# France's overdose deaths nearly tripled in a decade, police drug office says, reviving fines-or-care debate

An Ofast note puts 2024 direct overdose deaths at 659, against 243 in 2014; about half involved methadone or buprenorphine, and the survey's coverage has grown.

By 567 Politics staff · 567politics
Published: 2026-11-10T02:20:48.035366Z
Updated: 2026-11-10T02:21:34.972369Z
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Deaths from drug and medicine overdoses in France have risen from 243 in 2014 to 659 in 2024, an increase of 171%, according to a note by the Office antistupéfiants (Ofast), the police agency that leads the fight against drug trafficking, reported on Monday by [AFP via franceinfo](https://www.franceinfo.fr/sante/les-overdoses-ont-plus-que-double-en-10-ans-alerte-l-office-antistupefiants_8275040.html) and by [RTL](https://www.rtl.fr/actu/justice-faits-divers/info-rtl-de-243-a-659-deces-par-an-le-nombre-d-overdoses-en-france-a-quasiment-triple-en-10-ans-7900693713). The note says drugs in France are more available, purer and cheaper than a decade ago, and that new synthetic substances add "a threat to public health."

The figures land in the middle of a political fight over how France treats people who use drugs. In July, Parliament adopted the government's RIPOST law, which raised the on-the-spot fine for drug use from €200 to €500 on the argument that users finance the trafficking networks behind a wave of killings. Addiction specialists and a group of big-city mayors argue that the rise in deaths calls for the opposite emphasis: naloxone, supervised consumption sites and a legal shield for people who call for help.

The headline figure needs a caveat. The source behind it, the DRAMES survey, counts deaths that toxicologists and forensic doctors choose to report, and it does not cover the whole country. Its long-run trend is therefore an indicator, not a complete register.

## What the numbers show

The Ofast note relies on the DRAMES survey ("deaths related to the abuse of medicines and substances") run by the addiction-monitoring center at Grenoble University Hospital with France's medicines agency, the ANSM. The [2024 results](https://ansm.sante.fr/uploads/2026/06/12/20260612-plaquette-drames-2024.pdf), published in June 2026, list 718 deaths: 659 caused directly by one or more substances and 59 indirectly, such as drownings or falls. The direct count is down from 732 in 2023, which RTL said was the peak of the series.

The 2024 victims were aged 14 to 71, with an average age of 39. Men accounted for 79%. Where the place of death was known, 61.8% died at home, 12.1% on the street, 6.6% in hospital and 2.4% in prison.

The largest share of deaths did not involve street drugs alone. Methadone and buprenorphine, opioid medicines prescribed as substitutes for heroin, were implicated in 338 of the 659 direct deaths, or 51%, according to the Ofast note as reported by AFP. The DRAMES report breaks that down into 280 deaths involving methadone and 58 involving buprenorphine. It puts the death rate at 3.9 per 1,000 people treated with methadone and 0.6 per 1,000 for buprenorphine, so methadone carries a risk about 6.5 times higher. Cocaine was implicated in 222 deaths and heroin in 75.

```chart
type: bar
title: Substances implicated in direct overdose deaths in France, 2024
note: Deaths can involve several substances, so the bars add up to more than the 659 total. Cannabis is counted only where a heart condition or seizure was found.
source: [ANSM / CEIP-A Grenoble, DRAMES 2024](https://ansm.sante.fr/uploads/2026/06/12/20260612-plaquette-drames-2024.pdf)
---
Substance | Deaths
Methadone | 280
Cocaine | 222
Heroin | 75
Cannabis | 65
Buprenorphine | 58
Amphetamines, mostly MDMA | 41
Cathinones | 28
GHB | 17
Ketamine | 14
```

The chart shows how much methadone dominates. The DRAMES report says the combination of methadone and cocaine remains the most frequent pairing when a death involves two or more substances. RTL quoted the Ofast note as saying that cocaine went from 7% to 34% of deaths between 2013 and 2024, "notably because of an association with methadone."

Some trends point in different directions. The DRAMES authors say cocaine-related deaths fell from 2023 to 2024, in both number and share, and heroin deaths continued a sharp decline. Deaths involving cannabis, amphetamines, ketamine and new psychoactive substances kept rising. The Ofast note says deaths involving amphetamines, mostly MDMA, have exceeded 40 a year since 2023, against 17 in 2022.

### Why the long-run comparison is uncertain

DRAMES is not a census. In 2024, 796 notifications came from 64 experts in 32 laboratories and services covering 85% of French departments, the report says. Deaths without blood toxicology, suicides, homicides and road deaths are excluded. The sources reviewed for this article do not say how many departments the survey covered in 2014, so it is not possible to tell how much of the 171% rise reflects more deaths and how much reflects wider reporting. The Fédération Addiction, a network of addiction services, cites a narrower comparison from the same survey: 503 direct deaths in 2019 against 659 in 2024, a 31% rise in five years, in a [statement on Paris](https://www.federationaddiction.fr/actualites/presse/explosion-des-surdoses-a-paris-la-federation-addiction-rappelle-que-chaque-mort-par-surdose-est-une-mort-evitable/).

The Ofast note itself was not published. Its contents are known through AFP and RTL, which said they consulted it. The DRAMES figures it cites can be checked against the ANSM report, and they match.

## The supply side: purer, cheaper, more varied

The police note frames overdoses as a consequence of supply. "Since 2017, and especially since 2023-2024, France has seen very high availability of narcotics," it says, according to AFP. Cannabis remains the most used illegal drug, with "five million users in 2023," while cocaine use "continues its rapid progression." Nearly one adult in ten said in 2023 that they had tried cocaine.

Average purity has climbed. Cocaine purity rose from 63% in 2023 to 75% in 2025, and cannabis resin from 18% in 2013 to 31% in 2025, the note says. RTL quoted it as saying "the constant increase in supply and in the level of active ingredients increases the risks to public health."

Synthetic drugs are a growing concern. The French monitoring center for drugs (OFDT) counted "between 450 and 500 new synthetic products" in circulation last year, according to the note. Synthetic cannabinoids, "particularly popular with young users," can have effects "up to 200 times stronger" than THC, it says. Between January 2025 and April 2026, the Grenoble center recorded nearly 500 reports of exposure to synthetic cannabinoids, mostly among boys aged 13 to 18, RTL reported.

Paris shows the trend at local scale. The Paris prosecutor's office counted 59 overdose deaths in the capital by early autumn 2026, against 30 in the whole of 2025, according to the Fédération Addiction and RTL.

## Two policy answers: higher fines or wider harm reduction

### The government: sanctioning users as part of the fight against trafficking

The government's recent response has targeted users as well as traffickers. President Emmanuel Macron promised higher fines after the November 2025 killing in Marseille of Mehdi Kessaci, the brother of anti-trafficking activist Amine Kessaci. "You have to hit them in the wallet, because taking drugs is not festive," Macron told readers of La Provence, as quoted by [LCP](https://lcp.fr/actualites/consommation-de-drogue-les-deputes-repoussent-en-commission-le-doublement-de-l-amende) (quotations translated from French).

The RIPOST bill, first drafted under Bruno Retailleau when he was interior minister and carried by his successor Laurent Nuñez, raised the fixed criminal fine for drug use from €200 to €500, with a higher rate of €1,000 for late payment. "There is a strong will in the government to sanction the consumer. They cannot stay outside all of this, the score-settling, the trafficking, it is no longer possible," Nuñez told senators, [Public Sénat](https://www.publicsenat.fr/actualites/parlementaire/narcotrafic-le-senat-durcit-les-sanctions-contre-les-consommateurs-de-stupefiants) reported. The Assembly's law committee deleted the measure in June, but a joint committee of deputies and senators restored it, and the [National Assembly](https://www.assemblee-nationale.fr/dyn/actualites-accueil-hub/projet-de-loi-visant-a-offrir-des-reponses-immediates-aux-phenomenes-troublant-l-ordre-public-la-securite-et-la-tranquillite-de-nos-concitoyens) adopted the final text on July 21. The rapporteur, Vincent Caure of the pro-Macron Ensemble pour la République group, argued that the old fine was lower than penalties for lesser offenses. The case for the policy rests on deterrence and on the link between drug money and violence; Nuñez's interior ministry has also faced scrutiny over public order in [a parliamentary inquiry](/news/france-nunez-inquiry-october-17-testimony-november-2026).

No government reaction to the Ofast note itself had been published by Monday evening in the sources reviewed.

### Addiction services and mayors: naloxone and consumption sites

The Fédération Addiction, which represents about 850 treatment and prevention services, says "every death by overdose is an avoidable death." In its statement on Paris it asks for wider access to naloxone, an antidote to opioid overdoses that bystanders can give, including automatic supply with opioid prescriptions and stocks for outreach teams, first-aiders and police. It also wants funded drug-checking services and a "Good Samaritan" law, modeled on Canada and some US states, so that a person who calls emergency services for an overdose cannot be prosecuted for use or possession on the basis of what responders find. "Faced with an overdose, saving a life must always come before punishing use," the federation says.

Only two supervised consumption sites, known in France as haltes soins addictions (HSA), operate, in Paris and Strasbourg, and both still have experimental status. On October 1, the mayors of 12 cities, including Paris, Lyon, Marseille, Lille and Strasbourg, wrote to Prime Minister Sébastien Lecornu asking him to make the sites permanent and to authorize projects waiting in their cities, the [Fédération Addiction reported](https://www.federationaddiction.fr/actualites/thematiques/les-maires-de-plusieurs-grandes-villes-ecrivent-au-premier-ministre-pour-relancer-les-haltes-soins-addictions/). They said the existing sites reduce drug use in the street and discarded syringes. No public reply from Matignon was found.

### The left: care rather than fines

Left-wing lawmakers opposed the higher fine. In the Senate, Ecologist Guy Benarroche said that "since 2020 and the application of the fixed fine, there has been no decrease in drug consumption," citing a Senate report, and added that the number of cocaine users had risen 80% in a year. In the Assembly, Communist deputy Elsa Faucillon said the repressive path taken "for several years now is absolutely counterproductive." La France Insoumise deputy Andy Kerbrat, who has spoken publicly about his past drug use, told the law committee during its hearing of Nuñez: "It is not the fine, it is not the prosecutor, it is not the sentence that helped me, it is care." He said only 35% of drug-use fines are actually paid, a figure 567politics could not independently check. Some in the center agreed: Ludovic Mendès, a deputy affiliated with Macron's group, said the measure amounted to "once again wanting to hit the consumer," according to LCP. Some on the left, including Ecologists, want a debate on legalizing cannabis. Party positions on these questions are summarized in our profiles of [La France Insoumise](/parties/france/lfi), [The Ecologists](/parties/france/ecologists) and [Renaissance](/parties/france/renaissance).

### Weighing the arguments

The new figures do not settle the dispute. The DRAMES data identify which substances were in victims' blood, not whether a given policy caused or prevented deaths. About half of the deaths involve an opioid substitution medicine, often combined with cocaine, which is relevant to arguments about treatment and naloxone as well as to arguments about supply. The government's case is about the violence of the trade more than about overdose numbers. Supporters of harm reduction point to the low mortality in Portugal after it decriminalized drug use, a comparison the Fédération Addiction draws from an OFDT review; such cross-country comparisons depend on how each country counts drug deaths.

## Budget debates, the mayors' request and the 2027 campaign

Overdose policy is likely to come up in the 2027 health and Social Security budget debates, now in the [Senate](/news/france-senate-plfss-2027-pensions-residence-benefits-november-2026), and in the presidential campaign. It remains unknown whether the government will answer the mayors' request on supervised consumption sites, whether it will publish the Ofast note, and whether DRAMES coverage changes explain part of the long-run rise. No representative poll on drug policy from the past month was found, so this article does not describe what the French public thinks about the choice between fines and harm reduction. Macron's and Lecornu's records are on their [567politics](/politicians/emmanuel-macron) [profiles](/politicians/sebastien-lecornu).