For Lucas*, it all started with simple exchanges of messages on social networks during his second year. While the friends in his class test their limits by discovering strong alcohol or the effects of a joint, the high school student does not take a liking to these substances. On Instagram, a friend then told him about codeine, an opioid drug most often used to relieve coughs or certain pains. The product is in fashion: American rappers widely promote it in the lyrics of their songs, while the consumption of “purple drank”, a homemade cocktail made from codeine drugs and soda, is spreading everywhere in France.
At 15, Lucas buys his first bottle of syrup after school. The effects are immediate. “It cleared my head, I felt calm, that’s what I had been looking for for a long time. But in three months, I became addicted,” he says. Eight years later, the young man has just been taken care of by the Lyon resource center for drug addiction (Cerlam), specializing in the treatment of drug addiction.
“It all happened,” summarizes Lucas. For two years, he first made the rounds of pharmacies in his city to obtain codeine-based products, at the time available over the counter. “Some refused, others saw me pass four times a week and continued to sell me some.” In July 2017, when the Ministry of Health decided to limit its sale to only users in possession of a prescription, the teenager stopped his consumption, began to smoke cannabis, relapsed. He ends up getting doses on the Internet, or directly via dealers he contacts on Telegram. At the same time, he discovered “benzos” – for benzodiazepines, these anxiolytics prescribed on prescription to calm stress, anxiety or insomnia. Then comes the Covid, its confinements, its anxieties. “That’s when I consumed the most. I really became dependent: I was on three bottles of codeine syrup per week, three boxes of Phenergan to accentuate the effects, and about ten alprazolam [NDLR : l’anxiolytique le plus prescrit en France, plus connu sous son nom commercial, le Xanax].”
For “500 to 700 euros per month”, Lucas becomes a ghost. He goes to bed at 6 a.m., wakes up at 6 p.m., remembers only bits and pieces of this period. “However, I always had the feeling of not being addicted, of taking rather small quantities. But at the moment, I really want to separate myself from that.”
He is not the only one. Chief coordinator of Cerlam, Professor Benjamin Rolland observes “an overall increase” in requests for care among the youngest, “for addictions to all types of products”, including drugs. Although a minority, those under 25 admitted for an addiction to anxiolytics or opioids represent between 5 and 10% of patients treated by the center, which opened its doors a little over a year ago. “This phenomenon is reinforced by a general state of malaise among young people since the pandemic, the consequences of which go far beyond the sole addiction to certain substances”, he laments.
“Since the Covid, it has only increased”
Despite the return to normal life since covid, Dr Jean-Michel Delile, president of the Addiction Federation, observes with the same concern the massive development of lasting anxiety states in the youngest patients. “In such a context, the consumption of anxiolytics tends to increase, for longer and longer durations and even though this type of treatment should not be prescribed for more than three or four weeks”, explains- he.
A phenomenon observed by the High Council for the Family, Childhood and Age (HCFEA), which made at the beginning of March a report on the subject. For the year 2021 alone, the organization points out that the consumption of anxiolytics in children and adolescents increased by 16%, with 86,756 additional issues “compared to the expected results” for the period. At the same time, the reduction in budgetary resources in child psychiatry would no longer make it possible to accommodate children and their families within “a reasonable time”, nor “to associate these medications with regular specialized monitoring”, regret the authors of the document, who recall that only 597 child psychiatrists were listed in France on January 1, 2020, with an average age of 65 years.
“These drugs can be very useful for patients, and they should in no way be banned, nor should they be thought that they trigger an addiction at the slightest intake”, nuances Dr. Delile. “But you have to be aware that these substances can indeed, in certain cases, lead to a risk of dependence with problems of loss of control”, explains the psychiatrist, ensuring that he receives more and more requests from minors or their relatives for regular consumption of tranquilizers and psychotropic drugs. “Unfortunately, this phenomenon is in full development,” he breathes.
“Out of ten calls concerning minors, I will receive five for alcohol, two for cocaine and three for drugs, in particular for addictions to anxiolytics or certain opioids. Since the Covid, it has only increased “, abounds Jean-Charles Dupuy, responsible for answering the number set up by the association SOS Addictions. Some of them have become dependent after prescriptions for anxiety attacks or insomnia, while others have obtained the products directly from their parents’ medicine cabinet, or even from their dealers. “They then use them for the sole purpose of getting high,” says Jean-Charles Dupuy.
“I received the stamps in my mailbox”
“This is the problem with these substances: despite a certain awareness of doctors in recent years and a trend towards fewer prescriptions, there is a whole use that escapes us. The consumption of minors without prescriptions is extremely difficult to quantify”, explains Nicolas Authier, psychiatrist and director of the French Observatory of analgesic drugs (Ofma). Especially since the youngest sometimes only have to help themselves from the medicine cabinets of their loved ones: according to the most recent figures from the National Medicines Safety Agency (ANSM), France is, behind Spain, the second highest consumer of benzodiazepines in Europe. In 2015, 13.4% of the French population had used this type of substance at least once, and their treatment had been undertaken by a general practitioner in 82% of cases.
Same observation for so-called “strong” opioids (fentanyl, morphine or even oxycodone), the prescriptions of which increased “by around 150%” between 2006 and 2017 in France, according to the latest ANSM study on the subject. The consequences are direct: the number of hospitalizations linked to the consumption of opioid analgesics obtained on medical prescription thus increased by 167% between 2000 and 2017, and the number of deaths linked to this same substance jumped by 146% between 2000 and 2015, with “at least four deaths per week”.
To get his “benzos” or his codeine, Lucas never went through the office of a general practitioner. The young man obtained alprazolam from his grandfather’s stock, or directly from his dealer and on the Internet. “The pills cost between 4 and 5 euros. For codeine, the bottle of syrup went to around fifty euros after the law of 2017. Honestly, it was not so difficult to get some: I received that in my mailbox!”
Finding the drugs, “it was easy”, also remembers Juliette Boudre, whose son Joseph died of an overdose of opiates and benzodiazepines in December 2016. Two years earlier, at the age of 16, the teenager is prescribed Xanax by the doctor of the boarding school where he is educated in England, after an anxiety attack linked to the consumption of cannabis. Returning to France for the Easter holidays, it was not long before he unearthed new doses of “benzos”, simply by multiplying medical appointments. “Joseph set up a whole manipulative mechanism to get them: he couldn’t sleep, his pulse was accelerating, he felt like he was having heart attacks every quarter of an hour… And the doctors distributed the prescriptions”, says his mother, who particularly remembers the analysis of one of them. “Better to sleep with a drug than not to sleep at all, madam,” the practitioner slips to her. “And fall asleep forever, what do you think? That’s what I want to ask them today,” she says.
Because two years after his first intake of Xanax, and despite several detoxification treatments, Joseph relapsed. “His consumption was a cocktail of benzodiazepines and opiates, Lexomil, Xanax, codeine, morphine, which he obtained without any problem”, list Juliette Boudre. Until one evening in December when, on vacation in the south of France, the young man buys a dose of fentanyl from a dealer in a fairground. He mixes this extremely powerful opioid painkiller with benzodiazepines. The cocktail is fatal to him. “What is terrible is that Joseph is not the only one to have fallen into this, far from it. You have to realize that these drugs are far from harmless,” insists his mother. On April 26, a TV movie inspired by the story of Joseph gathered more than 3.5 million viewers on France 2. “Since then, I have received more than 600 messages from parents or relatives of minors stuck in this addiction. Every day, they tell me of their despair. The Covid hasn’t helped anything, we have to react,” says Juliette Boudre.
Professor Amine Benyamina, president of the French Federation of Addictology and head of the psychiatry and addictology department at the Paul-Brousse hospital in Villejuif, warns: “We have more and more young people who use these drugs in an indirect way, simply because they can get them in the most normal way in the world. Add to that the fact that they have been trivialized for a very long time, and do not carry the same ‘dangerous and illegal’ label as cocaine or heroin… And you get the situation we’re in today.” If the French phenomenon is in no way comparable to the scale of the crisis in the United States, where 100,000 people died of an overdose between 2020 and 2021, of which two thirds were due to the consumption of opiates, Dr. Benyamina insists on the need to carry out an in-depth study on the subject: in the coming weeks, a mission in this direction should also be entrusted to him by the Minister of Health François Braun.
*The first name has been changed.