Unlike the U.S. where crack cocaine is predominantly with bicarbonate soda, in France, crack cocaine is also derived from cocaine powder cooked with ammonia that take the form of “rocks” ready to use by smoking or injecting routes, named “crack”. Crack cocaine is sometimes further prepared with bicarbonate soda forming a freebase crack cocaine variety. The minor differences in preparing and labeling terminology of different subtypes of crack cocaine are considered to be social distinguishers  [19].

While the presence of crack cocaine was first documented in France in 1986 by arrest record data from the Office Central du Trafic et de Répression des Stupéfiants and it wasn’t until the mid-1990s that ethnographic data first described crack cocaine use in public spaces in Paris [20, 21]. The general framing of crack cocaine in France is characterized by both an intersection of open drug use in public spaces with crack cocaine’s associations with low socioeconomic communities. In France, illicit drug use was criminalized by the Law of December 31st, 1970, which is also included in the Public Health Law Code [7]. France can be considered a paradox because the country has a repressive approach to drug policy, quite like the U.S., but at the same time has implemented a strong, publicly funded drug treatment system in the 1970–1980s followed by harm reduction services to better address the health needs of people who use drugs since the 1990s [7]. Since the onset of the HIV/AIDS epidemic, France has largely focused efforts on accessibility to harm reduction by focusing on drug treatment for opioid use without a strong effort to support people experiencing problematic crack cocaine use even if there are intersections between stimulants use and opioid substitutive treatments use [22].

Notably, in France, crack cocaine has not been framed as a public health epidemic, even with the trend of crack cocaine use and the rise of open drug scenes in Paris and its suburbs [6]. The origins of the French response to people who use crack cocaine can be traced to a spike of increased crack cocaine use in France in the early the 2000s with data showing foci in Paris, North-East suburbs, and overseas territories including French Guiana and Réunion [5]. More recent French public health surveys demonstrate crack cocaine is one of the most commonly used illicit substance, after cannabis, by people who engage with harm reduction services and drug treatment centers [23]. This substantial increase in the number of people who use crack cocaine led to the creation of harm reduction tools such as the dissemination of clean crack pipes. In 2019, in response to the increased visibility of open drug use in Paris and its suburbs in public spaces, the city of Paris, regional health agency, and Ile de France Prefecture implemented a “Crack Plan” to improve access to harm reduction services and social housing for people who use crack cocaine openly in Paris. The “Crack Plan” also proposed to strengthen the harm reduction services for people who use crack cocaine by increasing a public-funded healthcare model that is embedded in the French model of welfare state that strives to protect the most vulnerable populations [24]. Indeed, since 2020, access to housing for people who use crack cocaine living in precarious conditions has increased in Paris, thanks to the COVID-19 pandemic that paradoxically helped the harm reduction providers to transform this topic into a priority [25]. At the same time, a repressive policy towards crack cocaine open scenes and users who lived in these deprived areas is still present in France, especially in Paris and its suburbs where open drug scenes are visible. In September 2021, this repressive policy was symbolized by a wall that has been built to avoid people who use crack cocaine to move again to a residential area in the North-East of Paris [26].

In contrast with racial considerations in American policy, racial designations based on self-identification are not available in France.. Even though no statistical data on race is explicitly collected, the first ethnographic data about people who use crack cocaine in the early 1990s described them mainly as people from former French colonies in overseas territories, which mainly implies they are people of color [21]. To add, the racial crossroad is further reflected with the terminology of Parisian crack cocaine dealers referring to themselves as modous a word that stems from the Mouridi community from Senegal, as a product of past French colonization in West Africa [5]. Further qualitative ethnographic data demonstrates an intersection between people who use crack cocaine and migrants- another term that elicits proxy terminology and highlights racial and ethnic inequalities from postcolonial France [6, 27]. The French media depiction of crack cocaine often supposes a relationship between people who use crack cocaine and migrants, but it is interesting to note that migrants are often presented in media as victims of malevolent drug dealers [27, 28].

Importantly, the French framing of crack cocaine is not without a racial dimension as drug policy and the criminal justice system exhibit formidable ties. Discrimination and structural inequities regarding arrests and incarceration according to race have been documented by quantitative social science research [29]. Additionally, ethnographic studies have described an overrepresentation of people of color in French prisons coupled with a threefold increase in court appearances and higher arrest rates for foreign-born French nationals [30, 31]. The difficulties for highlighting explicitly racial inequities can be partially explained by the “ French Republic Universalism” prism that claims that all French people who belong to the same nation need to be considered as “equal citizens” with the “same rights” regardless of their origins. This framing brings about a color-blind political discourse that is unable to publicly recognize that discrimination against people of color according to the French colonialist ideology  [32].

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