Pubdate: Thu, 27 Dec 2001
Source: BBC News (UK Web)
Copyright: 2001 BBC
Contact: http://newsvote.bbc.co.uk/hi/english/talking_point/
Website: http://news.bbc.co.uk/
Details: http://www.mapinc.org/media/558
Author: Emma Jane Kirby

BUSINESS BOOMS AT SWISS HEROIN CLINIC

Twenty people queue up in a room thick with cigarette smoke.

A man reading a local paper checks his watch impatiently, and from time to 
time he scowls at the heavy door at the front of the queue.

The door opens suddenly and the two people at the head of the line push 
through.

They look as if they might be collecting unemployment benefit checks or 
social security payments but they are not. They have come here for a 
syringe full of heroin.

In the next room, which is incongruously set out like a classroom, 10 
heroin addicts are shooting up at tables while doctors look on.

"It's not a cosy atmosphere - it's not meant to be like a coffee house - 
they shoot up, and they leave," says Dr Christoph Burki, the Director of 
the Koda heroin prescription scheme in the Swiss capital Berne.

"We don't want them enjoying their euphoria in here - they can do that 
outside."

Dramatic rethink

Since 1994, Switzerland has been giving hardened drug addicts free heroin 
on prescription in a bid to stabilise the health of current addicts and to 
protect the public from the open drug scene.

It was part of a dramatic rethink of the government handling of the drug 
problem in Switzerland, which by the early 90s had reached epidemic 
proportions, leaving a country of just seven million with more than 30,000 
people addicted to hard drugs.

"We had to do something," says Ueli Loecher from the Department of Public 
Health in Berne.

"We tried an approach of repression and intolerance, treating heroin 
addicts as criminals, but it simply got us nowhere.

"We had to recognise that these people had a serious health problem."

The scheme is only open to extreme addicts, with mental and physical health 
problems, and with a history of at least 10 years of hard drug abuse, and 
several serious previous attempts to come off heroin.

The scheme got official federal and public approval when the initiative 
came before two national referendums in 1997 and 1999, and there are now 20 
clinics across the country.

"The results were remarkable. Seventy per cent of addicts remained in the 
treatment programme and went on to methadone programmes or detox programmes 
and became drug free," says Mr Loecher.

"While in the programme, their health situation improved, physically and 
mentally, their social integration improved, their criminal activity 
decreased significantly and overall the outcome was that they could be 
stabilised, they could hold jobs and they went back into society."

Katarina sits in the waiting room between her two morning injections. She 
looks at Dr Burki with admiration.

"I've been in this programme for two years now," she says.

"People criticise this programme but look at me. Before, I got my heroin on 
the street and I couldn't handle anything.

"Now I have money, because I only have to pay a little for my habit, I have 
a job as a cook and they've taken my son out of care and allowed him to 
live with me again. I'm reintegrated into my own life."

Like most of the addicts on the scheme, Katarina has now cut her heroin 
consumption by half and no longer uses cocaine.

"This is why we are expanding this programme," says Dr Burki.

'Terrible scene'

"At present we have 160 patients but from early 2002, we'll take on a third 
more again," he says.

"I used to work as a doctor on the open drug scene and there the scene was 
terrible - blood everywhere, people injecting in their heads, neck veins 
and groins.

"Here it's a clean, sterile and professional environment. We no longer see 
infections, no more abscesses, and the HIV and hepatitis rate is down."

There are those who don't share Dr Burki's positive attitude.

Yves Bichsel from the right-wing UDC party would rather see a police 
crackdown on the drugs problem rather than what he sees as a softly softly 
approach.

"The figures are poor for those who leave the scheme and become drug free," 
he says.

"Some addicts have been there now seven years already; it's a good way for 
them to get cheap heroin and it solves nothing."

David, a patient at the clinic for two-and-a-half years smiles ruefully 
when this is suggested to him.

"On the street I was the lowest you can get. I took the dregs from other 
people's syringes.

"I had holes and sores all over my body and I spent all day and all night 
searching for drugs. Now I have a job and a house like normal people.

"This is not an easy programme; it's not easy being addicted to heroin - 
but with this programme, I am finally controlling my habit." 
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MAP posted-by: Keith Brilhart