Cocaine seizures vs. terrorists: All the Armed Forces maintain liaison offices in the Congress. This week I noticed a new, large sign outside the Coast Guard which boasted that they had seized 4.7 billion dollars worth of cocaine. Curious, I asked the two Coast Guardsmen how many terrorists had been intercepted and arrested. They said they believed none, but were not sure. I introduced myself and requested the CG in the century of 9/11 should be focusing on terrorists rather than drugs. I have written to the CG asking for information. I left the two guys perhaps questioning the efficacy of CG efforts.
Natural High: I am still bouncing off the ceiling from last week’s news on the massive cut in federal money to fund drug task forces. I will spend time next week learning how it happened, who to thank and how to educate the Congress to maintain the cuts in Fiscal Year 2009.
Switzerland: the land of neutrality, chocolate and ‘smart on drugs’ policy: This week Jasmine Tyler, of the Drug Policy Alliance, and I met with Dr. Dora Fitzli, the health and science advisor at the Swiss Embassy. The occasion was a hand-off to Jasmine of the work* and contacts I made a year ago. Jasmine and DPA have tentatively planned to hold 2-3 seminars in Congress on the Swiss program dealing with heroin addicts. The Swiss program is widely held as the most successful in the world and has been duplicated in 6 countries. I am confident that Dr. Fitzli and Jasmine will produce a world-class seminar.
* SWISS HEROIN-ASSISTED TREATMENT 1994- 2008: SUMMARY
Overview: Due to the severe drug problem in Switzerland in the early 1990s, (rising number of injection drug users, visibility of open drug scenes, AIDS epidemic, rising number of drug related deaths, poor physical health, high criminality) the Swiss made a fundamental shift in approaching the problems caused by heroin addiction. The Swiss offer treatment-on-demand. Of an estimated 22,000 addicts, 16,500 are in treatment and 92% are given daily doses of methadone at conventional clinics. The Swiss treat about 1300 addicts with maintenance doses of heroin via 23 special clinics operating in cities and two prisons. The Swiss approach has resulted in lower rates of crime, death, disease, a drop in expected new users as well as an improvement in mental and physical health, employment and housing. The program has been copied by six countries: Germany, Holland, Belgium, England, Spain and Canada.
* To qualify for a heroin prescription: 1) at least 18 years old; 2) been addicted (daily use) for at least two years; 3) present signs of poor health; 4) two or more failed attempts of conventional treatment (methadone or other); 5) Surrender drivers license; 6) Heroin can only be obtained at the clinic and must be consumed on site (oral or injection). (Note: Under strict control and specific criteria [for example full employment] a few are allowed to take one oral dose daily away)
A. Patients can receive up to three doses of heroin per day. 60% take the heroin via needle injection, the rest via pill. The use of the oral pill is increasing.
B. Patients average about three (3) years in this plan. However, they may stay in treatment indefinitely. 20% of original patients are still in the program.
C. The vast majority of patients are satisfied or very satisfied with the program.
D. Average age of patient: 38 years.
*Crime Issues: 60% drop in felony crimes by patients. 82% drop in patients selling heroin.
*Death Rates: No one has died from a heroin overdose since the inception of the program. The heroin used is inspected for purity and strength by technicians.
*Disease Rates: New infections of Hepatitis and HIV have been reduced for patients in the program.
*New Use Rates: Lower than expected. 1) As reported in the Lancet June 3, 2006, the medicalisation of using heroin has tarnished the image of heroin and made it unattractive to young people. 2) Most new users are introduced to heroin by members of their social group and 50% of users also deal to support their habit. Therefore, with so many users/sellers in treatment, non-users have fewer opportunities to be exposed to heroin, especially in the rural areas.
*Cost Issues: 48 dollars/day: Patients pay from zero to 12 dollars per day depending on their ability. Note: About 30% of patients work for a living and pay part of the costs. Note: The Swiss save about 30 dollars per day per patient mostly in lowered costs for court and police time, due to less crime committed by the patients.
** This summary was taken from five published reports. The Swiss Federal Office of Public Health reviewed and approved its release. Additional questions should be directed to Dr. Dora Fitzli, the science and health advisor to the Swiss Ambassador at the Embassy. Her English is near native fluency.
NOTE: This summary was researched and written by Howard J. Wooldridge of LEAP.
