site.

[English]

Senator Banks: You referred to the fact that there are many different approaches among your neighbours in Europe. In Canada, we are next to a large country with which we do a lot of business, and they are our only direct neighbours. The United States has a national attitude with respect to drugs that, at the moment at least, leads more to the legal answer to the problem, in order to try to eradicate the importation of drugs.

Would you speak briefly about the nature of the relationship that you have been able to develop between France and its neighbours, particularly those that have distinctly different approaches from the one that France has at present?

[Translation]

Ms Maestracci: The situation has changed considerably in the last five years. Five years ago, the parties held radically different positions and the European meetings in Brussels were the scene of some very heated and contentious debates. France, which had a fairly repressive policy, and the Netherlands, which had a relatively tolerant policy, opposed each other very heatedly.

In reality, this was a dispute based for the most part on the perception that each country had of the other. All of the European nations have focused on objective scientific data; this has been widely accepted. As soon as we begin focusing on objective scientific data, we see that there are not 56 different solutions. In the end, the European countries have tended to bring their policies more closely into line with each other, rather than differentiating them. Moreover, that is what the European Monitoring Centre has now concluded. In the end, the policies that transcend the political pronouncements are much more similar than one would imagine. In Europe, the main approach to these issues is to provide health care and social measures for users, not to be overly repressive by sending them to jail. All European countries agree on this point, that they prefer alternative sentences or administrative penalties for using drugs in public. We have a certain degree of unanimity today on this point.

There are some countries that are setting up experiments or that have zones of tolerance. The zone of tolerance in the Netherlands, for example, is much smaller than you might think. Basically, you can buy up to five grams of cannabis in the cafés; there are penalties for quantities exceeding five grams. The cafés are supplied through the illicit drug trade.

Although a zone of tolerance does exist, it is relatively weak. On the other side of the border, or in France, quantities of 20, 25 or 30 grams of cannabis are tolerated because, at the border, or in the northern departments of France, a great deal of cannabis is circulated in small quantities. French public prosecutors have tended to be relatively tolerant regarding amounts associated with personal use.

One realizes that, since not everyone can be charged and the law must play this symbolic role, each country has a number of zones of tolerance and sanctions drug trafficking much more than drug use.

What made progress possible - and there was a deadlock in Europe because relations between the Netherlands and France were terrible due to the drug issue - was greater mutual understanding. The Netherlands thought that France was a police society and the French thought that marijuana could be bought and sold on any street corner and that all drugs could be sold freely in the Netherlands. It was important for each to know what the other's policies were. Having the same scientific and epidemiological data meant that policies were brought closer together. It took time, but at one point it became clear that we agreed on many more things than we disagreed on. I visited the Netherlands in early July, and the press release issued at the end of the trip stated that, although there did remain some differences because we come from different cultures, what we have in common is much more important than our differences. Perhaps your situation will develop in a similar way.

The Chairman: Thank you very much for your presentation. We will no doubt be writing to you. I would like to have heard what you had to say about therapeutic injunctions, and on the evidentiary weight of the information that the magistrate must consider in order to choose one option over another. I will write to you and we will publish your answers.

The meeting was suspended.

The meeting resumed.

The Chairman: We have before us Mr. Jean-Michel Coste. Among other distinctions, Mr. Coste holds a degree in demographic science from the Université de Paris I and a master's degree in sociology from the Université de Paris V.

Since 1995 he has been the Director of the French Monitoring Centre for Drugs and Drug Addiction. In 1993 he was the chargé de mission at the délégation générale à la lutte contre la drogue et la toxicomanie, where he contributed to the collection, analyses and review of data and information about drugs and drug abuse. In addition, he took part in setting up the French focal point of the European Information Network on Drugs and Drug Addiction and the French Monitoring Centre for Drugs and Drug Addiction. In 1991, he was the chargé de mission in the office of the Deputy Director of Health Studies and Statistics. In 1986, he was the Chief of the Health Department's Hospital Statistics Office, and in 1982 was responsible for the division dealing with institutions for disabled persons within the Office of Social Action Statistics of the Social Affairs Department.

We wish you a warm welcome, Mr. Coste. We are grateful that you accepted our invitation and we thank for your interest in our work. As I said a few minutes ago to the previous witness, you will speak for 20 to 30 minutes and then we will ask you questions. If we run out of time, I will be responsible for writing to you and we will publish both the questions and the answers that you provide in response.

Mr. Jean-Michel Coste, Director, Observatoire français des drogues et des toxicomanies (Monitoring Centre for Drugs and Drug Addiction): I want to thank the Senate committee for giving us this opportunity to contribute to its work. You have asked me to make some remarks on two topics: the French Monitoring Centre for Drugs and Drug Addiction, and the main trends in illicit drug use and its consequences.

I will start by giving you a quick overview of the Monitoring Centre for Drugs and Drug Addiction. At the end of the 1980s, public authorities came up with the idea of setting up an independent public structure to monitor drug use and addictions in France; this occurred more or less at the same time as Europe was also thinking about setting up a European agency which became the Observatoire européen, the European Monitoring Centre.

In a rather short timeframe, in 1993, two documents were published, one European and the other French. The Monitoring Centre for Drugs and Drug Addiction was created in France, and a European directive led to the creation of the European Monitoring Centre for Drugs and Drug Addiction. I must point out that this European Monitoring Centre was established as a result of a French initiative.

It took a fair amount of time to get the ball rolling between the early 1990s and the end of 1995, when the French Monitoring Centre for Drugs and Drug Addiction actually came into being, because the details were quite complex and a number of ministries had to reach an agreement on the project.

In France, the Monitoring Centre has a specific status known as a public interest group. In fact, it is an autonomous public institution that is made up of three different bodies. Balancing their roles and powers is extremely important.

There is also a board of directors that sets the broad strategic objectives, determines our work plan and also the means to be used to accomplish the mission. The board of directors includes a representative from each of the main ministries represented on the interministerial committee in charge of fighting drugs and drug addiction.

The Interministerial Mission is also represented, as are two other associated bodies: the Fédération des observatoires régionaux de la santé [the Federation of Regional Health Monitoring Centres] and a network of documentation centres specializing in the field.

The second body is the Scientific Committee. It is made up of State statistics institutional representatives, from the Institut national de la statistique [the National Statistics Institute] and the Institut national de la recherche dans le domaine médical [the National Institute on Medical Research] and the main managers of data-producing bodies on the subject. Also represented on the committee is the Statistics and Research Branch of the Ministry of Health and the Office central de répression du trafic des stupéfiants [the Central Bureau for the Prevention and Suppression of Illicit Traffic in Drugs] as well as the manager of one of the information sources: the data base on offenders under the Drug Act.

The second part of the Scientific Committee is made up of researchers, experts appointed in a personal capacity who represent the various disciplines involved in our work. It is the second body, the Scientific Committee, that provides opinions and, as part of the Monitoring Centre, closely monitors and validates the scientific content of our activities and our publications.

The third body is an ongoing study. At present, there are 25 people at the Monitoring Centre who work full-time on describing drug use and drug addiction in France, with a budget of roughly $25 million francs. Those are the main components of the Monitoring Centre.

The legal nature of the Public Interest Group reflects the public authority's desire to create an independent structure and to maintain close links at the same time, because the objective of this Monitoring Centre is to generate knowledge, namely in the area of monitoring, that is helpful in guiding public decision-making. So it is not a research institute whose main objective is research for the sake of research, but there is a very close link. Our work is always conducted with a view to helping in public decision-making. That is a quick presentation of the legal status and the organization of the Centre.

The mission of the Monitoring Centre is to oversee the collection of data and available indicators, with a view to improving the information system. I will briefly describe, as mentioned by Ms Maestracci, the shortcomings of the French system which included the lack of provisions to enable the ongoing monitoring of use by the general population, which is one of the main indicators, as well as summaries often based on comparisons and the clandestine aspect of illicit drugs. Often, the sources of information shed light on only part of the phenomena, and that illustrates the need for work involving cross-referencing, identification, and the analysis of these clusters of indicators so that broader trends can be identified.

This work is illustrated in one of our major publications which is a report entitled "Indicateurs et tendances" [Indicators and Tendencies], which is a comprehensive snapshot of drug use and addiction in France. It is published every two or three years. This corresponds to our activities, to part of our mission, since our mission is primarily national, or French. Our mission is also partially European, since we are the counterpart to the European Monitoring Centre. We contribute to the work of the European Monitoring Centre by periodically providing an overview of the situation in France, and by implementing the work plan determined by the European Monitoring Centre.

What areas are we involved in? Our monitoring work covers four main areas. These broad objectives were set by the board of directors at the end of 1998 and covered the period similar to the one for the government plan from 1999 to 2001. In addition to the basic work conducted by the Monitoring Centre in terms of identification, analysis and synthesis of available administrative or institutional indicators, the Ministry of Health periodically conducts surveys on care sought by drug users. The Minister of the Interior has a data base on offences under the Drug Act. These are two sources that we monitor and for which we may be called upon to recommend improvements, namely as regards standards that are being developed in Europe in the area of official causes of death. This is one of the areas where we hope to make some progress, since at present, we can only identify part of the phenomenon. I will go back to a comment made by Ms Maestracci which is very important: we can only describe what we can see, when we equip ourselves with the means to see it. As regards mortality, it is extremely difficult to identify any trends when we know that a large number of drug-related deaths can go undetected with the current information system.

This is one of the parts which, since the Monitoring Centre was set up at the end of 1995, has been largely developed and for which we now have routine procedures, even if there are some areas where we are trying to make improvements to statistics in France, for example, as regards mortality, by trying to introduce mechanisms to measure the extent of this phenomenon.

One of the shortcomings we identified during our initial examination of the existing sources of information was the lack of surveys of the general population. To address this, three years ago, the Monitoring Centre set up an action centre so that in France we can now have regular studies conducted on the same basis which will enable us to identify evolving trends over time in areas such as the number of people using such and such a product, the age of users, and frequency of use.

This provision has four main parts: a regular survey every two years on opinions and perceptions - this is a fundamental phenomenon - a representation of what the French think about drugs. It is important to note that in 1999, the vast majority of French people agreed with the policy to reduce risks through needle exchanges or substitution.

This survey monitors opinions on public policies as well as the views of the French on drugs, and their potential dangers which enables us to measure these views on the various legal and illicit drug products. This is a very important remark even if my comments, at your request, will focus on illicit drugs. We conduct work on all drugs, and in the surveys, it is quite important to have an overall approach given the intricate nature of drug use. When we conduct a survey on perceptions, opinions and drug use, we always cover both legal and illicit drugs.

There are three other parts: these are surveys of drug use in the general population, in other words, the widest range possible, people aged 15 to 75. Specific components deal with young people in the strategic age group where they are introduced to illicit drugs - which are harder and harder - in school. This survey is conducted in a European context. Ms Maestracci spoke about the survey of young people aged 16. In France, we broadened the age group as much as possible, but it is still consistent with the European protocol. There is another survey which offers a wealth of information, and it is conducted among older teenagers, during the day devoted to military preparation. In France, this day has replaced military service.

Since the year 2000, young girls have been required to participate in this day devoted to military preparedness. There is an entire group of young people around the age of 18 who are required to attend this day devoted to preparing for defence. Attendance is high, because there are administrative obligations; young people cannot obtain their diploma or their driver's licence if they do not attend this day. Ninety-eight percent of the age group participates in this day devoted to military preparation. This is a wonderful opportunity to conduct an epidemiological survey. We were able to start doing that in the year 2000. This will be an annual survey and a true barometer of drug use among young people in their late teens.

I emphasized this part to illustrate the type of work that we have been able to conduct. The Monitoring Centre's objective is to analyze and use existing data. We can propose improvements, but we will not recreate something similar, and when something does not exist, the Monitoring Centre's team uses the budget we have available to us to develop such surveys either alone or in conjunction with teams of external researchers.

The third area we focus on in our work deals with one of the prospective concerns addressed to a large extent by Ms Maestracci, and that is monitoring recent trends, to avoid waging the wrong war, and trying to detect as early as possible the emergence of new trends, which is currently what is happening in the area of synthetic drugs.

This is a rather experimental approach for the European Union. The French Monitoring Centre will co-ordinate the European project, since the European Union also wants to put a similar provision in place.

This provision is called TREND, "Tendances récentes et nouvelles drogues" [Recent Trends and New Drugs] and it is based on a relatively simple idea, although implementing it is complex. It involves a network of observers at 13 sites in France, including 10 cities in metropolitan France and 3 in the overseas departments. This project involves mobilizing epidemiologists or researchers trained in ethnographic observation and in contact with drug users and prevention workers. These provisions will mainly be put in place as part of the risk-reduction policy that we call "front line provisions" or "low threshold requirements," in other words, we try to enter into contact with users by offering them, for example, housing, prior to their requesting care. These professionals work in the area of risk reduction and are also well-positioned observers who can help us identify emerging trends.

As part of this work, there is also a project to monitor substances that are consumed, since we want to know what young people are using, namely in terms of synthetic drugs. This project is based on collecting samples of synthetic drugs, namely products sold as Ecstasy, which are bought from users and analyzed in State laboratories to determine the specific make-up of these products. I will have an opportunity to present some of this data.

The final aspect of our work involves evaluating public policies. At the end of 1999, the Monitoring Centre was mandated by the interministerial committee to conduct a comprehensive assessment of the measures in the triennial plan. Our evaluation work also covers specific provisions, namely ones that are part of the four main components of the triennial plan that have been deemed priorities for evaluation by the interministerial committee. There is an existing evaluation process and we generally call upon outside teams that have already been hired for this purpose. That is an overview of what we do in the area of indicators, surveys, emerging trends and evaluation of public policies.

For the second half of my presentation, I had sent in a text that summarizes the main principles. The text contains more information than I will be able to present in the half hour I have been given for my presentation. It shows the basic trends in the use of illicit drugs as well as the health and social consequences of drug use.

I would prefer illustrating the Monitoring Centre's work as regards public policy by trying to address four series of questions that we have tried to answer. I am going to present some data that revolve around these four questions. I have also prepared a second document for you which contains basic graphs on the significance of drug use and its consequences. These are key tables that illustrate drug use in France in 2001.

The first question often revolves around the number of users. Two or three years ago, we were unable to provide a specific answer to this type of question, for example, how many people use such and such a product, whether it be drugs, tobacco or alcohol. The second question is which product generates the most problems? The third question is what are young people using? And the fourth question, to make the link with an indicator from an evaluation perspective, is what was the impact of the implementation of the harm reduction policy in France in the mid-1990s.

How many illegal drug users are there in France? These are simple questions that must be clarified with sub-questions, because it is never easy to answer questions as simple as that. What do you call a user? If it is someone who has experimented with an illegal substance, there are 10 million of them in France. The population of France is 60 million, and 20 per cent of people in France have experimented with an illicit drug, mainly cannabis. That data is included in the first table which is Figure 1, taken from a survey of the general population, in other words people aged 18 to 75. In the first column, for people aged 18 to 75, you have the frequency with which they experimented with different products, whether they be legal or illegal. For cannabis, it is 21.6 per cent of the population. So it is mainly cannabis. We also show substances with an entirely different order of magnitude, for example 1 per cent to 2 per cent, in the case of cocaine, LSD and amphetamines, and at an even lesser level, Ecstasy and heroin.

For occasional users, in other words people who use less than once a year, the number drops from 10 to 3.5 million. If we talk about repeat use as defined on the basis of at least 10 times per year, in other words use on an almost monthly basis, the numbers drop to 1.7 million. We can provide three answers to this question based on the definition of the term "user."

The main illegal drug used in France is by far cannabis. This is consistent throughout Europe.

Who are these users? They are mainly young people. Figure 1 shows that there are much higher rates of use among young people, since 46.8 per cent of all young people aged 18 to 25 have experimented with cannabis.

Figure 2 shows the result of the investigation I mentioned and that was done during defence preparation day. In the four columns you have only 17-year-old girls and boys from 17 to 19. Here you can see that the experimentation level with cannabis has gone beyond the symbolic threshold of 50 per cent and to date, you could say that a majority of French youth have tried cannabis.

For the other substances, you have the column on the right for consumption that is not at a marginal level because it is higher than 5 per cent. In those products you have hallucinogenic mushrooms, Ecstasy and LSD. In lesser proportions, cocaine and amphetamines are drugs used by 3 per cent of 19-year-old boys. Heroin use remains relatively marginal because it only concerns a bit more than 1 per cent of those 19-year-old boys.

Another element can be looked at through all this. It is to try to get a better idea of how to grade use. I think it is extremely important to answer the concerns of the authorities when, in matters of prevention, those authorities are looking for something whose objective is not only to prevent first use, but also to prevent going from regular use to use that turns into a problem.

From the investigation point of view, it is important to define this idea of problematic use and grade the users. It is possible to do this by trying to find occasional users, those who use repeatedly or regularly and those who constitute a problem.

Right now, we are trying to define three user criteria. We are trying to see if the young person uses cannabis on an intensive or daily basis, if he often uses alone or uses often in the morning. If we get a combining of those three criteria, I think we can define something covering the notion of problematic use of cannabis.

Still according to the same investigation, Figure 4, for cannabis, presents the different types of use and the corresponding values. There is the abstainer - the one who never consumed cannabis at all - the experimenter - who used once during his life but not during the last year - and then from occasional to intensive which is defined as 20 times a month or more. This whole gradation includes six different categories.

This table shows us that if young people who have experimented with cannabis at least once now make up a majority, the greatest number of those consumers remain occasional users. But when you look at the population whose level of use is higher, in other words boys of 19, you can see that for every ten 19-year-olds, you have four abstainers, three who are still at the experimental or occasional level, two who are repeat or regular users and one out of ten who use intensively.

If you cross that figure, 15.8 per cent of 19-year-old boys use cannabis intensively. Half that percentage also uses frequently in the morning and alone. That gives you approximately 8 per cent of 19 year-old boys who use cannabis in a way that could be qualified as problematic.

That summarizes the kinds of questions the authorities might want to find answers to. As for the other matters, I will be briefer.

Which drug causes the greatest problems in France? In all European countries, except some northern countries that have a specific problem with amphetamines, it is heroin, far and way. Although that is less and less true insofar as the trend is that it is not heroin alone anymore. Most problematic users of illegal drugs are multiple users. That is the first thing we can say.

In the area of multiple use, the substances other than opiates that are taking up more and more room are cocaine, alcohol and psychotropic drugs. In France, the estimate is 150,000 for the number of heroin and cocaine users who are problem users and a vast majority of those is taken care of in the context of replacement drug programs.

Even though it is decreasing, injection remains a frequent mode of administering the drug. In terms of consequences, the specific problems in terms of infectious diseases that result are AIDS and the hepatitis family. The estimate is today that 16 per cent of problem users are seropositive for HIV and 63 per cent - about two thirds - test positive for Hepatitis C.

What do the young people really use? I would first like to look at this question through a phenomenon that is emerging: the use of synthetic drugs that appeared in France in the early 90s.

Epidemiological investigations show that depending on age and sex, from 1 per cent to 7 per cent of young people use or have used that kind of product, generally in a festive context. It is important to emphasize this is done in the context of the use of other substances, in other words that it is rarely only synthetic drugs that are used but also a lot of cannabis and other substances such as stimulants. In some cases, you will also find heroin being used in the form of inhaled smoke. In the case of this rising phenomenon, we tried to find out what these young people use exactly. That is why we set up a synthetic drugs information system project.

In Figure 7, you have the results on samples sold as Ecstasy. The interest in this, as the samples were gathered by observers and prevention workers in the field, is that they can collect a certain number of observations about the context.

Was there a medical problem during the night? How was the product bought? And, for example, you can answer the question as to whether what was sold as Ecstasy really contained MDMA, the active ingredient.

So we isolated from the data base those samples that were bought as being Ecstasy. We found that one third fit the label in that they contained MDMA and MDMA only. When you run the numbers, you find that the dose of MDMA in a product can go anywhere from 1 to 10, from 1 to 20, in some cases, so the doses were extremely different and that, as you may suppose, poses many problems. The other thing is that one third of the samples contained MDMA with another active ingredient whose interaction is, of course, far from being well known. There is also a non-negligible percentage of 18 per cent that are diverted drugs, whose use can lead to serious problems. There is the kind of information that we also have to provide in connection with public health concerns.

My last question was this: What is the impact of the harm reduction policy implemented in France? In one of my texts, I broadly recall that the harm reduction policy began in 1987 with the unrestricted sale of syringes in France, but that it essentially grew from the end of 1993 on with the development of needle exchange programs and the beginnings of replacement programs that really took off in late 1995 and early 1996.

As an illustration concerning replacement drug programs, you have the curve on the number of patients treated through the replacement program and you can see that in France there were 50 drug users on replacement treatment at the end of 1993; 2,000 at the end of 1995; at the end of 1997 there were 50,000 and over 80,000 at the end of the year 2000 with something specific to France, as the dominant product is high dosage Buprenorphine rather than methadone.

In terms of the impact, we would have to try to find out more, because there could be associated factors, but overall, the experts believe there has been a positive impact, particularly in terms of AIDS and HIV-related deaths. You have two charts showing deaths, Diagram 10 and Diagram 11: Diagram 10 shows the impact of this harm reduction policy, namely the drop in the number of deaths caused by overdose reported by the police. As you can see, in 1994 the trend changed. This trend had been rising since the early 1970s, with a high point of 564 deaths reported in 1994. Since then, the trend has diminished, and the number of deaths is now standing at 119, so there has been a fourfold reduction in the number of deaths between 1994 and the year 2000.

The curve showing AIDS deaths is similar, albeit for completely different reasons. These reasons are quite different simply because of the primary impact of new AIDS therapies, which have quite markedly improved the life expectancy of HIV-positive drug users. So as you can see, AIDS deaths for drug users, which stood at 1,044 in 1994, have dropped to 148 in 2000.

The second positive impact is HIV. Diagram 8 shows the change in prevalence reported among injection drug users, falling from 23 per cent in 1994 to 16 per cent in 1999. There are some limits to this drop. For example, in the case of Hepatitis C, harm reduction strategies have not had the impact that we might have hoped for. The prevalence of hepatitis C remains at a very worrisome level: in 1994, it was 51 per cent, and today, the figure for 1999 was 63 per cent. So as you can see, nearly two thirds of drug users carry the hepatitis C virus.

Here is a very quick and very brief illustration of the impact of the harm reduction policy. I'll stop at this point because I believe I have gone well over my time.

[English]

Senator Kenny: I have been looking at the figures you have given us. I was particularly interested in the deaths from AIDS and the overdose deaths noted by the police from 1990 to 2000. You attributed these to your risk-reduction program. I am assuming that the program was in place right across the country; is that so?

[Translation]

Mr. Coste: The needle-exchange programs were gradually introduced in early 1994. But needle exchange in France was different than in other European countries. Drug users had general access to needles through pharmacies, which have been allowed to sell drug users needles over the counter since 1987.

There are two rather different mechanisms for providing sterile equipment: over-the-counter sales of needles starting in 1987, and the development of needle-exchange programs in the mid-1990s.

The other element of our risk-reduction policy was the establishment of low-threshold requirements in the mid-1990s. In other words, these are ways of helping drug users or making contact with street users that do not require the user to attempt abstinence. Users are offered front-line social services and health services. This contributes to the harm reduction policy.

The third aspect of the policy is replacement therapy, which unlike the other measures, was introduced over a much shorter period of time, between 1996 and 1997.

[English]

Senator Kenny: Assuming that your answer was, yes, that the program did take place across the country, and given the information you have provided to us, how do you attribute the drop in the death rate to the program you put in place? Surely, to be able to come to that conclusion, you would have had to run the program in some places to see what the results were, and not run the program in other places to see what the results were. You have not given us the case for where it was not run. How should we conclude that the program was effective?

[Translation]

Mr. Coste: You are quite right. If you look at it strictly in terms of evaluation, you cannot come to solid conclusions regarding the impact of a measure on an indicator, for example, unless you have established a mechanism with a control group, which is never done. You can do it by comparing areas that have established a needle-exchange program, for example one particular city, and another area that did not do so. There again, there will be some confusion, because the two cities are not exactly the same, and the population of drug users in the two cities may not necessarily be the same either.

If we want solid conclusions regarding this issue, we would have to do randomized studies, that is to say, take a population of drug users and give some people sterile needles, on a random basis, and not give them to the others. I am sure you realize that from an ethical point of view, it is difficult to do such studies.

I presented this data as impact indicators. It is true that we must remain careful about this data, because we do not have complete certainty, but an analysis of the international literature on these points concludes that in France, in the mid-1990s, unlike in some European countries, there was a very strong shift in policy, particularly with regard to harm reduction. This coincides with the trend turning around, and at present, we have far fewer strong hypotheses to explain why this trend turned around.

You are quite right. We cannot say with certainty that the reduction in overdose deaths is directly, irrefutably linked to the harm reduction policy.

[English]

Senator Kenny: We would all like to believe that the risk-reduction program was successful. Leaving aside the ethical questions, which I can understand, of not treating some people and treating others, what other possible explanations could you speculate for having this marked reduction in mortality? Is it possible that the high-risk groups were a smaller number? Had these people died by 1995 and, therefore, a smaller number of people were dealing with it? If you stretch your imagination, can you come to any other conclusions about what might have caused this drop off to take place, other than the program you had?

[Translation]

Mr. Coste: You have set out one of the other hypotheses. Indeed, in the early 1990s, the number of deaths among French drug users was relatively high. Part of that population died in the first half of the 1990s. This straightforward observation can explain that if the number of new drug addicts entering that population drops, at some time the number of deaths will drop as well. This is one of the explanations that I mentioned.

Although this factor was very important, it could not have been the cause because after all, we did see a fourfold reduction over four or five years. Such a marked change in the trend can only be explained by another factor, and we thought it was reasonable to conclude that it was the introduction of a replacement strategy. Replacement also meant, and this has been widely demonstrated, a better inclusion of drug users in society, which results in reduced mortality because people are no longer living on the street and they are monitored more closely, which allows us to minimize the number of deaths.

[English]

Senator Kenny: To change the subject slightly, you have given us figures on the usage of alcohol, tobacco and a variety of other drugs. In Canada, no one seems to die from marijuana. Some people do die from some intravenous drugs, and 45,000 Canadians die each year from tobacco-related diseases.

What is the experience in France? What level of usage of tobacco is there in France? You have given us figures here that show experimentation at least once; but when it is used on a regular basis, what are the mortality rates for tobacco vis-à-vis other drugs?

[Translation]

Mr. Coste: It is difficult to make comparisons between mortality due to tobacco, mortality due to alcohol and mortality due to illegal drugs. Yes, we do have figures. The problem is that we are not talking about the same thing at all.

In France, our current estimates are that 60,000 deaths are related to smoking and 45,000 deaths are related to alcohol use. If you compare these figures to those I gave you on the various uses of illegal drugs, which come to a total of 300, you can see that we are not talking about the same scale.

Despite everything, there are a number of precautions to take regarding techniques used to estimate tobacco- and alcohol-related deaths. We are trying to get a closer idea of all mortality related to these substances, something that we are unable to do in the area of illegal drugs. For example, there are deaths related to drunk driving. We are going to establish a study to try to measure these deaths. One of the spin-offs of this study is that we will try to see how many deaths in car accidents are due to cannabis use, because cannabis can also contribute to the number of deaths in car accidents.

As for current consumption trends in France, and also partly for reasons having to do with the prohibition of cannabis, the dominant product is hashish. The cannabis is mixed with tobacco and rolled into a joint. Although some people say that no deaths are caused by cannabis, if you smoke ten joints per day, you are smoking ten cigarettes with the rolling paper, with a homemade filter that does not work nearly as well as a cigarette filter. So it is difficult to make comparisons.

The orders of magnitudes are such that in terms of mortality, our public-health problems are tobacco, alcohol and then illegal drugs, in that order. This is so, even though we are not dealing with quite the same population when it comes to illegal drugs.

The people who die from tobacco or alcohol use are between 55 and 60 years of age. These are late deaths, whereas in terms of the number of years lived, the indicator is not the number of deaths, but rather, the number of years of life lost. That will bring up the proportion of deaths due to the consumption of illegal drugs. Basically, we are talking about a young population, around 30 years of age.

At present, in order to make the comparisons that we are trying to make, it is extremely important to work on all the fields that provide us with these figures and that provide orders of magnitude. However, given the approach we have to alcohol and tobacco, we cannot yet make comparisons with illegal drugs. They are still too difficult to compare.

The Chairman: These are statistics for smoking-related deaths. Can you provide us with this data?

Mr. Coste: Yes. The brief I prepared is for the most part based on the next report, which we will be publishing at the end of the year. It focuses solely on illegal drugs. In our report, we treat legal and illegal drugs the same way.

[English]

Senator Banks: You just mentioned a moment ago in responding to Senator Kenny that traffic deaths can be caused by intoxication from marijuana, as well as from alcohol. Is that an established fact? We have all kinds of evidence of traffic deaths being caused by people who were impaired by alcohol. I have not heard yet of traffic accidents having been caused clearly and directly by a driver who was impaired by marijuana. Someone who is impaired by alcohol is likely to be driving at 100 kilometres per hour where he should not be, whereas someone impaired by cannabis is more likely to be driving at 10 miles an hour where he should not be. Are there measurable numbers of deaths in traffic accidents caused by people who are impaired by marijuana?

[Translation]

Mr. Coste: No. I said that we were going to set up a study, and one of the objectives of this study will be to see what proportion can be attributed to cannabis use and what effect this use of cannabis has as a cause of fatal accidents. This study will be set up by the end of the year. Over two years, it will examine car accidents resulting in deaths, and samples will be taken from the victims to determine alcohol and also drug use. By the end of the study, we will be able to document the possible role of cannabis use in fatal accidents.

We have a research centre that is measuring the prevalence of the presence of THC amongst drivers. The extent of this prevalence may vary, but the problem is trying to analyze whether this use - in terms of methodology, this can be done, but we have not done it yet - caused the accident. That is what this study sets out to determine.

A study that was carried out in France determined that the risk of having an accident is twice as high for cannabis users. However, there were problems with the methodology of this study. Indeed, in this kind of study, everything depends on the comparison between the experimental group and the control group. The control group was made up of people who had been seen at the hospital emergency room, not people hurt in a car accident. This is a relatively debatable control group.

At present, this fact has not been clearly documented, and that is the purpose of this study. It may be conclusive, it may not. Such a study has been done for alcohol, but not yet for cannabis. We still are unsure about this.

[English]

Senator Banks: When it is completed, I hope you will be kind enough to let us have a copy of it.

My next point is illustrated in several of the charts that you have given us, but most dramatically in the third one. There is a very distinct and consistent difference between drug use as between men and women, in particular between adolescent boys and girls.

In your research, have you been able to determine a reason for that? Is it because girls are smarter? Is it because they are less likely to be wild and crazy people? Are they more prudent? Is there some useful information to be obtained from that seemingly irrefutable fact that might be put to good use?

[Translation]

Mr. Coste: We have not exhausted that topic, but I do have a few clues. In the case of some substances, girls consume more than boys. That is the case for mood-altering drugs, whose use is on the rise. This pattern of consumption is also found within the general adult population. The trends have also converged for tobacco. Until quite recently, girls smoked less than boys. The study that was carried out in 1999 and the Escapade Study show that young girls smoke more. The difference is significant. They have moved ahead of the boys when it comes to smoking. The difference is very minimal when it comes to mood-altering drugs. Alcohol use remains a very male phenomenon, as does cannabis use. However, if you look at the changes, the only investigation that allows us to establish a trend for the 1990s, with two reference points, 1993 and 1999, you can see that there is a very clear increase in use for both sexes, regardless of age. The 1999 curves are still well above the 1993 curves. You can see that experimenting with cannabis among the girls has clearly increased more than among boys. For example, among girls aged 18, cannabis experimentation has risen from 17 to 42 per cent, whereas amongst boys, this figure has gone from 34 to 58 per cent.

Regardless of age, the rate of use among boys is always higher. Multiple drug use and repeated use are relatively high. That is the case for tobacco and cannabis. In terms of trends, it would not be surprising to see use among girls rise to the level of boys.

Overall, there are major differences between boys and girls when it comes to risky behaviours. Enforcement reports showed differences in behaviour as well: in the early 1990s, cannabis use was very much a male phenomenon.

[English]

Senator Banks: Please do, when that report is finished, let us have a copy of it.

[Translation]

The Chairman: We would be very interested in reading that report once it is available.

Senator Maheu: When you answered the question from Senator Kenny having to do with tobacco-related deaths in France, which has a population of 60 million people, did you say that 45,000 deaths were linked to tobacco use?

Mr. Coste: The number of deaths related to tobacco use stands at 60,000, and the number of deaths related to alcohol use is 45,000.

Senator Maheu: In Canada, it is about 40,000 out of 40 million inhabitants. We are not far from double.

The Chairman: Would it be possible for you to send us the methodology that was used to monitor alcohol-and-tobacco-related deaths?

Mr. Coste: Yes.

[English]

Senator Kenny: The differences here are very significant. We would attribute 45,000 deaths to tobacco each year whereas we would attribute only 4,000 to alcohol, including drunk driving. It is a smaller country, different size, but the relationship of the two is quite different, and one has to then look at the methodology to decide whether we can compare the figures.

[Translation]

The Chairman: Once we receive that methodology, we will be able to make comparisons with our own figures.

One of your organization's tasks is to assess public policy. What methodology do you use to evaluate policy, and could you give me an example? I presume that a pass mark has not been reached and that political leaders have decided to change it.

Mr. Coste: In that area, unfortunately, France cannot provide you with many answers. It seems to me that Canada has a great deal more experience than we do when it comes to evaluating public policy. The approach taken in France is not integrated with professionals and mechanisms from public programs or policies. It is a medium-long-term approach. We really are at the first stage. By the end of 2002, we will have in place some elements of the policy that Ms Nicole Maestracci described to you. Training, for example, which is crucial, as well as the strategy of the public authorities, how this strategy has been implemented and what its impact has been. Then we will have a proper evaluation that will allow us to come to some conclusions regarding the implementation of the policy and its impact.

As for the four priorities, which include prevention programs within the départements and the training programs, this work will allow us to come to a number of conclusions. One extremely important step was reached when we brought together the various members of the interministerial group so that they could agree on the terms of reference of the three-year plan. This plan includes a number of principles and measures. We tried to combine all these elements, starting with rather general objectives and moving to operational objectives set by the various authorities.

The development of a consensus regarding the terms of reference can have a modest impact on preparation of the future three-year plan. We were hoping to establish a long-term approach. Then, specific mechanisms would be assessed in a more conventional manner. All of this comes at a time when the culture of evaluation in France is in its infancy.

The Chairman: I would like to ask you a few questions about the independence of your organization. Ms Maestracci told us that some agencies were hesitant to provide information that contradicted information that they had made great use of in the past.

In terms of your board of directors or those entitled to participate in your work, do you feel sufficiently independent to offer accurate and objective answers and information to those making the request? Do you have full discretion to achieve those objectives? Is the President of the Republic justified in granting you 25 million francs a year?

Mr. Coste: The question of independence is not a simple question. I prefer to use the term "autonomy" rather than independence. The problem is finding the right distance between clear autonomy with respect to findings and reports. Everything we publish is published under the sole control and authority of the Scientific Committee. There is real autonomy and independence with respect to the results and our publications.

The Chairman: That is an important distinction.

Mr. Coste: At the same time, the Monitoring Centre must remain close to the public authorities, particularly when it comes to the studies we are called upon to commission. That goes for questions raised by the Interministerial Mission. Sometimes it is harder to try to anticipate questions that may be raised in years to come.

A sufficiently close connection must be maintained between our work and studies and the day-to-day development of public policy. In my opinion, this is achieved through the Public Interest Group and the institutional organization. There is a good balance between the role of the Interministerial Mission on the board of directors and actual autonomy for the Scientific Committee over the content of what we produce.

The Chairman: You referred to substance evaluation. Tell us about THC content, because that question comes up all over the place.

Mr. Coste: In 2002, we will be conducting an experiment - in keeping with this same line of questioning - to find out what young people are actually using. Cannabis is mainly in the form of resin. There is not just cannabis, but lots of other things.

There is some data, gathered by our network of observers of emerging phenomena, that leads us to think that cannabis resin may be being blended with other products like benzodiazepines in order to produce greater effects. There is also the question of THC content. We would like to be able to document two things about cannabis: whether the cannabis being used has a higher THC content, and second, what is in blended cannabis products. This is, in effect, an extension of our previous work on synthetic drugs. We are now going to pursue that work on synthetic drugs, but also begin to explore the cannabis issue.

The Chairman: But you do not yet have data at hand on THC content?

Mr. Coste: Yes, we do. We have some data, but it comes from drug busts. Strictly speaking, therefore, the data does not deal with products that are used.

The Chairman: Presumably they would have been sold had they not been seized.

Mr. Coste: That is true. But subsequently, those products might undergo further blending and processing.

The Chairman: They are not yet ready to be sold to the user.

Mr. Coste: Exactly.

The Chairman: What do you make of the THC contents?

Mr. Coste: The THC contents are relatively high, but that is a question I can give you some information about.

The Chairman: We have received information on North America and would like to compare it with information on France.

Mr. Coste: That will be in the report that we are going to publish. I can give you the law enforcement laboratory analysis chart for the year 2000, fairly quickly.

The Chairman: Figure 13 on your last chart shows how many people have been questioned for drug use. There has been a sharp increase since 1990: four times as many people have been questioned. I understand that questioning does not necessarily mean that charges are laid?

Mr. Coste: Yes.

The Chairman: Is it not clear? The figures speak for themselves. Based on that, what should our evaluation of public policy in France be? I mean, arraignments have increased fourfold in ten years. Is it because there are four times as many users? Is it police efficiency?

Mr. Coste: There could be several reasons. For example, at this time, in France, we have reactivated our Vigie-pirate plan. That will doubtless lead to a certain number of Vigie-pirate as concerns terrorism, with rather strong police presence. The year Vigie-pirate was put into effect, there was a statistical accident on the number of arraignments.

We have been facing an increasing trend over the last 10 years that is tied in to an increase in use. We cannot measure whether use between the early and late nineties increased fourfold. However, there was a distinct increase in cannabis use.

Something else that we can see and that might be interesting to report are the 82,000 arraignments for cannabis use for 10 million people who have experimented with it. You will get an idea of the probability of being arrested if you are a cannabis user. As your denominator, you can use either the 10 million or the 3.7 million or repeat users, in other words the 1.7 million. If we were to take repeat users, for example, your arrest probability is relatively low. You can do the other comparison: a comparison with the legislation and what you can see about the implementation of the legislation and also, for a user, equity under the law.

The Chairman: I agree, but look at the heroin curve. It has decreased since 1994.

Mr. Coste: Yes. What we have there are arraignments for using, in other words the arraignments for trafficking are to be found somewhere else. We have the same indirect impact phenomenon due to the harm reduction policy and the trend, during the second half of the nineties, of a decrease in heroin use. It is not disappearing, it is still being used, but not as frequently. It is being replaced by substitute products, some of which are opiates, but there are also other products like stimulants, alcohol and diverted drugs. It is an indirect indicator so that is why you have to cross-tabulate the indicators. You will find them on arraignments, the HIV rates and the needle users as well as the mortality rate. So can you build based on the cross-tabulation and the convergence of those trends. This trend is one of the elements that allows us to say that the use of heroin in the second half of the nineties decreased in importance in France.

The Chairman: Thank you, Mr. Coste. We will send you a list of the questions we have not asked.

Before adjourning this meeting of the committee, I would like to remind all those interested in our work that they can read about and get information on illegal drugs if they go to our Web site: www.parl.gc.ca. You will find the statements from all our witnesses, their biographies and the documents they found it would be useful to give us, as well as 150 Internet links concerning illegal drugs. You can also use that address to send us your e-mail.

We will suspend this meeting and resume at 2:30 p.m.

The meeting is adjourned.