They know from the experience in Switzerland - an ultra-conservative country that now nonetheless prescribes heroin - that it is a silver bullet (or syringe?), bringing crime rates crashing down.
I'm confused to see Switzerland cited. They haven't stopped fighting a war against drug use - they're just doing it differently than us - but they do lock people up for drug offenses just like we do and I don't see where they actually prescribe heroin to addicts either though they do provide various services to them:
1. First Pillar: Prevention
Prevention measures are aimed primarily at achieving three objectives:
· to prevent drug use among individuals, especially children and youth;
· to prevent the problems and harmful effects related to drug use from spilling over onto the individual and society;
· to prevent individuals from going from casual drug use to harmful use and addiction, with all of its known consequences.([20])
The Confederation’s prevention strategy comprises six objectives:
· to make prevention part of everyday life;
· to focus not only on drugs but also on personal resources and the strengthening of the individual’s social network;
· to create alliances between the Confederation, the cantons, the communes and private structures (family, schools, recreational associations, etc.);
· to tap into scientific research;
· to enhance early intervention;
· to ensure the viability of projects funded by the Confederation, even when the Confederation opts out.([21])
It should be pointed out that the most notable change in prevention has been a transition from the concept that prevention was a matter of preventing someone from ever trying drugs to today’s concept of preventing the health and social problems related to drug use, thereby integrating the person’s social network and environment as well.
2. Second Pillar: Treatment
In Switzerland, there are many types of in-patient and out-patient treatment available to people suffering from drug addiction. The objectives sought through treatment include:
· breaking drug addicts of their habit;
· social reintegration;
· better physical and mental health.([22])
As mentioned earlier, heroin assisted treatment has been a recognized type of therapy in Switzerland since 1999. By the end of 1999, there were already 1,650 treatment spaces reserved for hard core heroin addicts in 16 treatment centres. In addition, during the same period, approximately 50% of opiate addicts (estimated to be 30,000) were being treated with medically prescribed methadone, compared to 728 individuals who were receiving this type of therapy in 1979. Those individuals addicted to one or more drugs also have access to in-patient treatment based on abstinence, to a limited number of spaces in transition centres, specialized withdrawal units or clinics, and treatment institutions, as well as out-patient consultation centres.([23]) In March 1999, there were 100 institutions providing in-patient withdrawal and rehabilitation treatment in Switzerland, for a total of 1,750 spaces.([24])
3. Third Pillar: Harm Reduction
The first so-called “low threshold” coping skills institutions made their appearance in Switzerland in the mid 80s. Their purpose was to reduce the health and social risks and consequences of addiction. First and foremost, these institutions gave drug addicts a roof over their heads and were often equipped with cafeterias, showers and laundry facilities. They provided addicts with someone who would listen and talk to him or her. These facilities have evolved over the past ten years and now incorporate medical support for harm reduction (for example, prevention of AIDS and other infections, needle exchange, out-patient medical care, etc.) and social support (street work, soup kitchens, emergency shelters, low threshold centres, etc.). The Swiss Federal Office of Public Health supports many harm reduction projects as part of ProMeDro. Such projects include:
· needle exchanges for drug addicts and inmates;
· injection sites (a statutory notice makes such sites legal);
· offers of employment and housing;
· support for women who prostitute themselves to buy drugs;
· consultation services for the children of drug-addicted parents.([25])
Furthermore, the cantons, communes and private institutions also provide such programs. In 1995, the SFOPH established a central service to support certain social assistance agencies, particularly those with low thresholds, and to advise the cantons, communes and private institutions on planning and funding harm reduction programs. Drug addicts have access to such programs without having to meet any particular prerequisites. The objective of these harm reduction services is to limit as much as possible the negative consequences of addiction so that the addict is able to resume a normal existence. In addition, these measures are aimed at safeguarding and even increasing the addict’s chances of breaking the drug habit.([26])
4. Fourth Pillar: Enforcement
The primary goal of enforcement is to reduce supply and to fight against the trafficking of narcotics, the illegal financial transactions related to such trafficking (for example, money laundering) and organized crime. Users are not the number one target of police operations in Switzerland. Enforcement of the federal Narcotics Act is, to a large extent, the responsibility of the cantons, although the Confederation does monitor the situation closely and can call for and carry out police investigations into drug trafficking. It should be noted that canton and commune laws on policing differ and sometimes result in varying interventions. Furthermore, the drug milieu changes quickly and the methods used to fight drug-related problems are improving and adapting to this milieu.([27]) These methods include:
· focussing enforcement activities on the manufacturing of drugs, trafficking and money laundering;
· assigning more officers to the “drug police” and making greater use of specialists from other sectors (finance professionals);
· intercantonal and international co-operation (agreements with police forces from neighbouring countries);
· accelerating and improving the processing of information (networking systems and access to the police department networks from many European countries);
· improving co-operation between the police and the private sector (banks, chemical industries, etc.);
· improving police effectiveness and making greater use of front-line liaison workers;
· strengthening the legal structure (for example, policing legislation, witness protection).([28])
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The current legislation also contains criminal provisions that apply to: anyone who unlawfully cultivates, manufactures, extracts, processes or prepares narcotics; anyone who, unless authorized, stores, ships, transports, imports, exports, provides, distributes, sells, etc., or buys, holds, possesses or otherwise acquires narcotics; and anyone who finances illicit traffic in narcotics, acts as an intermediary or encourages consumption (Narcotics Act, s. 19). Section 19 offenders are liable to imprisonment or a fine depending on the seriousness, according to the Narcotics Act, of the act committed. The intentional consumption of narcotics or the commission of a section 19 offence for personal use is punishable by detention or a fine (Narcotics Act, s. 19a). For petty offences, the appropriate authority may stay the proceedings or waive punishment and may issue a reprimand (Narcotics Act, s. 19a(2)). However, preparing narcotics for personal use or for shared use with others at no charge is not punishable where the quantities involved are minimal (Narcotics Act, s. 19b). Finally, anyone who persuades or attempts to persuade someone to use narcotics is also punishable by detention or a fine (Narcotics Act, s. 19c).
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The report found the following trends in 2000:
· a sharp rise in marijuana use;
· a sharp rise in cocaine use;
· a sharp rise in multiple addiction (use of various kinds of narcotics);
· a sharp rise in synthetic drug use (amphetamines and methamphetamines) – Thai pills([37]) have become the “in” drug;
· a downward trend in injection heroin use;
· virtually no open drug scenes in Swiss cities;
· 205 deaths due to drugs and recorded by the police (as compared to 405 in 1991) – those over 27 were the most affected age group, for men and for women, and Zurich and Bern were the most affected cantons, with 50 and 36 deaths due to drugs, respectively;
· 18- to 24-year-olds remain the most frequent users of marijuana, hash and hallucinogens, while those over 30 are the most frequent users of cocaine and heroin.([38])
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Federal Narcotics Act drug-related offences reported cases rose from 44,307 in 1999 to 46,558 in 2000. This represents an important increase over the 18,800 reported cases in 1990. A comparison of the number of reported cases per offence type in 1997 and 2000 reveals a downward trend for drug trafficking, smuggling, dual offences([39]) and an overall increase – with the exception of 1999([40])– in drug use cases. A table summarizing reported drug-related cases, seizures and deaths between 1975 and 2000 is included in appendix B.
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1990-2000 SUMMARY
Switzerland’s drug policy has evolved considerably in the last decade. There have been major changes in the perception of the issues and in the implementation of policy decisions, as well as in the impact of this drug policy, as verified by quantifiable data available for each of four pillars. Whereas in the mid-1980s drug addicts were largely viewed as marginalized people responsible for their own fate, today they are generally seen as ill, dependent people who are victims of a personal predisposition or outside circumstances. This new perception of the person with a drug dependency has given rise to a new approach based on social assistance and public health, rather than on enforcement and punishment. However, the enforcement approach was strengthened to deal with those who profit from drug trafficking. The four-pillar policy is intended to be a balanced, pragmatic approach that recognizes that drug problems cannot be completely solved, and that steps must be taken to mitigate the many effects of drug abuse and the illegal drug trade.([90])
In the area of prevention, the programs supported by the Federal Office of Public Health have reached several hundred thousand young people since the early 1990s. As for therapeutic treatment, it is estimated that, out of a population of 30,000 hard-drug users, approximately 15,000 addicts are receiving some form of treatment – either in-patient treatment based on abstinence with methadone or heroin prescribed, or out-patient treatment. There has been an increase in harm reduction programs, which help improve the physical and mental health of drug addicts, as well as their quality of life. For example, injection drug users made up between 36 and 40 per cent of new HIV cases in 1991, whereas in 1999, they accounted for only between 14 and 17 per cent of HIV cases. Similarly, the number of deaths attributable to a drug overdose (usually heroin) dropped from 405 in 1991 to 181 in 1999. As for deaths attributable to AIDS among injection drug users, the figures show a substantial decline, from 318 deaths in 1994 to 196 in 1996.([91]) Lastly, enforcement has been stepped up, with the number of charges for offences under the Narcotics Act rising from 23,400 in 1991 to 44,336([92]) in 1999. The majority of these charges involved consumption of drugs. New measures have also been introduced to all police forces to deal more effectively with drug trafficking and money laundering.([93])
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