Crime Reduction Partnerships
Reducing the Risks without Excluding: A Community Approach in Accompanying Drug Users
(Please note this page has been translated for Internet publication into English from French.)
Nature of the activity
A set of actions dealing with prevention and accompaniment for the benefit of drug users: low threshold greeting, drug related risks reduction program, prevention of AIDS and hepatitis, communal solidarity.
Main objectives
To reduce risks linked to drug abuse.
To support drug users in a policy of insertion thus preventing their exclusion and marginalisation.
To conciliate assistance to drug users and respect for the preoccupations of the local residents; make the latter aware of the Association’s activities and encourage them to join.
To develop solidarity in the neighbourhood.
Population concerned
Drug users, young people and local residents.
Area of activities
Quarters of the Association and the streets of the Goutte d’Or neighbourhood of Paris.
Beginnings
1987 Creation of the association.
1995 Syringe exchange program.
In the beginning
The Association Ego was founded in 1987 to satisfy the wishes of drug users of the Goutte d’Or neighbourhood. Since then, its activities have been based upon three forces: the local residents, the users, as well as the professional and voluntary technicians. The main idea is that each individual has a certain knowledge and can contribute to optimise action.
Personnel
Ego has a staff of eighteen permanent employees of which nine operate in different domains (sanitary, social, reception, journal etc.). A medical aide, an educator, co-ordinators and administrators complete the team that is supported by an important number of voluntary workers. Among the hired members of the Association, many ex-volunteers live in the neighbourhood.
Functions of the activities
Ego has constituted its own poles of activity, complementary to other welcoming and lodging structures of the neighbourhood: Sleep'in, the Boutique, and the Terrasse. They have created a meeting place for drug users.
'Low threshold greeting' is a sixty metre square quarter. Lia Cavalcanti defines it as a space for re-socialisation that functions as a lever to avoid exclusion. Users can read, play games, converse and relax while being treated as individuals rather than drug users. Every Wednesday at 7pm, an open debate gathers users, staff, volunteers and visitors. More than forty people will then sit in a circle and discuss. Talk is about the functioning of the welcoming committee, the problems or conflicts that might have arisen during the week, the scarcity of the available space, the future of Ego… and each one brings propositions to continue to build this common space.
Ego isn’t satisfied just by greeting volunteers; at first a group called 'Première ligne' (First line) set out to meet the more marginalised who had cut away from the specialised structures. Today, this work is insured by a specific mediation method and put to practice in three different districts. The welcoming committee greeted 13,000 visitors in 1999, of which 11,600 were users and 891 were inhabitants, and business keeps growing. Last year, 16,596 visitors were counted, of which 13,926 were users.
A place to pause and to reflect, the greeting place is also an information and orientation centre in response to various requests: lodging, legal or administration problems, or medical-weaning, substitution, residential treatment.
STEP, created in 1995, is a program both for syringe exchange as well as for the distribution prevention and risk reduction material. At La Chapelle boulevard quarter, the committee welcomes in those who wish to acquire the clean shoot kit, hygiene products or condoms; it recovers used syringes, passes on information or advice, and leads the persons towards sanitary or social structures depending on the problems expressed; 86% of requests have to do with socio-sanitary problems, the rest pertaining to lodging and employment. The established dialogue aims to give responsibility to the users as to the risks induced by practices towards self or environment.
An active line of 1,928 people was recorded for 14,742 visits in 1999, with an average of 41 visits per evening, mostly men. In 2000, 17,662 visits were recorded with active contacts for 1,982 of them. STEP deals mainly with the prevention of AIDS and hepatitis and is also frequented by non-users in need of condoms or general information.
'Nutrego program' offers balanced meals to sick and/or marginalised persons from 1pm to 3pm every day and from 2pm on Wednesday; the goal: to fight against malnutrition among drug users, their vulnerability factor, and reinforce their immune system. The program gets benefits from the ‘Au pétrin d’antan’ bakery, from l’Intermarché de Paris and from the City of Arcueil’s food bank. Nearly 7000 meals were distributed in 1999, with an average of 27 to 30 meals per day, 7,602 meals in 2000.
'Alter ego' is a trimestrial journal issued by the members of Ego, users and regular personnel; many articles with information and advice on hygienic and social prevention are given, allowing users to express themselves.
Research and development sector
The association also animates a participative development-action activity in two to three-day seminars, open to all, based on social work, prevention, operation and reduction of drug abuse and related risks. Studies are held each year on different aspects to do with drug use on the territory, for example, crack consumption on the rise, poly-drug-use… For these studies, Ego is an interesting observatory, receiving trainees and students able to use statistical elements regularly up-dated during the activity.
Ego believes in the community by way of three principal elements:
1. | An understanding of the neighbourhood's inhabitants while looking for answers for the users, answers taking into account the preoccupations, needs, history and culture of the neighbourhood. For instance, the weekly meetings at the greeting place, open to the neighbourhood, allows the expression of all; users and locals can thus exchange in this framework it becomes a place of mediation. |
2. | The Association’s efforts to help the locals understand its actions, initiate a new outlook, less stigmatising for the users, and bring concrete answers for their preoccupations; for example, claims concerning the discarding of syringes in dangerous places, accessible to children, lead the Association to deal with the users about this, the latter then becoming messengers to other users in a prevention campaign on the subject. The old group, Première ligne (First line), now Co-ordination toxicomanie 18 is devoted to this dialog with the population. |
3. | In terms of communal aid, an area was opened in the neighbourhood where inhabitants can come to fill out forms or get help for an administrative problem, make a photocopy or a phone call, all this allowing them to observe the users in another frame rather than the one that worries and promotes rejection (stair-wells, the street, dealing corners…). |
Observations
Three elements of this experience deserve to be particularly underlined:
the role of the inhabitants of the neighbourhood
the impact of the animators personality
the interest and the limits of the particular frame offered to drug users.
The inhabitants as the strength of the programme
Ego’s philosophy is based upon a principle of non exclusion, non judgmental attitude and respect of the individual, whatever their situation. There is also a pragmatic position about drug users: when the goal of abstinence becomes an illusion, teaching needs to be in place on how to manage and eliminate related risks. However, to offer a place for such an addition can provoke worries from the non using population. It is essential to take into account the inhabitants of the neighbourhood as they are inevitably victims of the nuisances provoked by the concentration of drug users on a given territory.
For the last few years, there has been a mobilisation of shopkeepers and inhabitants of the XVIIIth district of Paris, including judicial proceedings against programmes for drug users implemented in these areas, and this has gone on to attract more and more users to the same area. Ego has not been subjected to these pressures because of its constant concern to integrate the different parts of the neighbourhood in its processes.
The dialogue with the inhabitants, already fully part of Ego’s processes, has become an important dimension of any action led on this territory and it is in this frame that the ‘drug abuse co-ordination programme XVIIIth district’ driven by the DDASS, has been implemented in three areas of the district.
The impact of a dynamic and multidisciplinary team
Another detail of the practice is the creativity brought by the team coming from different origins. Each one of them has a course where life experience more than diplomas appears in the situations encountered by the drug users. This team diversity and its enthusiasm exist not only with users but also in the connections that the association builds with other professionals in the network. The team’s diversity also appears through complimentary knowledge: empirical (experience of drug use), cultural (knowledge of the local culture), technical (theoretical and methodological knowledge) and is mobilised for intervention. This joint knowledge seems to be one of the keys of the experience’s success.
Interest and limits of this particular frame
If the reception of drug users and the whole activities of Ego exist as a lever to promote drug user's insertion, this lever function can only succeed if public services in common with the public institutions involved are truly able to take over from a real insertion course. Through care, access to housing, psychological or psychiatrical follow up, social and educational accompaniment and access to and then maintenance of employment.
European Crime Prevention Award 2001 Jury Assessment
The jury is extremely positive about the way in which the Association Ego has been providing drug-users with help and trying to reduce the risks of drug usage in the Parisian district Goutte d’Or since 1987. The approach includes the provision of a special meeting place, the provision of clean needles and meals for weakened addicts. The strength of the project lies in the intense contact between professionals and volunteers, addicts and local residents. A project that deserves continuation and imitation.
Last update: Wednesday, August 08, 2007