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Official websites use. Share sensitive information only on official, secure websites. Epidemiological research shows that the proportion of drug users who become addicted to heroin is higher than to cocaine. Here we tested whether this difference could be due to a difference in the addiction liability between the two drugs. Addiction liability was assessed under a discrete-trials choice procedure by measuring the proportion of rats that prefer the drug over a potent alternative reward ie, water sweetened with saccharin. Previous research on choice between self-administration of i. This increase in the rate of heroin preference after extended heroin access persisted even after recovery from acute heroin withdrawal. Overall, these findings show that choice procedures are uniquely sensitive to different drugs and suggest that heroin is more addictive than cocaine. This higher addiction liability may contribute to explain why more drug users become addicted to heroin than to cocaine in epidemiological studies. Keywords: addiction liability, heroin, cocaine, choice, preference, alternative reinforcement. The transition to drug addiction only occurs in some drug users Anthony, Epidemiological research shows that the proportion of drug users who develop addiction after drug experimentation can considerably vary with the drug used Anthony et al , ; Anthony, , suggesting that different drugs may possess different addiction liability. For instance, more drug users become addicted to heroin than to cocaine Anthony et al , ; Anthony, However, as different drug users can choose different drugs, this difference in the rate of addiction between cocaine and heroin could reflect the characteristics of the drug users rather than, or in addition to, the differential addiction liability of these two drugs Kliner and Pickens, ; Anthony, ; Kendler et al , One classic way to address this problem has been to compare the reinforcing values of different drugs in non-human animals under controlled laboratory conditions Katz, ; Brady, These values can be measured using the progressive ratio schedule of reinforcement, which is considered as one of the best standard methods in the field Arnold and Roberts, Using this method, cocaine and amphetamine-like psychostimulants is consistently found to maintain higher breaking points than heroin or morphine in laboratory rats, suggesting that cocaine would be more addictive than heroin Richardson and Roberts, ; Ward et al , One well-known, though often overlooked, limitation of the progressive ratio procedure, however, is that it measures the net result of at least two different drug effects: the reinforcing value of the self-administered drug and its direct effects on performance. We recently found that the latter, value-independent effect contributes to the difference in breaking points between cocaine and heroin in rats. When this effect is minimized ie, by imposing a minimum interval between successive drug self-injections , the breaking point of cocaine is considerably decreased Cantin et al , while the breaking point of heroin is unaffected Lauriane Cantin, Magalie Lenoir and Serge Ahmed, unpublished results. Thus, the progressive ratio procedure does not seem to be well-suited to compare the reinforcing values of cocaine and heroin. Alternative procedures that minimize the influence of drugs' value-independent effects during measurement of their reinforcing values are thus needed. Choice procedures involving a common, alternative nondrug reinforcer eg, food are particularly well-adapted for this purpose. These procedures have been extensively used in both human and non-human primates Haney, ; Martinez et al , ; Walsh et al , ; Negus and Banks, but they are still largely understudied in rats Ahmed, ; Kerstetter et al , In one recent series of discrete-trials choice studies, rats were allowed to choose between pressing a lever to get water sweetened with saccharin—a potent, albeit biologically inessential, nondrug reward—or an alternative lever to receive an intravenous dose of cocaine Lenoir et al , ; Cantin et al , ; Augier et al , A potent rewarding alternative is necessary to insure that the opportunity cost of drug preference is sufficiently high. An equal level of effort was required on both levers and choice trials were sufficiently spaced to prevent the direct effects of cocaine at the moment of choice. Under these conditions, most rats chose almost exclusively the nondrug alternative Lenoir et al , ; Cantin et al , ; Augier et al , This behavior was robust to a wide range of experimental conditions, including increasing drug doses per injection Lenoir et al , and increasing levels of past drug consumption ie, total drug consumption before choice testing; Cantin et al , As continued drug use at the expense of other rewarding activities and despite associated costs are hallmarks of drug addiction, we propose i that drug preference over a potent alternative reward may represent a valid measure of addiction in animals and ii that the proportion of drug-preferring rats may represent a good index of addiction liability: the higher this proportion for a given drug, the higher its addiction liability Ahmed, , In epidemiology, addiction liability is estimated by the proportion of drug users who become addicted after repeated drug use Anthony et al , ; Anthony, The overall goal of this study is to measure this index for heroin after extended heroin access and to compare it with the previously estimated index for cocaine. Since the discovery that heroin and cocaine self-administration partly depend on different neural substrates Ettenberg et al , ; Koob, , there has been cumulative evidence for addiction-related differences between these two drugs Badiani et al , ; Koo et al , , even after extended drug access Lenoir et al , Notably, recent choice studies in monkeys demonstrated that while extended cocaine access had no effect on cocaine choices Banks and Negus, , extended heroin access considerably increased heroin choices, especially at the low doses Negus, ; Negus and Rice, Overall, the present study extends to rats these findings. Contrary to extended cocaine access which had no significant impact on the proportion of cocaine-preferring rats Lenoir et al , ; Cantin et al , , extended heroin access considerably increased the proportion of heroin-preferring rats. These convergent findings across species show that choice procedures are uniquely sensitive to different drugs and may suggest that heroin has a higher addiction liability than cocaine. The latter difference could contribute to the differential rate of heroin and cocaine addiction seen in human drug users Anthony et al , ; Anthony, Rats were housed in groups of 2—3 and maintained in temperature-controlled vivarium with a h light—dark cycle. Food and water were freely available in the home cages and rats were neither food- nor water-restricted during behavioral testing. After surgery, catheters were flushed daily with 0. Behavioral testing began 7—10 days after surgery. These chambers have been described in detail elsewhere Augier et al , Briefly, each chamber was equipped with two automatically retractable levers Imetronic , a commercially available lickometer circuit Imetronic , two syringe pumps, a single-channel liquid swivel Lomir Biomedical Inc, Quebec, Canada , and two pairs of infrared beams to measure horizontal cage crossings. Rats were allowed to choose between a lever associated with heroin lever H and a lever associated with water sweetened with 0. During sampling, levers S and H were presented alternatively in that order: H—S—H—S to allow rats to separately evaluate each reward before making their choice. Reward delivery was signaled by immediate retraction of the lever and brief illumination of a cue-light above it. During choice, both levers S and H were presented simultaneously allowing rats to choose mutually exclusively between the two to obtain the corresponding reward. Delivery of the chosen reward was signaled by simultaneous retraction of both levers and brief illumination of the cue-light above the selected lever. The response requirement was initially set to 1 response first 10 testing sessions and then incremented to two consecutive responses to avoid eventual accidental choice remaining sessions. Responding on lever S during sampling or choice was rewarded by a s access to water sweetened with 0. Briefly, on saccharin sessions, only lever S was available. Lever pressing on this lever was rewarded by a s access to water sweetened with 0. On heroin sessions, only lever H was available. To minimize differences between doses in heroin intoxication before each choice trial, the inter-trial interval was increased with the dose using the following method Lenoir et al , : typical inter-injection interval during continuous self-administration of the available dose ie, 3. Each dose was tested for 4—5 consecutive sessions. Self-administration sessions were run 6 days per week. After extended heroin access, all rats were first habituated to drink water sweetened with 0. During habituation, no levers were extended and rats could obtain saccharin by licking the cup 0. After stabilization of responding for saccharin, all rats were allowed to choose between saccharin and heroin as described above except for the following minor procedural differences. These minor differences, which are mainly due to historical reasons, had no significant impact on choice outcomes see Results. After escalation of drug intake, rats were then trained to respond on lever S for saccharin and then tested for choice as described in the above experiment. After choice testing between heroin and saccharin see above , these rats were allowed to choose between i. All data were subjected to mixed analyses of variance, followed by post hoc comparisons using the Tukey's Honestly Significant Difference HSD test. Comparisons with the indifference level were conducted using a t -test. Proportions were compared using the two-proportion z -test. This apparent discrepancy was due to more TO responses for heroin than for saccharin 6. On average, rats took a total of 2. Such drug pre-exposure was not sufficient, however, to change rats' preference toward saccharin during choice testing Figure 2c. The horizontal dashed line at 0 represents the indifference level. Values above 0 indicate a preference for water sweetened with saccharin, while values below 0 indicate a preference for intravenous heroin. Data in b and c were obtained by averaging individual performances over the last three stable sessions. For other information, see legend of Figure 1a. All data, except in c , were obtained by averaging individual performances over the last three sessions. The previous choice experiments involved rats with no or limited exposure to heroin self-administration before choice testing. They also responded more than ShA rats for the same heroin dose, as measured during the first hour of the last three sessions In total, ShA rats took 2. Choice between heroin and saccharin after extended heroin access. Saccharin sessions alternated with sessions of heroin self-administration. Choice sessions alternated with sessions of heroin self-administration. Individual preferences were computed by averaging preference scores over the last three choice sessions. Effects of a more extended heroin access on saccharin responding and on choice between heroin and saccharin. As expected, total heroin intake gradually escalated over time, from an initial mean level of 1. On average, LgA-9h rats took a total of To test this hypothesis, extended heroin access was discontinued during 3 weeks during which rats were given daily access to saccharin to allow recovery from HW. As expected, acute withdrawal from extended heroin access sHW suppressed responding for saccharin Figure 4d. Three days after recovery from HW, LgA-9h rats were retested for choice between heroin and saccharin during 10 consecutive sessions. They now completed virtually all trials across all choice sessions Performance during HW was compared with the last three preceding choice sessions. Lack of effects of heroin withdrawal on choice between heroin and saccharin. Four out of 10 LgA-9h rats preferred heroin over saccharin. Data in c—e were obtained by averaging individual performances over the last three sessions of each condition. To further assess the impact of past heroin use on the frequency of heroin-preferring rats, a retrospective analysis of all choice experiments conducted in the laboratory, including unpublished studies, was performed. This amount ranged from 0 to To further analyze the relationship between past drug consumption and drug choices, we defined four intervals or levels of past heroin consumption ie, of 2. There was no systematic change in sampling behavior with increased past heroin use, except for a significant increase in saccharin sampling latency at the highest level of past drug use Supplementary Figure S4. In fact, the proportion of heroin-preferring rats tended to be higher than the highest proportion of cocaine-preferring rats at all levels of past heroin consumption, except the lowest one. Effects of past heroin consumption on heroin choices. The number of rats per level of past heroin consumption is indicated below each bar. This study is consistent with previous research in monkeys showing that extended access to heroin, but not to cocaine self-administration, can dramatically increase subsequent drug choices Negus, ; Negus and Rice, ; Banks and Negus, Overall, these convergent findings demonstrate that choice procedures are uniquely sensitive to drug differences and may suggest that heroin is more addictive than cocaine, though other interpretations are possible see below. These findings add to growing evidence for significant addiction-related differences between cocaine and heroin Ettenberg et al , ; Koob, ; Badiani et al , Extending findings from monkeys to rats is important because this can open up new opportunities with significant impact on future addiction research. First, rats are generally more amenable than monkeys to invasive interventions for studying the neurobiology underlying drug choices and preferences, which is currently poorly understood. Second, rats can be tested in large cohorts, an advantage that can prove critical for studying some important features of addiction, such as, for instance, factors underlying individual vulnerability to addiction. Extended heroin access and HW were associated with a robust escalation of heroin intake, as previously shown Deneau et al , ; Ahmed et al , ; Chen et al , ; Vendruscolo et al , , and with the emergence of clear motivational markers of dependence Chen et al , , such as a blockade of normal body weight growth and a suppression of saccharin responding and intake. The latter phenomenon increased with past heroin consumption but gradually returned to normal after prolonged abstinence, confirming previous research in rats Parker et al , ; Lieblich et al , In theory, HW could have contributed to increased heroin choices after extended heroin access by either increasing the reinforcing value of heroin or, alternatively, by decreasing the value of sweet water, or by producing both effects Ahmed et al , ; Koob and Le Moal, Both conditioned and unconditioned heroin or morphine withdrawal has previously been demonstrated to increase responding for heroin in rats Shaham et al , ; Kenny et al , and heroin choices in monkeys, especially at the lowest doses of heroin tested Negus, ; Negus and Rice, However, there was no evidence for a role of HW in increased heroin choices in the present study as this increase persisted even after prolonged abstinence ie, 3 weeks and evidence for recovery of the reinforcing value of saccharin. These behaviorally debilitating effects, probably due to flu-like signs of acute withdrawal, are consistent with previous research using other behavioral procedures in rats Hutcheson et al , and with recent evidence in heroin-withdrawn monkeys choosing between heroin and food Negus, ; Negus and Rice, However, though monkeys completed less choice trials during HW, this effect was not associated with a decrease in heroin intake, as observed here in rats. As a result, rats cannot take a sufficient amount of heroin to avoid the negative effects of HW on performance. By contrast, during sessions of extended heroin access, there is no temporal limitation on heroin intake, which allows rats to rapidly cumulate heroin intake to oppose or prevent the negative effects of HW Kenny et al , As HW intensifies with repeated exposure to extended heroin access, this self-regulation process is supposed to drive heroin intake escalation Ahmed et al , ; Koob and Le Moal, ; Kenny et al , Thus, discrete-trials choice procedures may not be well suited to study acute HW in rats because of their sensitivity to its behaviorally debilitating effects. However, these procedures may be particularly amenable to study protracted affective withdrawal, which can go on for weeks in rats and months to years in humans. Protracted affective withdrawal may explain why heroin preference persists after dissipation of the debilitating effects of acute withdrawal in the present study. At a neurobiological level, there is evidence that protracted affective withdrawal is associated with increased activity in brain stress systems, such as corticotrophin-releasing factor and norepinephrine systems. Chronic activation of these brain systems has been hypothesized to increase the reinforcing value of opiates via negative reinforcement and to enhance the vulnerability to relapse after prolonged abstinence Koob, Importantly, however, chronic activation of brain stress pathways does not always negatively interfere with food reward Dallman, , which may explain why, in the present study, increased heroin choices persisted during protracted withdrawal despite recovery of saccharin intake. If individual drug preference despite the opportunity of making a different choice reflects an addiction-like state, then this large difference may suggest that heroin is more addictive than cocaine Anthony et al , ; Anthony, This conclusion is reinforced by the outcome of our pilot drug substitution study showing that when cocaine is substituted to heroin, heroin-preferring rats rapidly and almost exclusively switch their choice to sweet water. This conclusion is also consistent with other research that have compared the reinforcing value of cocaine and heroin using procedures that minimize the direct effects of drugs on performance. For instance, rats' responding for heroin before the first drug injection is generally higher than rats' responding for cocaine Arroyo et al , ; Alderson et al , ; Everitt and Robbins, ; Lenoir et al , Rats also run faster and without hesitation in a runway to get heroin than to get cocaine Ettenberg and Geist, The hypothesis that heroin is more addictive than cocaine is contradicted, however, by other research showing that rats prefer cocaine over heroin when facing a choice between the two drugs Ward et al , ; Caprioli et al , In one study, virtually all rats 15 out of 16 preferred exclusively cocaine to heroin, regardless of the doses available for choice Ward et al , The origin of this discrepancy between studies is currently unknown and deserves additional investigation. Perhaps the difference between heroin and cocaine in the rate of drug preference is due to the specific kind of nondrug options available ie, water sweetened with saccharin rather than, or in addition to, the addiction liability of the drug per se. There are more synergies and commonalities between sweet reward and opiate drugs, including heroin, than between sweet reward and cocaine Berridge, ; Avena et al , ; Kenny, Second, there are also evidence for cross-tolerance and cross-dependence between opiates and sweet food or drink after chronic exposure Lieblich et al , ; Colantuoni et al , Third, intake of sweet water before withdrawal onset can prevent some of the physical symptoms of opiate withdrawal in morphine-dependent rats Jain et al , Finally, at the neurobiological level, both sweet and heroin rewards depend on nucleus accumbens opioid signaling and are only weakly influenced by midbrain dopamine neurons Ettenberg et al , ; Koob, ; Pecina and Berridge, ; Zhang and Kelley, Opioid modulation of these hotspots amplifies both palatability of and motivation for sweet reward while dopamine modulation of the same hotspots only amplifies motivation for sweet reward. If heroin induces an opioid-like and cocaine a dopamine-like modulation of accumbal hotspots, as one would expect given their respective pharmacology, then this may partly explain the difference between these two drugs in our choice procedure. However, it is not clear how such differential drug modulation of sweet hotspots should translate into more heroin choices than cocaine choices rather than the opposite. Nevertheless, because sweet reward has more similarities and synergies with heroin than with cocaine, it is possible that a different pattern of cocaine and heroin choices would be obtained with a different nondrug reward eg, exercise, sex, or non-aggressive social interaction. Finally, contrary to heroin, cocaine can have, in addition to its rewarding effects, anxiogenic effects, especially in initially drug-naive rats Ettenberg and Geist, Avoidance of these effects may contribute to the difference in drug choices between heroin and cocaine and may explain the rapid increase in sweet choices when heroin was substituted by cocaine in the present study. However, this explanation is unlikely because diazepam—a benzodiazepine that blocks the initial anxiogenic effects of cocaine Ettenberg and Geist, —did not increase cocaine choices Augier et al , , as one would expect if rats refrained from choosing cocaine because of its anxiogenic effects. Several potential limitations to this study need to be discussed. First, as explained above, rats cannot control the rate of drug consumption during discrete-trials choice testing and thus cannot attain or maintain their preferred level of intake. The inability to attain or maintain drug intake at a preferred level may expose rats to the delayed opponent affective effects of drugs that can follow their immediate rewarding effects Ettenberg, , thereby possibly making drug choices more ambivalent than saccharin choices. This factor is unlikely, however, to have a significant role in our procedure, at least in the case of cocaine, because blockade of the delayed negative effects of cocaine by diazepam Ettenberg, did not increase drug choices Augier et al , Second, our choice procedure is apparently not sensitive to drug doses present study; Lenoir et al , , contrary to other choice procedures in monkeys Negus, Clearly, this lack of sensitivity is not due to the dose range tested, because the same dose range can produce significant dose-dependent effects on other behavioral outcomes, including locomotion present study; Ahmed and Cador, ; Lenoir and Ahmed, ; Lenoir et al , , reinstatement of drug seeking after extinction Ahmed and Cador, ; Lenoir and Ahmed, , and rate of drug self-administration Lenoir et al , The apparent lack of dose sensitivity of our choice procedure is more likely due to the large difference in reward value between the drug and saccharin, a difference that was intended to be difficult to surmount to increase the validity of drug preference as a measure of addiction in animals see Introduction. We previously showed that rats can shift their preference toward cocaine only when the value of saccharin is considerably decreased, either by a fold decrease in saccharin concentration or by a fold increase in saccharin cost Cantin et al , Choice procedures in monkeys were perhaps more sensitive to drug doses because the difference in reward value between drugs cocaine, heroin and food was less pronounced than in the present study. Overall, the present study shows that the proportion of heroin-preferring rats increases with extended heroin access and is much higher than the highest proportion of cocaine-preferring rats as measured under similar choice conditions. We interpret this difference as evidence that heroin has a higher addiction liability than cocaine, a difference that may, at least partly, contribute to the differential rate of heroin and cocaine addiction observed in human drug users Anthony et al , ; Anthony, However, more research is needed to test the generality of this hypothesis across a wide range of individual and environmental factors susceptible to influence drug preferences Caprioli et al , ; Kerstetter et al , Finally, we also thank the reviewers for their criticisms. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. Find articles by Magalie Lenoir. Find articles by Lauriane Cantin. Find articles by Nathalie Vanhille. Find articles by Fuschia Serre. Find articles by Serge H Ahmed. Open in a new tab. Click here for additional data file. Similar articles. Add to Collections. 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Drugs in France - statistics & facts

Bordeaux buy Heroin

This story is part of a series exploring harm reduction strategies and drug policies that have been successful in Western Europe. Maybe unexpectedly, people who use drugs also frequent this part of town. Planterose is a small street with cafes, businesses and a coworking space just behind the basilica. In the middle sits what appears to be a hipster, grunge-style cafe. A garage door opens up to an outdoor seating area covered in bright graffiti where people sit sipping coffee and smoking, while their dogs rest against the wall. This is the Planterose DropIn Center, where drug users come to drink coffee, hang out and get clean needles and other materials for safe drug use. Up a spiral staircase are offices for the doctors, social workers, nurses and educators who work with this population. But in France, there are more than harm reduction centers and clinics that offer opioid substitution treatment and other medical treatment to drug users anonymously and free of charge. The French have deployed a number of strategies to reach and support drug users. Some of those include giving them safe places to sleep; checking their street drugs for unwanted substances; and reaching into the countryside to help rural users. The goal behind harm reduction in France is to serve the immediate needs of a person using drugs, as well as make a meaningful connection and build trust. This has been a successful model in France, which experienced a heroin and AIDS epidemic in the late s and early s. Driven mostly by heroin, drug-related overdoses deaths rose 63 percent in five years, reaching a total of deaths in This increase of about 10 percent per year is on par with that in the United States currently. The number of newly diagnosed HIV infections doubled to more than 2, a year over the same time frame. According to the latest French data , overdose deaths have plateaued in the last decade and fluctuate between to a year in a country of 67 million people. In comparison, the U. S had more than 70, overdose deaths in a population of million. And in , the number of new HIV infections in France related to injection drug use dropped to a total of In the U. The French are using hepatitis C treatment as prevention, the idea being that the more people you treat and cure, the less the disease spreads. Last year, harm reduction centers with licensed prescribers began treating for hepatitis C. Delile said that before, only hematologists could treat the infection. Harm reduction centers also conduct rapid tests for hepatitis C and HIV. Additionally, the French health care system lifted restrictions on hepatitis C treatment reimbursement in Before, only those with more advanced stages of the disease could get coverage. Delile, who is based in Bordeaux, said this has already started to work in his city. Prevalence of hepatitis C in Bordeaux has declined from 40 percent among drug users in to about 20 percent presently. Now, there are 10 centers that have mail-order harm reduction programs that involve shipping needles and other supplies to residents in the countryside. Morane Barbarat, a chemist, is in charge of the rural mailing program at the Planterose center in Bordeaux. Do you inject? He tells me his history and how he got into the life. Barbarat ships the supplies they request to a given address. She started mailing orders in the summer last year and had shipped 87 orders to 53 people by November. She encourages those with mail orders to call her whenever they need something or are experiencing a problem. Sometimes people order supplies for their friends as well. Barbarat said that is fine, but she urges the person placing the orders to have their buddies call her so they can talk. Thibaut, a drug educator and social worker who asked we only use his first name , is in charge of the two trucks that go into the rural areas surrounding Bordeaux. He has some regular stops and he also looks for opportunities to meet new groups of drug users who may be squatting in abandoned buildings or at camping sites. Every other week he meets up with another truck that provides showers and help to homeless people. Regular visitors know to expect him there. He brings harm reduction supplies, conducts rapid HIV and hepatitis C tests, and gives prevention advice. His truck is from the Red Cross and still has the old signage on it. Occasionally, his team will take regular unmarked cars into neighborhoods to be more discreet when needed. Marie, a nurse with another truck from the center, said she encounters a lot of seasonal farm workers from the wine industry around Bordeaux. She said many are from Spain or Portugal. Due to the economic situations in those countries, many come work in the French fields. Thibaut said he wants to help drug users make social connections again and build up their character so they feel valuable to society. Marie told the story of one man in his 50s who had been living on the streets a long time with extreme paranoia. She said he refused treatment or psychological help and every social institution in town knew him. Eventually, they had him hospitalized in a psychiatric facility where he got treatment for his paranoia for the first time. He was recently diagnosed with terminal cancer. But she takes comfort in the fact that his life will end in the nicest environment. Another newer development in the French harm reduction landscape is drug checking. There are about 10 harm reduction centers with a chemist on site to check drugs for unknown and unwanted substances. And about 50 sites collect samples and send them to a lab for the same purpose. One cold evening last November, two men brought a portion of their MDMA ecstasy to a harm reduction center in Paris, just north of the city center. One of the men had a bad reaction to his recent supply and wondered if there was something else in it. Sebastian Roquian, a chemist, has spent the past two years doing on-site drug analyses for up to 15 harm reduction facilities across Paris. He took a crumb-size sample of both and ran a few tests comparing them to standard MDMA. He ultimately determined that there was nothing different about the MDMA the men brought in and talked to them about their use of the drug. How often they use it? Did they mix it with alcohol, if so how much? All of these factors could result in a bad reaction. A lot of times they are cut with cutting agents. Sometimes they are very harmful, sometimes not. Sometimes they are strong, sometimes not. Currently in Paris, 50 percent of the drugs analyzed are cocaine, 20 percent are heroin, the rest are ecstasy, other psychoactive substances and stimulants. A few decades ago, the Paris market was saturated with heroin, he said. Most people who take opioids in Paris use morphine tablets, he said. Across the Paris network, he said there have been about five samples with fentanyl in the last two years. The people who brought it in said they bought it on the dark web. Roquian said the costs of drug testing vary depending on the equipment. The method Roquian uses costs about 10 euros for each test, however he added that you also have to pay the salary of the person conducting the analysis. During the day, the facility acts as a harm reduction center with clean supplies for injectors and smokers. There are social workers, nurses on staff, and a psychologist who comes once a week. Also during the day, social workers hold workshops, covering topics such as well being, cooking classes, cultural outings and sports. The social workers said some clients open up and share more during workshops than in counseling sessions. Every day at p. The spots fill up in 10 minutes. In the winter, staff frequently have to turn people away. Admission is 1. More and more people are using the kitchen at night to cook. They can do their laundry and shower. The SleepIn center serves more than different people in a year between housing and day services. Bisset said that one of the challenges, but also strengths of the night team, is that they can work with someone who has clearly used a lot and is actively high. Other homeless shelters would turn those people away. The night staff also give out harm reduction materials until 1 a. There is a rule against using drugs inside the SleepIn center, but Bisset said they know that some do, and there are safe disposal buckets throughout the facility, including the bathrooms. Republish This Story. Taylor Knopf writes about mental health, including addiction and harm reduction. Knopf has a bachelor's degree in sociology with a minor in journalism. Skip to content Read all of our joint coverage with The Charlotte Ledger here. Drug users come to the harm reduction center in Bordeaux get coffee, socialize, shower, do laundry, get clean drug use supplies and talk to nurses and counselors. Photo credit: Taylor Knopf This story is part of a series exploring harm reduction strategies and drug policies that have been successful in Western Europe. So these countries created spaces for them. So it started supporting them. Photo credit: Taylor Knopf. Morane Barbarat, a chemist, shows the standard harm reduction package originally created in the s during the HIV outbreak, but the Bordeaux harm reduction center has all sizes of needles. Thibaut right is a social worker who heads of the rural mobile outreach program from Bordeaux. In , France authorized drug check sites, safe places drug users can bring their samples to see if there are any unknown substances in them. Sebastian Roquian, a chemist, tests two drug samples for unknown substances at a harm reduction site in Paris. The walls behind him are covered with art from drug users and an artist who comes in to work with them once a week. A man rings the bell outside the gate to the SleepIn Center in Paris to ask for harm reduction supplies. Republish our articles for free, online or in print, under a Creative Commons license. Taylor Knopf. Previous Flu causes more hospitals across the state to restrict visitors. Loading Comments Email Required Name Required Website.

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