FRANÇAIS :
Les Centres d'accueil et d'accompagnement à la réduction des risques pour usagers de drogues (CAARUD) s'adressent en priorité à des publics vulnérables et constituent depuis leur mise en place, il y a dix ans, un élément central de la politique de réduction des risques et des dommages (RdRD) en France. Chaque année, les structures adressent à la Direction générale de la santé (DGS) et aux Agences régionales de santé (ARS) un rapport d'activité standardisé ; ceux-ci sont ensuite transmis à l'OFDT pour y être analysés.
Ce numéro de Tendances présente les résultats de l'exploitation des rapports d'activité de la totalité des CAARUD recensés sur le territoire en 2014, soit 144 structures.
ENGLISH:
The support centres for the reduction of drug-related harms (CAARUDs) represent a central aspect of the policy on harm reduction measures in France. These 144 low-threshold centres are aimed at vulnerable populations exposed to major risk due to their substance use habits. Their missions are to prevent and reduce harm related to substance use and to improve the social situation of users.
This analysis of the 2014 CAARUD activity reports offers a comprehensive overview of the geographical coverage of the scheme, the resources used and the intervention capacities of the facilities. The CAARUDs play a central role in distributing prevention material, alone responsible for more than half (55%) of the syringes dispensed to injecting drug users. Although the true needs of drug users are difficult to identify, the difference in the situations is striking: location of CAARUDs restricted to large cities, varying and often fairly restricted opening times, very low representation of the female population. Although all CAARUDs everywhere share the same missions, the small teams in certain facilities, and the lack or inconsistency of professional qualifications at many facilities raise questions as to whether all users can have access to the same level of harm reduction services.