source: https://www.northcarolinahealthnews.org/2019/01/21/switzerland-couldnt-stop-drug-users-so-it-started-supporting-them/
January 21, 2019
The Swiss people took drastic measures to reduce the number of people dying from opioid overdose. Their approach is effective - and unorthodox. The first in a series describing how Europeans have tackled their overdose issues.
ZURICH and GENEVA, Switzerland — Today, Platzspitz Park serves as a peaceful respite for those meandering along the Limmat River and past the Swiss National Museum. But it’s best known by the nickname “Needle Park.”
That’s because in the 1980s the park was hijacked by thousands of heroin users and dealers. The space, despite being in the heart of downtown Zurich, became one of the most famous examples of Switzerland’s “open drug” scenes.
Local police were tired of trying to control and disperse large groups of users, so Needle Park became one of the spots law enforcement left alone.
Rates of HIV infection soared from the sharing of needles. And the number of drug overdose deaths climbed.
People were injecting and dying outside one of the most beautiful hotels in Zurich. The same thing happened near political buildings in Bern, the nation’s capital, said Rita Annoni Manghi, director of the opioid substitution and heroin-assisted treatment programs at Hôpitaux Universitaires Genève.
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Platzspitz Park, nicknamed “Needle Park,” sits next to a river by the National Swiss Museum in downtown Zurich. It’s a clean, peaceful space now, but in the 1980s was filled with heroin users and dealers.
It was the equivalent of people dying on the White House lawn, she said.
“So you are obliged to see the problem,” she said. “And Switzerland is not so modern, but it’s very pragmatic. And Swiss politics is very pragmatic.”
The rise in HIV infections, drug overdose deaths and the public nature of the drug problem led the Swiss to make major changes in how they approached illegal drugs and treated people who use drugs.
And in 1994, Switzerland went on to pass one of the most progressive and controversial drug policies in the world, which included the dispensing of heroin.
“Switzerland is no one’s idea of a leftist country,” Joanne Csete wrote in her paper “From the Mountaintops: What the World Can Learn from Drug Policy Change in Switzerland.”
“Its famous tradition of protecting bank secrets, its having granted women the right to vote only in the 1970s, and its referendum-based rejections of minarets on mosques and decriminalization of cannabis illustrate its quirky conservatism,” Csete wrote.
But the Swiss are pragmatic. Instead of endlessly fighting drugs, they took a new approach and began supporting drug users through new treatment options.
The majority of Swiss citizens supported the measures, despite some pushback inside and outside the country.
The nation cut its drug overdose deaths significantly. HIV and Hepatitis C infection rates dropped. And crime rates also dropped.
The Four Pillars
To address the Swiss drug problem, elected officials, community members, law enforcement and medical experts all worked together to create the “four pillars” drug policy.
Those four pillars of the Swiss law are harm reduction, treatment, prevention and repression (or law enforcement).
“The goal was not to fight drugs anymore. It’s completely ridiculous to fight drugs,” said Jean-Félix Savary, secretary general of the Romand Group of Addiction Studies in Geneva. “We came to this conclusion and decided to change.”
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Rita Annoni Manghi, medical director of the opioid substitution and heroin-assisted treatment programs at Hôpitaux Universitaires Genève (left) sits a heroin injection spot inside the facility with Christel Ding (right), a nurse who supervises the program.
“It was a big revolution. We don’t try to ask people not to take drugs, but take care of problems generated by the situations around people being addicted to drugs.”
The policies became as much about public order as public health, Savary said.
There was some resistance among some Swiss civil groups. Their push ultimately forced a national referendum in 1997 challenging the four pillars policy. But 70 percent of Swiss citizens voted in favor of the law. The four pillars have withstood other challenges as well, as the majority of Swiss voters continue to support it.
The multi-pronged approach included some controversial measures — such as legalized drug consumption rooms and heroin-assisted treatment facilities — but ultimately, the statistics show it has been successful.