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These Houdou Université de CAEN ANNEE 2004 U.F.R DES SCIENCES PHARMACEUTIQUES SERIE N° THESE POUR LE DIPLOME D’ETAT DE DOCTEUR EN PHARMACIE PRESENTEE PAR Mlle Géraldine HOUDOU SUJET : ANALYSE ET USAGE DES SUBSTANCES PSYCHOTROPES EN MILIEU FESTIF : INTERET DU SUIVI DES CONSOMMATIONS Soutenue publiquement le 15 novembre 2004 JURY : M. François SICHEL, Professeur Président Mme Danièle DEBRUYNE, MCU-PH Examinateur Mme Mathilde LECHEVREL, MCU Examinateur REMERCIEMENTS A Monsieur le Professeur François SICHEL, qui me fait l’honneur de présider cette thèse. Tous mes remerciements pour le suivi de ce travail, comme pour les précédents, et pour son enseignement prodigué au cours de mes études en sciences pharmaceutiques. Qu’il trouve ici l’expression de mon profond respect. A Madame Danièle DEBRUYNE, qui m’a guidée tout au long de ce travail. Mes remerciements sincères pour sa disponibilité et pour sa confiance accompagnant mon intégration au sein du laboratoire. Qu’elle trouve ici l’expression de ma toute reconnaissance. A Madame Mathilde LECHEVREL, qui me fait l’honneur de juger ce travail. Qu’elle soit assurée de ma vive reconnaissance. A Monsieur Reynald LE BOISSELIER et Madame Valérie AUCLAIR, qui m’ont fait partager leurs connaissances précieuses, et épaulée dans la réalisation de ce travail. Qu’ils soient chaleureusement remerciés. A Thomas QUENTIN, qui a suivi ce projet depuis son commencement. Sa bonne humeur quotidienne et sa grande humanité ont accompagné sa réalisation dans les meilleures conditions. Qu’il soit assuré de ma profonde amitié et reçoive mes encouragements pour la réalisation de son travail. A toute l’équipe du laboratoire de pharmacologie du CHU de Caen, qui m’a accueillie et aidée, et sans qui la réalisation de l’étude n’aurait pu se dérouler. Qu’elle soit assurée de ma profonde reconnaissance. A mes parents, sans qui le suivi de mes études et leur aboutissement n’aurait pu avoir lieu. Qu’ils soient vivement remerciés pour leur confiance et leur soutien et qu’ils soient assurés de toute mon affection. A Frédéric VANHOEVE, qui s’est régulièrement inquiété de la progression de cette thèse. Qu’il reçoive mes remerciements sincères pour ses encouragements profitables. A Frédéric, Mélanie, Manu, Carole, Samuel, Gaëlle, Fabien, Fabienne et son farinier, Fadi, Nathalie, Anthony, Valentin, Céline, Vanessa, Aurore, Yohann, Benjam, Mathieu, Alexis, Dorothée, Valérie, Loïc, et tant d’autres, qui se sont intéressés régulièrement à la réalisation de la thèse, et dont l’amitié exprimée fût un soutien essentiel. Qu’ils trouvent ici le témoignage de toute mon affection. 1 « L’ecstasy, c’est encore pire que le saut à l’élastique. Chaque ecstasy est un plongeon dans le vide sans respect des normes de sécurité. » Frédéric Beigbeder Nouvelles sous ecstasy, Gallimard 2 SOMMAIRE SOMMAIRE .......................................................................... 3 INTRODUCTION ................................................................... 8 1 CADRE RÉGLEMENTAIRE ................................................... 14 1.1 CONTRÔLE INTERNATIONAL .......................................................................................14 1.1.1 Organes de contrôle ...................................................................................15 1.1.1.1 L’Organisation Mondiale de la Santé ..........................................15 1.1.1.2 L’Organe International de Contrôle des Stupéfiants......................15 1.1.1.3 Le Programme des Nations Unies pour le Contrôle International des Drogues...........................................................................17 1.1.2 Les Textes Fondateurs................................................................................17 1.1.2.1 La Convention unique de 1961 sur les stupéfiants........................17 1.1.2.2 La convention de 1971 sur les substances psychotropes. ..............19 1.1.2.3 Convention de 1888 des Nations Unies contre le trafic illicite de stupéfiants et des substances psychotropes. ...............................20 1.2 CONTRÔLE EUROPÉEN. ..............................................................................................21 1.2.1 Organes de contrôle ...................................................................................21 1.2.1.1 L’Observatoire Européen des Drogues et Toxicomanies (OEDT)......21 1.2.2 Classification juridique des stupéfiants et des psychotropes. ..................22 1.2.3 Mise en place d’un réseau de pharmacodépendance européen ...............23 1.3 CONTRÔLE EN FRANCE..............................................................................................24 1.3.1 Organisation................................................................................................24 1.3.1.1 La MILDT ...............................................................................24 1.3.1.2 Le système national de pharmacodépendance .............................25 1.3.1.2.1 Les Professionnels de santé qui déclarent les cas ...............25 1.3.1.2.2 Les CEIP et leurs centres correspondants..........................26 1.3.1.2.3 La Commission Nationale des Stupéfiants et des Psychotropes (CNSP) .....................................................27 1.3.1.2.4 L’OFDT ........................................................................27 1.3.2 Classification juridique des stupéfiants et psychotropes..........................28 1.3.2.1 Transposition en droit français des traités internationaux:.............28 1.3.2.2 Sanctions pénales ...................................................................30 1.3.3 Le programme SINTES : détails du dispositif ...........................................31 1.3.3.1 Le réseau socio-sanitaire..........................................................32 1.3.3.2 Données de la Base SINTES .....................................................33 1.3.3.3 Laboratoires attachés ..............................................................34 2 DÉFINITION DES DROGUES ............................................... 36 2.1 INTRODUCTION ........................................................................................................36 2.2 LEXIQUE .................................................................................................................37 2.2.1 Drogue.........................................................................................................37 2.2.2 Les drogues de synthèse............................................................................38 2.2.3 Stupéfiants..................................................................................................39 2.2.4 Psychotropes...............................................................................................39 2.3 RELATION STRUCTURE/ACTIVITÉ ET TENTATIVE DE CLASSIFICATION.................................41 2.3.1 Les hallucinogènes......................................................................................41 2.3.1.1 Les phényléthylamines (PEA)....................................................44 2.3.1.1.1 La mescaline ................................................................44 2.3.1.1.2 Les dérivés soufrés : analogues de la thiomescaline. ..........45 2.3.1.1.3 Les analogues du 2C-D. .................................................46 3 2.3.1.1.4 Les composés BOX ........................................................47 2.3.1.1.5 Les analogues du 2C-T...................................................48 2.3.1.2 Les dérivés psychédéliques de l’amphétamine. ............................49 2.3.1.2.1 Les alkoxyamphétamines ...............................................50 2.3.1.2.2 Les dérivés méthylènedioxyamphétamines .......................51 2.3.1.2.3 Les analogues du DOM...................................................52 2.3.1.3 Les tryptamines......................................................................53 2.3.1.3.1 Les N,N-dialkyltryptamines.............................................54 2.3.1.3.2 Les alkyl-tryptamines Aryl-substituées, ............................54 2.3.1.3.3 Les alpha-méthyltrypatamines ........................................55 2.3.1.3.4 β-carbolines. ................................................................56 2.3.1.3.5 LSD et dérivés. .............................................................57 2.3.1.4 Hallucinogènes anesthésiques...................................................59 2.3.1.4.1 Les arylhexylamines ......................................................59 2.3.1.4.1.1 Le PCP...............................................................60 2.3.1.4.1.2 La Kétamine. ......................................................61 2.3.1.4.1.3 La tilétamine ......................................................62 2.3.1.4.2 Le GHB........................................................................62 2.3.2 Les stimulants.............................................................................................63 2.3.2.1 L’amphétamine.......................................................................64 2.3.2.2 La méthamphétamine..............................................................65 2.3.2.3 L’éphédrine............................................................................67 2.3.2.4 La caféine ..............................................................................68 2.3.2.5 La Cocaïne .............................................................................68 2.3.3 Les entactogènes ........................................................................................70 2.3.3.1 Les phényléthylamines. ...........................................................72
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