Heroin Assisted Treatment in Switzerland
"Based on its 1992 call for proposals, the Federal Office of Public Health authorized HAT trials in Zürich, Bern, Basel, and Geneva involving about 1,000 persons in the first instance (Bammer et al. 2003). Studies of HAT continued in Switzerland beyond the first trials. The full results of this work are beyond the scope of this paper, but what may be hundreds of peer-reviewed journal articles on the trials, as well as a book produced by FOPH (Rihs-Middel et al. 2005), attest to the care taken to document a wide range of health and social outcomes from the HAT experience. In brief, some of these results are as follows (See esp. Uchtenhagen 2009, 34 and Bammer et al. 2003, 365):
" It was possible to stabilize dosages of heroin, usually in two or three months, without a continuing increase of dosages, which some had feared.
" There was significant and measurable improvement in health outcomes for patients, including significantly reduced consumption of illicit heroin and even illicit cocaine.
" There was a significant reduction in criminal acts among the patients, to the point where the estimated benefits of this effect well exceeded the cost of the treatment (See also Killias et al. 2005).
" Heroin from the trials did not find its way into illicit markets.
" Initiation of new heroin use did not increase.
" Utilization of treatments other than HAT, especially methadone, increased after the advent of HAT rather than declining as some had feared.
In short, the fears of opponents of HAT were largely refuted by solid evidence, though, of course, political debate would continue."