ZURICH — As U.S. communities continue to experiment with programs to cut drug addiction and HIV infection spread by drug users, some have cited European experiments with the decriminalization of drug use. But before venturing further in this direction, policy makers should acquaint themselves with an elaborate new “scientific” program set in motion in 1992 in Switzerland, which has the highest per-capita rate of drug addiction and HIV infection in Europe.
Seven hundred of the 30,000 to 40,000 opiate addicts in Switzerland were targeted; nine cities participate. The experiment — in which heroin, morphine and methadone are administered intravenously, orally and by smoking — is scheduled to end in December 1996. Previously, the Swiss addicts were concentrated in central parts of major cities, such as “Needle Park” in Zurich. But the result was increased drug use, crime, violence and prostitution, which quickly became intolerable. So the addicts are now in government-sponsored centers and “shooting galleries.”
In analyzing this “scientific” project, I met with its administrators and evaluators and visited the major heroin distribution center, Arbeitsgemeinschaft fur risikoarmen Umgang mit Drogen (ARUD), in Zurich, which currently treats 70 to 80 heroin addicts. Most have a criminal record, are unemployed and are on social welfare. Nearly half are HIV positive. A majority of the patients are multidrug users, and many use cocaine in addition to the heroin they’re given at the center. Their outside drug use, however, does not prohibit their participation in the program. Urine analysis to monitor drug consumption is conducted once a month on a set day because “the treatment in our center is based on trust,” said Andre Seidenberg, director of ARUD.
The center is easily accessible and anyone can enter. A half-dozen people sit in the waiting room smoking specially developed cigarettes containing 100 milligrams of heroin, which are distributed by the receptionist behind the window. She also provides syringes with heroin up to nine times a day and a maximum of 300 millligrams. Each addict is listed in a computer system that monitors his consumption. The injecting room, off the entrance, contains a large mirror used to provide the addicts with a better view of their veins, so they can inject more efficiently, explained the director. Why feed heroin to the addicts? “Because the addicts prefer heroin [to methadone],” responded Dr. Seidenberg, “and we should give them what they want without conditions.”
The design of the project calls for supervision of the injecting process, to make sure the addicts don’t save the drugs to sell them later on the street, but I saw none. Although the addicts return the syringe after the injection, they could easily inject the heroin into a small container to be sold later. Moreover, in addition to the injectable heroin, they are given 26 heroin cigarettes to be used at home overnight. The heroin costs the addicts about $12.50 a day, covered by health insurance, the City Council, the canton (state) or the federal government. The design of the project also calls for support services — especially psychiatric and medical treatment, job training, occupational therapy, etc. But none of these are available at the center.
In an emergency, the addict is sent either to a psychiatric hospital or to an emergency room. As for therapy: “There is no proof that there is long-term effect to therapy — therapy doesn’t make a difference,” Dr. Seidenberg said. And as for work, “you go when you feel like it — you really don’t have to [work],” according to Ueli Locher, the deputy director of the Department of Social Services of Zurich.
The Swiss experiment originated from a desire to reduce HIV infection among the population. Complementing this experiment are information programs and pamphlets supplied to teenagers, young adults and adults. This information equates homosexuality and drug addiction and describes both as “alternative lifestyles.” Both sexual activity and drug use are described in detail with illustrations and the motto that “if you want to experiment — do it well.”
Currently, according to Mr. Locher, “cocaine is not given [to addicts] because of political reasons.” But he and his comrades in drug liberalization hope that this will change and that all drugs will be available to those who need them. Drug supply by the government is supposed to reduce the number of addicts, but so far there is no indication that fewer people are taking illegal drugs in Switzerland. There are no signs that crime and violence have gone down. And the Swiss taxpayer is footing the bill for a growing number of AIDS patients, more welfare recipients, and a growing police force.
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Ms. Ehrenfeld is the author of “Narco-Terrorism” (Basic Books). She is currently writing a book on the movement to legalize drugs. (See related letter: “Letters to the Editor: Swiss Program Rescues `Hopeless’ Addicts” — WSJ Sept. 27, 1995)
- The op-ed was published in The Wall Street Journal, on Sept. 6, 1995, p.A18