Page last updated June 9, 2020 by Doug McVay, Editor/Senior Policy Analyst.

16. Crime Reduction

"Overall, results indicate that heroin prescription is a very promising approach in reducing any type of drug related crime across all relevant groups analyzed. It affects property crime as well as drug dealing and even use/possession of drugs other than heroin. These results suggest that heroin maintenance does not only have an impact by reducing the acquisitive pressure of treated patients, but also seems to have a broader effect on their entire life-style by stabilizing their daily routine through the commitment to attend the prescription center twice or three times a day, by giving them the opportunity for psychosocial support, and by keeping them away from open drug scenes."

Ribeaud, Denis, "Long-term Impacts of the Swiss Heroin Prescription Trials on Crime of Treated Heroin Users," Journal of Drug Issues (Talahassee, FL: University of Florida, Winter 2004), p. 188.

17. 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."

Csete, Joanne, "From the Mountaintops: What the World Can Learn from Drug Policy Change in Switzerland," Global Drug Policy Program (New York, NY: Open Society Foundations, May 2010), p. 19.

18. Swiss Heroin-Assisted Treatment

"It has emerged that heroin-assisted treatment is a suitable option only for a small proportion (currently 4%) of the 30,000 severely dependent injecting drug users. Heroin-assisted treatment is not a replacement for other substitution or abstinence-based therapies, but an important addition for those drug users that have so far fallen through the therapeutic net. This is confirmed by the relatively modest increase in patient numbers since the bar on the legally permitted maximum number was lifted."

"Heroin-Assisted Treatment (HeGeBe) in 2000," Swiss Federal Office of Public Health (Bern, Switzerland: SFOPH, August 28, 2001), p. 2.

19. Treatment Description

"Despite the availability of a wide range of treatment programs, including methadone substitution, not all drug addicts with serious health and social problems could be motivated to enter treatment. A core group remained, which was characterized by numerous social and physical deficiencies. In an attempt to reach this group, Heroin on prescription was launched in 1994 as part of a nationally-based research project. Admission criteria were a minimum age of 20 years, at least a two-year duration of daily intravenous heroin consumption, a negative outcome of at least two previous treatments, and documented social and health deficits as a consequence of their heroin dependence. The treatment consisted of between one to three injections of heroin a day, and medical, psychiatric, and social monitoring.
"After three years, the results showed, amongst numerous other findings, that:
"• The program is able, to a greater extent than other treatments, to reach its designated target group.
"• The improvements in physical health proved to be stable over the whole period.
"• Illicit heroin and cocaine use regressed rapidly and markedly, whereas benzodiazepine use decreased only slowly and alcohol and cannabis consumption hardly declined at all.
"• The participants' housing situation and fitness for work improved considerably.
"• The income from illegal and semi-illegal activities decreased dramatically (10% as opposed to 69% originally).
"• Both the number of offenders and the number of criminal offenses decreased by about 60% during the first six months of treatment."

van der Linde, Francois, "Moving Beyond the 'War on Drugs': The Swiss Drug Policy," James A. Baker III Institute for Public Policy (Houston, Texas: Rice University, April 11, 2002), p. 4.

20. Medicalization of Heroin

"The harm reduction policy of Switzerland and its emphasis on the medicalisation of the heroin problem seems to have contributed to the image of heroin as unattractive for young people."

Nordt, Carlos, and Rudolf Stohler, "Incidence of Heroin Use in Zurich, Switzerland: A Treatment Case Register Analysis," The Lancet, Vol. 367, June 3, 2006, p. 1830.