1A great many studies have been devoted to the use of psychotropic drugs - illegal narcotics or medically prescribed therapy - and the majority of them are inspired by the notion that drugs are a source of deliverance. This interpretation seems to be taken for granted, and from doctors who prescribe drugs as a therapy to help patients regain their mental balance all the way to mystic texts describing the "trip" as the pathway to a life of freedom and independent self-discovery, everyone seems to think that these substances can free the individual from a false, distorted identity. Although psychotropic drugs do no such thing and on the contrary, only further imprison an individual in the illusion of having regained his autonomy, our perception remains influenced by this interpretation. When we use words like "dope" to denounce the enslavement of the personality to drugs, we are nonetheless referring to the idea of deliverance, even though what we mean to suggest may be quite the opposite.
2The notion of a "promised identity" is influenced both by psychology and by a rather simplistic brand of ecology. In the first case, the single reference point is the individual, and personality is analysed in terms of "deviance", much like the physicist studies elements whose trajectories are subject to abrupt changes. The drug user is seen as reacting passively to his own "atrophied personality": he appears sometimes as a victim and at other times as someone whose behaviour is asocial. In the second case, the strictly psychological factors are put aside and the environment is blamed. Since the social context can only be considered here as a vague and faceless group of individuals, the only identifiable factors, which can incidentally appear to be the main causes of disorders, are the disruption of the urban architectural fabric or the anxiety caused by automobile traffic - unless these are merely elements selected because of a compulsive need to collect stress factors. However, the findings of the present study point to a completely different interpretation and call for a revision of common notions concerning the use of psychotropic drugs. We have chosen to consider this issue from a new angle which emphasizes, in opposition to the idea of deliverance, the theme of resistance.
3Our research, carried out in the city of Rouen, is based on data obtained from prescriptions which include at least one psychotropic drug listed among the 40 most-often-prescribed drugs, for the year 1991 (this list includes five kinds of drugs: neuroleptics, tranquillizers, sedatives, sleeping pills, and antidepressants). This information was obtained through the Social Security health care unit in Rouen and other Social Security organizations, in the form of requests for reimbursement sent in by the patients. Given the size of the task, we selected four days (one per quarter of year) yielding a total of 7,500 prescriptions.
4The study confirms most previous research findings concerning age and gender. About one in two patients is over 60 years of age. Seven out of ten patients are women. The number of prescriptions increases with the patient's age, reaching a high point at 65. In some areas, 100% of the users are women.
5However, once this data is set in context, a rather puzzling element appears. If age and sex, that is, the individual factors, had a generic and totally discriminatory influence, there should be no variation in drug use in demographically similar areas. But this was not found to be the case: the areas with the most users were not necessarily those with a higher concentration of women or elderly people. Age and gender seemed to play only a relative role in determining the geographical or spatial distribution of psychotropic drug users.
6The reasons governing the spatial distribution of drug users become clearer once the area's social make-up, the income of the inhabitants and the type of housing are taken into account. Thus we can see a strong correlation between the size of the working-class population and the number of prescriptions. The larger the working-class population, the higher the number of requests for reimbursement of these drugs. Proportionally, most users live on the Left Bank and along the Cailly Valley; there are relatively few in other areas, especially in the North and on the Eastern plateau.
7A link can also be observed between psychotropic drug use and unemployment rates. The correlation between the two is strongest in median unemployment zones, but less strong in zones of high unemployment : in areas more hard hit than others by the economic crisis and where the risk of falling below the poverty line is highest (whether the unemployment rate is a sign of this remains open to question), drug consumption decreases. The same thing holds for income distribution: drug use increases as income level decreases, but this correlation only holds true to a marked extent in communities which show rather high average income levels. Above or under this threshold, the correlation is less marked. Thus, drug consumption cannot be considered a sign of social instability, nor would it be accurate to say we are witnessing a "medicalization of social exclusion".
8To sum up and clarify this point, it is necessary to take into account several variables tied to urban forms of habitat. Drug use is not highest in huge low-cost housing developments and apartment blocks, but rather in areas where the working class live in old, often dilapidated single-family homes, for the most part built before 1949. Since these neighbourhoods are in decline, the houses are for the most part in a state of disrepair, as shown by the high proportion (above average) of vacant homes, the high degree of deterioration of sewage and heating systems and finally by the fact that the rental value of these homes is one of the lowest in the city and surrounding suburbs. These areas were the first to be hit by the economic recession, especially in the textile industry, and as a result, for quite some time they have not had the benefit of business tax revenues which could have been used to set up wide-ranging social services. Furthermore, due to the relative lack of subsidized public housing in these areas, they tend to be excluded from urban redevelopment and local renovation programs.
9The use of psychotropic drugs, as this study shows, is not an indicator of an individual's rejection of his responsibilities, nor is it a therapy for asocial or deviant behaviour. Using psychotropic drugs requires good knowledge of the health care system and its procedures, and is the sign of a choice based on a real acceptance of what is so called "correct" coping behaviour. It is also an indication of a wish to show rational, adapted, but also acceptable behaviour, a desire for social integration, to remain "inside" the bounds of society, even when the community one belongs to is in a state of collapse.
10Furthermore, the study highlights the impact of the social milieu. By social milieu, we mean the social configuration of a specific geographical area, which itself is organized according to the nature of its existing building structures. The milieu is represented by several levels of social exchange: the relationships between the residents of a neighbourhood - the contacts, or lack of contacts between various socio-economic groups, the rise or decline of certain communities - are all linked to urban history, to the city's economic transformations, to cycles of urban renewal. In the old industrial suburbs of greater Rouen, economic recession went along with the disintegration of working class communities and the depreciation of housing values. Today's threat to property ownership and the inability of the working class to afford the price increases induced by housing rehabilitation policies has made it difficult for this population to protect its identity and heritage. Psychotropic drugs thus make up for the lack of support on the part of community-based mutual aid structures. In a context where one's social identity in the city is threatened, drug use represents a personal attempt to save one's self, one's position and one's origins.