{"word_count": 3175, "character_count": 21041}
Cecilia Comelli, Elora FahlkeIntroduction For the 13th session of the ISSDP conference, we would like to present a study we conducted as part of the Drug and Urban Security (Drusec) project, which was funded by the French National Research Agency (ANR) and the German Federal Ministry of Education and Research (BMBF) from 2017 to 2020. DRUSEC is a joint Franco-German social science research project that combines approaches from sociology, geography, public health, and substance abuse studies. Its aim is to study issues of public safety stemming from drug and alcohol use in public and semi-public spaces of French and German cities. It is a large-scale project anchored in multiple disciplines, various types of fieldwork, and different research models. For this presentation, we have decided to focus on an issue that a sociologist and a geographer from our team examined here in France: harm reduction in festive settings.ContextWe conducted a qualitative socio-geographic study on harm reduction practices in two festive settings: regular downtown weekend outings, and periodic music festivals occurring in exceptional time and space frames. Research was conducted in two cities of Southwestern France: Bordeaux and La Rochelle.Different festive settings“Ordinary nights out”: these are regular nights out in public spaces or in nightlife establishments (bars and nightclubs, among others). These spaces are attended by a younger population, usually students, from Thursday nights to Sunday mornings. Partygoers do not attend any particular event. These regular outings feature massive binge drinking and, depending on the time frame, the kind of setting, and the profile of users, can feature other drug use.On the contrary, music festivals can go on without interruption over the course of several days. They take place in ephemeral space-time frames. The audience is specific to the concert’s musical genre. There is usually an entry fee, which means the audience tends to be older and more financially stable — at least when it comes to those who enter the festival’s official perimeter. The festival’s periphery (the “off”) tends to attract a younger, more financially precarious crowd who adopt a nomadic lifestyle over the summer. Polydrug use of psychoactive substances happens more frequently in the “off” scene and depends on the musical genre, whereas alcohol is always present.Two French CitiesWe conducted our field work in two student towns of Southwestern France: Bordeaux and La Rochelle. These cities have in common their large student populations and their active tourist industries. In a society where people have more free time, cities have taken on the role of entertainment settings, therefore allowing tourism to expand. Central urban spaces play an essential role in the growth of these industries. Therefore, the main stakes of urban renewal revolve around historical town centers, which have been hosting an increasing number of sometimes recurring events. These events can attract large crowds that sometimes use psychoactive substances, which has led to the establishment of prevention/repression policies in public spaces.Long nicknamed “Sleeping Beauty,” Bordeaux has become increasingly attractive thanks to this urban renewal. Today, 250,000 people live in Bordeaux proper, and one million live in the metropolitan area. The city also harbors 80,000 students and 6 million tourists per year. Regular weekend partying occurs mainly in the recently renovated center of town, where partygoers will find most bar and restaurants. The growth of nightlife in these gentrified neighborhoods can trigger conflicts about the proper use of public space, for the most part in relation to noise stemming from binge drinking among younger people.La Rochelle is a nightlife hub on the coastline with a 75,000-resident count in 2015. One in four of these, including the student population, are ages 15 to 29. As in Bordeaux, nightlife happens mostly in the city center, which is home to regular festive events where some users engage in risky behavior. Attendance varies according to the season, as La Rochelle welcomes large crowds of tourists in the summer. La Rochelle is unique in its combination of regular nightlife attended throughout the year by local residents and ephemeral summer events attended by locals and tourists alike.Nightlife and psychoactive drug useThe first thing we noticed was that psychoactive drug use is inherent to and indistinguishable from nightlife social practices — no matter the musical genre, the type of population in attendance, or the location. The second thing was that as the night goes on, partygoers engage in increasingly risky behavior. This evolution in drug use can be analyzed through the lens of “nightlife stages,” as described in night studies (Gwiazdzinski, 2005). Gwiazdzinski describes three different stages of nightlife, which we witnessed in our fieldwork:- The early stage (until midnight/1am): city administration offices and businesses close after 8pm, which marks the beginning of urban entertainment, particularly on weekends and in cities where tourism represents significant seasonal profits for the local economy. In cities and music festivals, partygoers in the early stage have quite varied profiles. They mostly differ based on the entertainment offer (particularly in terms of musical genres) of the various bars and nightclubs. In the early stage, all ages are mixed. The crowds may include some families, and the atmosphere is quite good-natured. Partygoers exhibit rather safe behaviors and take only reasonable risks when they consume psychoactive substances. The most frequent substance is alcohol, the effects of which become visible toward the end of the early stage, particularly among teens and younger adults. The end of the early stage represents a shift for partygoers, who are presented with two options: go home to sleep or continue to party until early morning.- The middle stage (between 1am and 4am), also called the “heart of the night,” is the time period when most activities have come to a stop. Entertainment only continues in some parts of the city (nightclubs for the most part). When public transportation continues to run, rarer options serve fewer neighborhoods of the city. Even when musical events continue, most music festival attendees leave the venues to get home at the same time that nighttime entertainment closes (bars, restaurants, movie theaters). People who stay out for the “heart of the night” are rather young (18-30 years old); they tend to be intoxicated either with alcohol or with other psychoactive drugs depending on the context. Partying becomes more intense and we have noticed that consumers take more risks.- The last stage of the night is the early morning (after 4am), when the last partygoers meet residents going about the beginning of their day. City life emerges progressively. Partygoers in nightclubs, music festival venues, or public spaces are often heavily intoxicated or under the influence of psychoactive drugs. Substance use depends on the context, the musical genre, and the user profile. This is the period when most episodes of loss of consciousness occur, in part because polydrug use is very frequent among people who party throughout the night.Based on our assessment that there exist diverse substance use practices, we wondered how harm reduction efforts adapt to these different contexts, and whether those who are in charge of implementing public measures of harm reduction take into account the evolution of behaviors and substance use practices throughout the night.MethodsFor our research, we set up a qualitative methodology including 50 interviews with harm reduction actors, along with ethnographic observations in nightlife venues.Interviews with harm reduction experts In Bordeaux, we interviewed harm reduction professionals and volunteers (in CAARUD centers of the CEID and of La Case, and with the techno + organization) as well as elected officials, city government employees, and city police officers. In La Rochelle, we conducted interviews with professionals from the CSAPA (in community organizations and hospitals), the CAARUD (AIDES), social first responders , and city government officials (services for the prevention of petty crimes and officials in charge of the health education and promotion project). Our question grid includes several topics, including harm reduction in nightlife settings. We mainly asked these actors about their respective field interventions among target populations.ObservationsFor our nightlife observations, we were occasionally able to shadow the operations of harm reduction organizations. We conducted observations in the course of interventions in public spaces as well as in the perimeters of nightlife venues. In addition, our researchers investigated music festivals, downtown parties, and harm reduction structures on their own. Our observations focused on several topics, like the social and spatial organization of the locations and events under investigation, the interaction between harm reduction professionals and partygoers, different use practices, itineraries and transit of users, as well as the nature of professional interventions.FindingsOur field observations and our interviews with harm reduction professionals and volunteers allowed us to show that harm reduction approaches evolve according to the three distinct stages of nightlife mentioned earlier and according to the festive context. Harm reduction and the stages of nightlifeIn all contexts of observation, we noticed that harm reduction volunteers and professionals adapt their interventions to evolutions in partygoers’ behavior throughout the night:In the early stage, they mostly set up prevention measures. These measures target all partygoers: potential consumers, their friends, and anyone who might witness the consequences of risky behavior. Efforts to raise awareness about psychoactive drug use — particularly alcohol — usually come in the form of “good practices” and other tips (like staying hydrated, not going out on your own, or keeping a list of emergency contacts, for example). Harm reduction professionals, city government officials, volunteers, or civil service employees often lead this kind of intervention, which can happen at a fixed point or on a vehicle.In the middle stage of the night, harm reduction professionals in the field distribute equipment to drug users: sterile injection equipment (injection kits), snorting equipment (straws), crack pipes. These are often mobile or semi-mobile interventions that aim to meet users where they are.Finally, in the last stage of the night, harm reduction efforts tend to consist of assisting or even rescuing users suffering from loss of consciousness or overdose. In practice, users who suffer from light and benign discomfort are given access to a “chill out” space to rest and relax as they come down their high. Depending on their state, they may be transferred to the nearest hospital.The description provided here simplifies the complex reality of harm reduction practices, as field interventions require harm reduction workers to adapt primarily to users’ situations by effectively combining different types of interventions (prevention, equipment distribution, and assistance).Harm reduction in festive contexts While their governments support and promote the idea that they are nightlife destinations, Bordeaux and La Rochelle also wish to maintain their image as peaceful and orderly cities. With that aim, both cities have adopted local policies that mainly attempt to curb alcohol and drug consumption. Elected officials have made it their goal to wage war against what Isabelle Bianquis calls “bad drinking” (Bianquis, 2012), meaning excessive drinking in public spaces. Thus, in urban contexts, harm reduction has both public health and public safety objectives. Since the early teens, both cities have adopted policies that aim to curb consumption, particularly among younger alcohol consumers. These policies come in many shapes and forms, such as public visual advertisement, nightlife charters, reinforced police presence, or prevention squad interventions.Antidrug policies are implemented in various ways according to the nature of the events: ordinary weekend events, official music festival perimeters, or unofficial festival periphery (camping or parking spaces that make up the “off” area).For regular downtown events, local actors have set up a variety of actions to assist psychoactive substance users. In Bordeaux, harm reduction professionals teamed up with the city government for two types of interventions in the context of the city’s “Alternative festive” (Tendances Alternatives Festives, TAF) policy. The first type of intervention is carried out by the National Association for the Prevention of Alcohol and substance Abuse (Association Nationale de Prévention en Alcoologie et Addictologie, ANPAA). Harm reduction squads are dispatched throughout the tramway system and in downtown nightlife neighborhoods in the evenings of Thursdays through Saturdays, between 6pm and 1am (the early stage of nightlife). The squads spread a message of prevention, harm reduction, and solidarity. They distribute condoms and sliding paper indicators that allow users to measure their blood alcohol content based on the number of drinks they are having.The second type of intervention, “Hangover Café,” is carried out by the Committee for the Study and Awareness of Drug Abuse (Centre étude et d’information sur les drogues, CEID). The “Hangover Café” is open throughout the night from Thursday night to Sunday morning. A team of harm reduction workers drive a truck to various locations throughout the night. From 10pm to 2am, they park on the Place de la Victoire, a gathering place for students with numerous bars. From 2am to 7am, they drive the truck near nightclubs. Unlike the prevention squads, the “Hangover Café” offers a resting space, coffee, water, and harm reduction drug use equipment— particularly snorting straws and some injection equipment.Unlike in Bordeaux, harm reduction in La Rochelle is mostly handled by city government. The city dispatches two substance abuse risk prevention professionals in public nightlife spaces. Their aim is to ensure public safety from consumption-related risks (safety, public disorder…) and to reinforce coordination between different actors of the nightlife scene. The La Rochelle city government risk prevention agents work from March to October, and have extended hours on Thursdays, weekends, as well as during the summer months (June, July, August) to watch over student parties and summer festivals.A harm reduction organization of La Rochelle has recently begun to work in the student party scene. In order to learn more about student consumption practices, they organized a substance testing intervention in a nightclub. Harm reduction organizations do not have a monopoly over nightlife in La Rochelle, whether ephemeral or regular. Two community organizations who do not specialize in harm reduction intervene in the festival scene: the Association for the City’s Student Fund (association de la foundation étudiante pour la ville, AFEV) and the Free and Anyonymous Center for Awareness and Screening (centre d’information, de dépistages et de diagnostics anonyme et gratuite, CEGIDD). During the Francofolies festival, for instance, they set up prevention and awareness measures like free water distribution, alcohol intake awareness cards, and information pamphlets. These organizations focus mainly on alcohol consumption, and they are the only ones present in the festivals of that region.Access to exceptional events like music festivals is generally ticketed. For example, access to the Francofolies festival costs between €25 and €60 per evening. On top of audiences who come to see the concert, this kind of musical event always attracts a crowd of people who decide to stay outside the official perimeter of the festival (the “off”). In La Rochelle, these “off” spaces feature no harm reduction interventions targeting psychoactive drug users. On the other hand, city police forces and the Red Cross (for first aid responses) are present in the area. However, harm reduction interventions can sometimes take place in the “off” festival areas, as is the case in festivals of the Bordeaux region, where CEID professionals are present to distribute equipment.Fixed and mobile harm reduction We noticed that harm reduction interventions can be fixed (in the case of harm reduction stands and booths) or mobile (where harm reduction actors meet users where they are). Within official music festival perimeters, harm reduction seems to be more stationary, while they tend to be more mobile in the “off” area. Downtown, there is a combination of sedentary and mobile interventions, always with the aim to meet users where they are.In the eyes of professionals, harm reduction interventions in festive settings, whether mobile or stationary, have two purposes: the first is to impact the user population directly; the second is to raise awareness about harm reduction among partygoers, who are often younger and who engage in more risky behavior. In downtown nightlife events and in festivals, harm reduction actors can gain visibility and raise awareness about the different services they offer throughout the year and the locations where they operate outside of festive settings.Obstacles to harm reduction in festive settingsSince the 2004 public health reform, harm reduction in festive settings has become a recognized mode of action in its own right. However, several issues compromise the implementation of these measures.First off, harm reduction actors in festive settings need to be “flexible.” They must adapt their strategies to the evolving stages of the night and to the norms and values of the nightlife social spaces where they take action. Nonetheless, harm reduction in nightlife settings remains optional for established structures like rehabilitation and drop-in centers. Even though social workers hope to widen their impact among all types of populations, they continue to face several obstacles.Harm reduction in festive settings faces difficulties acquiring recognition and securing a legitimate status for the various workers taking action in this field. Still, today, this type of harm reduction intervention is recognized by the majority of actors in the broader field of harm reduction as a precious tool for assisting drug users.Harm reduction in festive settings, which remains optional, has been sidelined by some organizations due to lack of financial or human resources. Difficulties also stem from the necessity to conform to labor laws (work hours, resting time). These aspects of human resources need to be factored in even as nightlife events occur mainly during weekends, at very specific hours, and sometimes over the course of several days. Additionally, funding is not predictable, and this type of intervention relies on a system of calls for tenders that does not allow to create projects in the long term. This pushes organizations to abandon nightlife interventions or to use budgets that were not originally intended for this type of activity. This type of harm reduction, specific to festive settings, has thus become a typically underfunded branch of harm reduction.ConclusionThrough the research we conducted, we noticed the absence of uniformity in harm reduction implementation in festive settings. The implementation of these specific types of interventions largely depends on local political moods and on the organizations’ ability to set them up. Elected representatives seemed most concerned with massive binge drinking.However, in the fields we observed, we noticed that professionals adapt to the progressing time stages of nightlife. As the night progresses, psychoactive drug use rises, which leads users to take higher risks. On top of these adaptations, professionals also adjust their actions to the type of event (regular or extraordinary) and to the type of population they seek to assist.Although harm reduction actors are as flexible as they can in legal events, illegal events continue to pose problems. Our research needs to be complemented by a study of illegal events, especially as partygoers in illegal events tend to display particularly risky behavior through polydrug use. Because these events are hidden, few harm reduction professionals know where and when they take place. In that context, only community actors like “Techno +” are able to take action, because they often know about future events thanks to their ties with the techno movement and its volunteers.Citer cet article: Cécilia Comelli et Elora Fahlke, "Night-time drug policy: adjusting harm reduction implementation strategies in nightlife festive settings in France," contribution au colloque de l'ISSDP, 2019, https://drusec.hypotheses.org.