Question 17995 — places of deprivation of liberty

Summary

Ms. Andrée Taurinya questions Mr. the Keeper of the Seals, Minister of Justice, following his visit on July 23, 2025 to the Roanne detention center, on public health policies capable of eradicating the HIV and HCV epidemic in prisons. During her visit to the USMP, the MP questioned the management of the establishment about the continuity of care between the open environment and detention and in particular the availability of risk reduction tools. This approach makes it possible to consider addiction as a chronic illness without denying the illicit nature of certain uses, which is aimed at people whose practices prove dangerous for themselves and others. According to accessible data from the Prévacar survey (2010) which needs to be updated, the prevalence of viral hepatitis C (HCV) is estimated at 4.8% among prisoners, including half with a positive viral load, the mode of contamination depending on drug use in 70% of cases. The prevalence of human immunodeficiency virus (HIV) was 4.5 times higher than in the general population, or 1.04% of the detained population. However, 53.5% of the prison population suffers from a substance use disorder compared to 12.9% in the matched general population (Fovet, 2022, France). According to the OFDR survey ESSPRI (2023) relating to the level of use of psychoactive substances among prisoners, 49% declare having used cannabis, 13% cocaine, 4.7% crack, 5.4% ecstasy, 5.1% heroin. 3.5% of them have resorted to injecting a drug or a substitute product during their detention. In a context of continued increase in prison overcrowding, prison remains a significant source of transmission of HIV and HCV. However, continuity of care is not ensured regarding the availability of RdR tools. This is what the Addiction Federation's 2023 survey reveals on the working conditions of addiction treatment, support and prevention centers (CSAPA) in prison. Thus, 32% of CSAPAs surveyed affirm that vapes are available in their establishment, 29 % for “roll your straw”, 22% for bleach. More seriously, only 5% of the CSAPAs questioned affirm that mouthpieces, aluminum filters, crack pipes, syringes are available to prisoners as part of exchange programs (PES) while nearly 3,000 prisoners would be required to use used equipment, thus aggravating a major public health problem. When the MP asked the very concrete question of implementation of a needle exchange program in an establishment housing nearly 600 prisoners, the prison administration responded that addiction awareness days were already planned for the year. The nursing staff working on site confirmed to the MP the extreme difficulty of making this type of tool available given the silence and inertia of the establishment's management. in this matter. It is common knowledge that drugs circulate in prison environments, the pages of Le Progrès having reported this concerning the precise situation of the Roanne detention center. Law No. 2016-41 of January 26, 2016 to modernize the health system made it possible to extend the principle of continuity of care between the open and closed environment to the RdR. The Council of State recognized that the application of this policy to detained persons is not subject to prior intervention by the regulatory authority - as the Minister recalled in his response of April 8, 2025 to the Member's written question no. 2766 (OJ of December 10, 2024, p. 6548). Consequently, the principle of equivalence of care between the open environment and the closed environment concerning RdR makes Decree No. 2005-347 of April 14, 2005 approving the framework directly applicable. national risk reduction actions for drug users, which is therefore applicable in detention. However, according to the latest news, the requests of the on-site nursing staff have been ignored until now by the management of the establishment. She therefore asks him to indicate the measures he will take to make effective the availability of RdR tools at the Roanne penitentiary center as in all of the prisons. establishments placed under its responsibility.

Machine translation from French. The official text remains authoritative.

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