The militant initiative that led to the advent of "harm reduction"

In 1982, Dr Elliot Imbert , Dr Marie-Christine Charansonnet, and a group of fellow doctors from a municipal health centre near Paris, France, set up a free and anonymous consultation intended for people who inject drugs. In 1986, they began offering free HIV screening tests. 60% of them were found to be positive.

At that time in France, every day, 10 people who used drugs via intravenous injection were contaminated with the AIDS virus, and even more contracted hepatitis C.

It became urgent to stop the sharing of syringes, and to make clean syringes available to people who inject drugs. A significant obstacle was removed in 1987 with the legalisation of syringe sales in pharmacies, which, until this point, could only be issued upon presentation of a prescription and only to persons over 18 years of age.

In spite of such progress, harmful practices persisted.

There was much work to be done, between discovering and comprehending these clandestine practices, and identifying their connection with often precarious environments. A great number of charitable associations cooperated to work on this issue.

The invention of devices for injection

With the support of a few partners, Dr Elliot Imbert developed the first Steribox® injection kit, which contained syringes, vials of sterile water, alcohol swabs, and condoms. The kit was made available throughout France in 1994 and funded by the French State in 1996, which is still the case today.

The next step was to design and manufacture specific devices for the key stages of preparing and filtering the mixture to be injected.

By analysing drug users' practices, the Apothicom team realised that the cooker needed to be small in order to limit the preparation to a single dose, and that it had to be composed of an inert heat-resistant material.

Apothicom then designed a 10 µm membrane filter in order to limit venous damage related to the injection itself. This filter made it possible to more effectively eliminate dangerous particles, such as cutting agents from street drugs and medication excipients. It is compatible with all syringes, including fixed needle syringes.

After several phases of R&D, the first Sterifilt was created, and has been distributed since 2004.

The manufacturing processes for these new devices were gradually established thanks to large investments in the development of production machinery.

New innovative devices

Apothicom's focus on real-world situations allowed for constant innovations, making it possible to provide drug users with new devices

For example, the injection of crushed pills – a practice that had been on the rise for around 15 years at this point – indicated the need to develop larger cookers to facilitate preparations.

So it is that the Maxicup was developed, offering a cooker with double the capacity of the Stericup. A built-in handle was added to both the Stericup, and Maxicup in 2019, offering better stability.

The injection of crushed pills also requires the use of more resistant, anti-clogging filters. Apothicom Distribution therefore developed 2 new membrane filters:

• Sterifilt FAST, in 2020, which allows for the rapid filtration of crushed pills.

• Sterifilt+, in 2021, which eliminates bacteria thanks to its 0.22 µm membrane.

Single-use sterile cookers and filters are considered medical devices in Europe. Apothicom's devices are now distributed through needle and syringe programmes and across safe injection facilities in over 20 countries.