Source: The Globe and Mail (Toronto, Canada)
Author: Timothy Appleby     Saturday, 4 April 1998
Contact:  http://www.theglobeandmail.com/

CRIME AND DISEASE CUT BY PROJECT

ZURICH -- Long-time heroin addict and dealer Marco P. may have hit bottom
when he drew a 3 1/2-year prison term, but his habit did not. Behind bars,
the fierce addiction that has consumed 17 of his 32 years continued.

Now, thanks to a national heroin-dispensing program that last year earned
ringing approval from Switzerland's cautious electorate, Marco sees some
rays of hope.

Three times a day, he shows up at the squeaky-clean injection room of the
Project Crossline clinic, housed in a nondescript government building. And
at one of its steel counters, under the close scrutiny of health-care
professionals, he does what he used to do at home, or in parks or alleys :
fill a vein with top-quality heroin.

What differs these days is that instead of selling heroin for a living, or
stealing, a relatively healthy Marco holds down a construction job. And his
daily heroin dosage has dropped from 650 milligrams to about 420.

"It's better to be a junkie like this than a junkie on the street," he
concludes, and in a country with one of the highest addiction rates
inEurope -- 30,000 junkies among a population of seven million -- most agree.

Aimed at the most recalcitrant addicts, people who have been injecting
heroin for many years, repeatedly trying to quit, the Swiss experiment
began in 1994. Eighteen clinics were set up across the country including
one in a prison.

When data from the 1,146 participant addicts were collated two years later,
the results were striking: Criminal activity had fallen 60 per cent. The
number of addicts with permanent jobs rose to 32 per cent from 14 per cent.
There were only 11 new cases of hepatitis and HIV infection (all though to
be from cocaine use outside the program), and the death rate has fallen by
half.

A few addicts (83) had even been able to do what Marco P. still wants to
do: quit using heroin altogether.

And when balancing the state cost of the program against the medical and
law-enforcement bills racked up bu Switzerland's other addicts, the net
saving amounted to about $45 a junkie each day.

"It's a success in that it proved to be feasible," said Ambros Uchtenhagen,
head of Zurich's Addiction Research Foundation, which set up the project.

"For a long time, we had the impression that heroin prescription was a
failure, based on the British experience. Then we took a closer look and
found their resources may have been inadequate."

(Britain has had a small, doctor-prescribed heroin program since the late
1960's; the only other is in the Netherlands, which began a Swiss-modelled
15-addict experiment this year.)

Last May, a federal Canadian task force urged that heroin and cocaine be
decriminalized along British lines for addicts, noting that among
Vancouver's drug-addict population, there is an HIV-infection rate of 25
per cent and, in Montreal, a 20-per-cent rate.

The Liberal government has not responded, perhaps because the message is
one that the U.S. government, and most Canadian police, do not want to hear.

Neither did the Swiss police at first. But that changed in the runup to a
referendum in September. More than 70 per cent of Swiss voters gave the
go-ahead to renewing the program.

"The police became actively in favour," Crossline project manager Urs
Vontoble recalled. "They'd step up and tell people 'Look, it's good.'" 

Fresh in the voters' minds was the disasterous 1986-1992 era when Zurich's
Platspitz (Needle) Park and a disused rail station became anarchic, police
tolerated zones where addicts could buy, sell and inject heroin with
impunity. Foreign addicts flooded Zurich.

The clinics, which also dispense small amounts of morphine and methadone,
are only for Swiss nationals.

"People are very happy with the current law," lawyer Cristoph Bercurrent
said. "The streets became safe, or much safer than they used to be. We saw
the misery of people who became drug addicts and the situation became much
better." 

The heroin is what Mr. Vontobel calls "the honey for the bees" -- the
incentive for addicts to avail themselves of other help: health care, job
placement, counselling.

"Because we see them on a daily basis, they trust us and come to us when
they have something, and they can be treated immediately," Dr. Judith Seitz
said. "And if we refer them to a hospital, they're more willing to go than
they would otherwise."

Seperate frm the heroin clinics are needle-exchange programs in many Swiss
towns and cities, along with the methadone programs encompassing half the
addict population.

But nothing has the allure of high-quality, legal heroin, and such is the
waiting list that next year, the clinics' current 800 heroin slots are
expected to at least double. Drugs, hard and soft, remain illegal in
Switzerland.

"What we are doing here has nothing to do with legalizing heroin," Mr.
Uchtenhagen said. "It's making heroin legally available for those most in
need of treatment .... It's for a well-defined, chronic, marginalized group
of addicts who could not profit from other treatment."