In an upscale area of Abidjan, you have to go through a small, discreet door to access the Reception, Care and Support Center (CASA), where drug users, particularly vulnerable and marginalized in Ivory Coast, come together.
This West African coastal country has become in recent years a transit country for the international trafficking of heroin, cocaine or medicines whose use is diverted.
And while there is little official data on consumption, Dr. Fériole Zahoui, an addiction specialist at CASA, estimates "between 30,000 and 40,000 the number of drug users in Abidjan", three to four times more than ten years ago.
Thanks to word of mouth, the center, opened in 2018, has gradually become known and now welcomes around twenty users daily who come to rest, wash, but also to benefit from free, tailored social, medical and psychological support.
Because Ivory Coast has not chosen the path of total repression against drug users: a 2022 law reduced the sentences for consumers, from 1 to 3 months in prison instead of 1 to 5 years previously.
Late in the morning, calm reigns in the CASA break room: some are dozing, others are chatting or watching television. Pushing open the doors, you find a pharmacy, a testing laboratory, consultation rooms, an infirmary…
A true self-contained medical center with the feel of a warm, welcoming home, discreet so as not to disturb the neighbors. For many, CASA is first and foremost a home, and its community a family to rely on when addiction has taken everything away.
Standing beside his sleeping partner on the floor, Hassan Mohana told AFP that he comes every day to take his methadone treatment, a substitute for heroin, but also to rest and shower before starting his night shift.
"It allowed me to find myself again, to keep a job, to reintegrate into society," explains the 40-year-old man, who has been attending CASA since it opened.
Heroin and "Gaddafi", a mixture of tramadol and alcohol, popular because of its low price (less than one euro per dose), are the main drugs consumed by users who frequent the center.
CASA distributes methadone, a substitute that allowed Mamadou Touré to experience "a second birth" by stopping the heroin he had been using since adolescence.
"For years, I alternated between the smoking room and prison," testifies the 47-year-old man.
Today, he says he has found meaning in his life: he has become a peer educator at the center, a mentor who helps users to get back on their feet in turn.
– “Like dogs” –
With her nine-month-old daughter asleep against her chest, Massita Konaté remembers the hell of the smoking dens, where she lived for years.
"People die there like dogs, nobody comes to get them," testifies the young mother, whose forearms bear the marks of heroin injections.
At 35, Massita is also on methadone. Although she has found an apartment, she continues to spend her days at CASA to "be with people who understand her."
CASA cannot accommodate all consumers: therefore, patrols are carried out in smoking dens, also called ghettos.
In these makeshift shelters, users smoke crack, cannabis, inject heroin, and try to survive.
A warm welcome is given to the familiar faces of CASA volunteers and employees, who have come to do prevention work, distribute condoms or single-use syringes.
"We don't have the strength, we are weak. But with help, we can change, and work," assures David Junior, 34.
"Many people who are sick at the smoking room don't dare come to CASA," explains Anicet Tagnon, head of community activities. "So the center goes to them," he continues.
"There is a significant issue of information. Some people don't even know they could have access to methadone," emphasizes Dr. Fériole Zahoui.
Since its opening, initiated by Doctors of the World and managed by the NGO Espace Confiance, CASA estimates it has supported more than 3,000 people. Its annual operating costs are approximately €218,000, largely funded by the cooperation agency Expertise France.
A second center based on the same model has opened in San Pedro, in the west of the country, another major port of arrival for international drugs.
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