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."