Opioid based treatments are part of a broader therapy that includes social, educational and psychological measures. The Swiss approach has resulted in lower rates of crime, death, disease, a slight drop in expected new users as well as an improvement in mental and physical health, employment and housing.
Full Answer
What is Switzerland’s drug policy and how does it work?
To address the Swiss drug problem, elected officials, community members, law enforcement and medical experts all worked together to create the “four pillars” drug policy. Those four pillars of the Swiss law are harm reduction, treatment, prevention and repression (or law enforcement). “The goal was not to fight drugs anymore.
Does Switzerland have the most progressive drug policy in the world?
And in 1994, Switzerland went on to pass one of the most progressive and controversial drug policies in the world, which included the dispensing of heroin. “Switzerland is no one’s idea of a leftist country,” Joanne Csete wrote in her paper “ From the Mountaintops: What the World Can Learn from Drug Policy Change in Switzerland .”
What can we learn from the Swiss approach to heroin treatment?
*The Swiss annually purchase about 100 kilos of heroin for treatment. Since 1994 Swiss patients have received over 10,000,000 doses of heroin without a fatality. ** The Swiss approach gives us a glimpse of a context in which drug issues are handled by the medical community.
How did Switzerland's four pillars policy affect drug use?
"Switzerland’s progressive implementation of the Four Pillars policy resulted in a significant decrease in problems related to drug consumption. The rise in heroin consumption, by far the greatest problem in the late 1980s, was halted and has steadily declined since the early 1990s.
What was the drug use in Switzerland in the 1960s?
How many people were treated for substance abuse in Switzerland in 2007?
About this website
How does Switzerland deal with drug addiction?
The Four Pillars To address the Swiss drug problem, elected officials, community members, law enforcement and medical experts all worked together to create the “four pillars” drug policy. Those four pillars of the Swiss law are harm reduction, treatment, prevention and repression (or law enforcement).
When did Switzerland legalize drugs?
1994The Swiss were the first to legalize prescription heroin in 1994 under the nation's four pillar drug policy. The law aimed to curb drug overdose deaths and high HIV infection rates, as well as end the country's “open-drug scenes.”
What is the purpose of drug treatment?
Drug treatment is intended to help addicted individuals stop compulsive drug seeking and use. Treatment can occur in a variety of settings, take many different forms, and last for different lengths of time.
What are 3 options for drug abuse treatment?
There are many options that have been successful in treating drug addiction, including:behavioral counseling.medication.medical devices and applications used to treat withdrawal symptoms or deliver skills training.evaluation and treatment for co-occurring mental health issues such as depression and anxiety.More items...•
What the World Can Learn from drug policy Change in Switzerland?
From the Mountaintops: What the World Can Learn from Drug Policy Change in Switzerland. Published by the Open Society Foundations, this report looks at how evidence-based services such as heroin treatment, injection rooms, and needle exchange can lower HIV infection rates, improve health outcomes, and lower crime rates ...
Is Coke legal in Switzerland?
Personal use is punished with a fine, contrary to common belief possession of up to 18 grams is not legal. According to a recent study, 5 Swiss cities (St Gallen, Bern, Zurich, Basel and Geneva) were listed among top 10 European cities for cocaine use.
What is the effectiveness of treatment?
The term treatment effectiveness connotes a technical but straight for-ward meaning throughout the health-care community. Basically, effectiveness is the likelihood that a certain treatment protocol will benefit patients in a certain clinical population when administered in clinical practice.
What is the medical term for treatment using drugs?
pharmacotherapy. [fahr″mah-ko-ther´ah-pe] treatment of disease with medicines.
How effective is drug therapy?
They found that patients receiving combination psychological and drug therapy were most likely to respond. They were: 27% more likely to respond than those receiving psychotherapy alone. 25% more likely to respond than those receiving drug treatment alone.
What is a treatment plan for substance abuse?
A substance abuse treatment plan is an individualized, written document that details a client's goals and objectives, the steps need to achieve those, and a timeline for treatment. These plans are mutually agreed upon with the client and the clinician.
What is treatment model?
The model proposes that the manner in which an individual views, appraises, or perceives events around himself/ herself is what dictates their subsequent emotional responses and behavioral choices.
What are community treatment programs?
Community Based Treatment refers to a specific integrated model of treatment for people affected by drug use and dependence in the community which provides a continuum of care from outreach and low threshold services, through detoxification and stabilisation to aftercare and integration, including maintenance ...
What was the drug use in Switzerland in the 1960s?
In the late 1960s, the use of psychoactive drugs rose, with the use of cannabis and heroin or other opiates leading the way. As addiction figures rose, the Swiss began to have this problem presented to them in a grim and blatant form. Zurich became known as a center for heroin abusers in Europe. An area in the middle of Zurich known as Platspitz became known as “Needle Park.” Thousands of heroin addicts gathered to shoot up, snort cocaine, hang out, leave their refuse and generally create an unhealthy and ugly scene.
How many people were treated for substance abuse in Switzerland in 2007?
In 2007, 20,000 people received substance abuse treatment in Switzerland. A little less than half of these people were in drug treatment facilities for opiate addiction. Another quarter entered drug rehabs for help with cocaine addiction and about a fifth of those in drug treatment facilities for their addictions to cannabis.
How many people in Switzerland receive heroin?
Most substitution patients in Switzerland receive methadone, while about 8 percent — 1,400 patients — receive heroin. Globally, handing out heroin as a treatment drug remains controversial. In Switzerland it’s largely accepted as an effective way to treat some addicts. But few European countries have followed its example.
What happened to the last drug camp in Zurich?
Eventually, Zurich police shut down the last remaining drug camp in the heart of the city.
How many drug addicts were there in the 1990s?
Back in the early 1990s up to 3,000 drug addicts a day frequented Zurich’s Platzspitz Park, dubbed ‘needle park’ by The New York Times. Switzerland’s largest city was a magnet for the country’s heroin users, whose numbers skyrocketed from just 3,000 in 1975 to 30,000 in 1992.
What was the place where drug users lay in their own blood?
Just a short walk from Zurich’s central station, Platzspitz was a melting pot of misery. As witnesses from the time put it, you could see drug users lying in their own blood and feces, while others were shooting up beside them. The park reeked of the vomit and decay enfolding the camp.
When did Zurich make methadone available?
For example, in 1992 Zurich made methadone available to heroin users who were formerly denied the treatment. Mark was one of the addicts who got therapy and found housing with a social project. “Those programs helped tremendously to get people off the street,” he says.
When was the last update on Switzerland 2021?
Last update on June 02, 2021. Written by Stefanie Knoll. It took a controversial break from tradition for Switzerland to erase a national embarrassment: it started handing out heroin and drugs to addicts. How did Switzerland’s drug laws change with the times to solve a national problem?
Who is the chief of psychiatry at Arud Centers for Addiction Medicine?
The conditions there were no better than at Platzspitz. “At this point, the pressure to find a solution was overwhelming,” says Thilo Beck , chief of psychiatry at Arud Centers for Addiction Medicine, a nonprofit that provides drug addicts with therapy.
How much heroin is consumed in Switzerland?
It has been estimated that just the 10% heaviest users of heroin in Switzerland (most of whom fall into the HAT target group) consume around 50% of all the heroin imported. 21 As a result, the reduction in their consumption of illicit drugs as they enter the HAT programme (and the absence of any increase in new heroin users) could lead to a substantial decline in the overall production and transit of illicit heroin for use in the country. So in addition to the potential benefits on an individual and domestic level for consumer nations, if these programmes were rolled out widely, it could significantly reduce the global demand for illicit heroin. This in turn would lead to a corresponding reduction in illicit production, transit and supply – and the vast criminal costs they generate.
When did the Swiss HAT system change?
In 1992 , a change in the law enabled such an exploration. The Swiss HAT model differed from the old British System in that rather than being given ‘takeaway’ prescriptions, patients were required to attend a clinic once or twice a day and to use their prescriptions on site under medical supervision.
How many people in the UK use heroin?
Despite an exponential rise in use since then, today less than 200 of the UK’s more than 200,000 users receive heroin on prescription. Switzerland, like much of Europe, experienced a rapid rise in injecting heroin use during the 1970s and 1980s, but ultimately adopted a very different policy model to the UK.
What is chapter 5 of the British Medical Association?
British Medical Association Board of Science (2013) ‘Chapter 5 – Drug policy in the UK: from the 19th century to the present day’ in Drugs of dependence: the role of medical professionals. The relevant legislation being the UK Dangerous Drugs Act of 1920, and the Hague International Opium Convention of 1912.
Which countries prescribe heroin?
A number of countries – including Switzerland, the UK, Germany, the Netherlands, and Canada – prescribe heroin for use under medical supervision, as part of successful programmes to treat long-term users of illicit opioids. Recently Glasgow and Durham, UK, have put forward proposals for Heroin-assisted treatment ...
Where is the drug facility for heroin?
A supervised drug consumption facility in Bern, Switzerland. The prescribing of medical-grade heroin as a treatment for heroin dependence has a long history, having been firmly established in UK medical practice by the 1926 Rolleston Committee, 1 after which it operated in parallel with the criminalisation of non-prescribed heroin ...
Was heroin diverted to illicit markets?
Heroin from the trials was not diverted to illicit markets. Initiation of new heroin use fell (the medicalisation of heroin making it less attractive), and, in turn, there were reductions in street dealing and recruitment by ‘user-dealers’ 10 11.
How many people died from opioids in Switzerland in 1986?
The number of new HIV infections also dropped significantly. In 1986, more than 3,000 people tested positive for HIV in Switzerland.
What are the four pillars of Swiss law?
Those four pillars of the Swiss law are harm reduction, treatment, prevention and repression (or law enforcement). Sponsor. “The goal was not to fight drugs anymore. It’s completely ridiculous to fight drugs,” said Jean-Félix Savary, secretary general of the Romand Group of Addiction Studies in Geneva.
What is harm reduction?
Harm reduction strategies aim to lessen the damage caused to a person by their use of drugs. Needles exchange programs fall under this category, as do legalized drug consumption rooms.
What percentage of Swiss citizens voted for the 4 pillars?
Their push ultimately forced a national referendum in 1997 challenging the four pillars policy. But 70 percent of Swiss citizens voted in favor of the law. The four pillars have withstood other challenges as well, as the majority of Swiss voters continue to support it.
When did Switzerland start hepatitis C testing?
In 2017, there were fewer than 500 new positive tests in a country of 8.4 million. Switzerland began mandatory Hepatitis C reporting in 1988. The number of reported cases peaked between 1999 and 2002, declining since then.
Did Swiss citizens support drug treatment?
Instead of endlessly fighting drugs, they took a new approach and began supporting drug users through new treatment options. The majority of Swiss citizens supported the measures, de spite some pushback inside and outside the country. The nation cut its drug overdose deaths significantly.
Is Swiss politics pragmatic?
And Swiss politics is very pragmatic.”. The rise in HIV infections, drug overdose deaths and the public nature of the drug problem led the Swiss to make major changes in how they approached illegal drugs and treated people who use drugs.
What is the prevalence of drug use in Switzerland?
Prevalence of Drug Use in Switzerland. "The consumption of cannabis, cocaine and ecstasy has increased in the past ten years. At present, around 20% of the population over 15 years of age have consumed cannabis (24% of men and 15% of women).
Why are drugs policy measures being queried?
Pressure on the part of the public and from politicians is thus currently very slight, while at the same time a number of drugs policy measures are being queried due to increasing pressure for public spending cuts.
Why is heroin use declining?
According to Ditton and Frischer, such a steep decline in incidence of heroin use is caused by the quick slow down of the number of non-using friends who are prepared to become users in friendship chains.
Is cocaine used in Switzerland?
Prevalence of Heroin and Cocaine Use in Switzerland. "According to what is currently known, there are only a small number of dependent drug users who exclusively consume cocaine; most of those who are dependent on drugs consume heroin first and foremost. However, cocaine is increasingly consumed in addition to heroin.
Is drug policy lower priority in Switzerland?
After that the importance attached to the drug problem in opinion polls decreased. Today only a handful of people still regard the drug issue as one of our country’s most pressing problems.
Is heroin prevalent in Switzerland?
Prevalence and Trends in Heroin Use in Switzerland. "Heroin has been, at least until very recently, the principal drug problem for Switzerland, as for most Western European nations . In the mid-1990s Switzerland had a heroin addiction prevalence that may have been the highest in Europe.
What was the drug use in Switzerland in the 1960s?
In the late 1960s, the use of psychoactive drugs rose, with the use of cannabis and heroin or other opiates leading the way. As addiction figures rose, the Swiss began to have this problem presented to them in a grim and blatant form. Zurich became known as a center for heroin abusers in Europe. An area in the middle of Zurich known as Platspitz became known as “Needle Park.” Thousands of heroin addicts gathered to shoot up, snort cocaine, hang out, leave their refuse and generally create an unhealthy and ugly scene.
How many people were treated for substance abuse in Switzerland in 2007?
In 2007, 20,000 people received substance abuse treatment in Switzerland. A little less than half of these people were in drug treatment facilities for opiate addiction. Another quarter entered drug rehabs for help with cocaine addiction and about a fifth of those in drug treatment facilities for their addictions to cannabis.
Background
Summary of Impacts
- Changing the law or regulatory infrastructure to allow heroin prescribing, while important, has not driven all the positive outcomes listed below by itself. These outcomes also reflect the wider realignment from a criminal justice to a public health model, and the investment in services that has followed. However, the change in policy and law, much like the introduction of decriminalisa…
Cost-Effectiveness
- There have also been studies considering the cost-effectiveness of HAT in three countries – Switzerland, Germany and the Netherlands. These report the costs of such programmes to be between €12,700 and €20,400 per patient per year – considerably higher than the cost of OST (with methadone estimated at between €1,600 and €3,500 per patient per year). This is due to b…
International Benefits
- It has been estimated that just the 10% heaviest users of heroin in Switzerland (most of whom fall into the HAT target group) consume around 50% of all the heroin imported.21As a result, the reduction in their consumption of illicit drugs as they enter the HAT programme (and the absence of any increase in new heroin users) could lead to a substanti...
References
- British Medical Association Board of Science (2013) ‘Chapter 5 – Drug policy in the UK: from the 19th century to the present day’ in Drugs of dependence: the role of medical professionals.
- The relevant legislation being the UK Dangerous Drugs Act of 1920, and the Hague International Opium Convention of 1912.
- European Centre for the Epidemiological Monitoring of AIDS (EuroHIV) (1999)‘HIV/AIDS surv…
- British Medical Association Board of Science (2013) ‘Chapter 5 – Drug policy in the UK: from the 19th century to the present day’ in Drugs of dependence: the role of medical professionals.
- The relevant legislation being the UK Dangerous Drugs Act of 1920, and the Hague International Opium Convention of 1912.
- European Centre for the Epidemiological Monitoring of AIDS (EuroHIV) (1999)‘HIV/AIDS surveillance in Europe’, Saint-Maurice, France.
- Savary, J.F., Hallam, C., and Bewley-Taylor, D. (2009) ‘The Swiss four pillars policy: an evolution from local experimentation to federal law (Briefing Paper no. 18)’, The Beckley Foundation.
