Addiction Treatment in France

Having worked as an addiction counselor in France, in the UK and in my home country, Iceland, it still puzzles me how the Minnesota Model has a more difficult time becoming accepted in France. In Iceland, there is a long tradition of treating alcoholism and addiction through the 12-step approach, with almost every treatment provider using it as the basis for their work.

It was a surprise to see how very different the situation is in France. Many professionals here have never heard of the Minnesota Model and only have a very vague idea – if any – about the 12-step fellowships and often those ideas are based on misunderstandings. As a consequence, patients are often not informed about AA or NA exist (or any other fellowship for that matter).

Today, only one treatment center in France uses the Minnesota Model as its basic framework (the APTE center), a halfway house and one psychiatric clinic. An English-run 12-step treatment centre (that I was a part of) was set up in Paris, and worked hard to spread the message, but unfortunately it had to close a few years ago.

There are many reasons why the Minnesota Model has had a hard time getting established in France. France is historically a catholic country and the French are very attached to the separation of state and church. Many consider themselves as atheists. Public schools, hospitals and other institutions are required to be completely neutral when it comes to religion. Finally, they are also very vigilant (and rightly so) not to let sects or any extreme religious groups gain ground in France.

In this context, a treatment framework based on the 12 steps, with its frequent references to God (as we understood Him) and spirituality, is met with immediate suspicion. All reference to spiritual concepts is in fact considered as a sign of belonging to some religious sect. This suspicion is reinforced by the fact that some sects have in fact offered addiction treatment – with catastrophic results.

To overcome such reserves and preconceived ideas, I find it very important to carefully explain the origins of the Minnesota Model and how it has spread around the world, in spite of cultural and religious differences, because of its unique message to addicts and their families that recovery is possible no matter how hopeless it may seem.

Today, in spite of all the obstacles, I can see a real change in mentality from what it used to be. French AA and NA have grown in number and more and more people are aware of the 12-step fellowships. Also, as more French people have studied and lived abroad, some come back with at least some knowledge of 12-step treatment as a part of that experience. Then, for the first time last year, the French Society of Alcohol Medicine (SFA), dedicated their conference to the 12-step fellowships and other self-help groups.

All this gives me hope that the Minnesota Model will plant its roots in France as it has done elsewhere so that addicts and their families can have easier access to treatment and lasting recovery. In the meantime I will keep up the work, one patient at a time, aided by my colleagues who share my vision.

Castle Craig now has a new website about addiction treatment in French