STATE-SANCTIONED DRUG SCHEME

New Ways of Treating Drug Addiction in Zurich and Amsterdam

Mattheus has a lid on things. Every morning he wakes up in a flat he has
kept for years, to a steady job and a long-term relationship. The health
authorities in Zurich are keen to make sure that he stays that way. So at 8
o'clock every morning, on his way to work, and then at six every evening on
his way home, he drops off at a local clinic so the state can provide him
with heroin.

Without it Mattheus, a long-term addict, says he couldn't function. He
would spend his entire time looking for drugs or the money to buy them.
With it he says he has the "rest and a regulated lifestyle" he needs and is
out of the drugs scene altogether. The regular doses of heroin which he
gets from the state, he says, even makes him feel healthier. Within two
years he hopes to be drug free.

Switzerland, a country notorious for its soporific purity, is experimenting
with drugs again. The nation's largest city, Zurich, is once again at the
forefront. Mattheus is one of some 200 long-term heroin addicts in Zurich
who has benefited from a national programme of giving a small number of
addicts the drugs they need to get through the day - a scheme which has
slashed crime rates and increased employment in the city among a group
which until recently had been written off.

"We still believe that a life dependent on drugs is not a good life," says
Rosann Waldvogel who is the head of the town's heroin project. "So the aim
is not to encourage dependency. But these are a very specific group of
people. They have been addicts for a long time and all other attempts to
wean them off drugs have failed. We don't just hand out heroin either. In
order to get it they have to come in for other forms of help as well. There
are meetings with social workers, nutritional advice, therapy and so on.
And this helps them lead a more regular lifestyle and takes drugs off the
streets." The results have been impressive. The number of those who took
part in the scheme with permanent jobs rose from 14 per cent to 32 per
cent; unemployment dropped from 44 per cent to 20 per cent; and the share
of those involved in theft and drugs plummeted from 69 per cent to 10 per
cent. "It means these people don't have to steal to get money. It gives
them time to settle themselves and to get involved in other projects. It
works well for a very specific group of people," says Norbert Klossner of
the Zurich police department.

Eveline Gugger, who has been a heroin addict for 11 years and has been
getting her supplies from the state for four years, has reduced her intake
by two-thirds, moved off the streets and into a flat and got a job in the
kitchen of a restaurant.

"This scheme has saved my life," she says. "As well as taking less heroin,
I've given up cocaine and I can live a life I never lived before." The same
targeting might work in Britain. The Swiss model is partly based on the
experience of a similar project in Liverpool which produced less dramatic
but encouraging results, but was not taken up nationally. Most of the UKP4
billion of drug-related crime in Britain is caused by about 200,000
addicts. But the project in Switzerland was a political experiment as much
as a medical one. For such a scheme to work it demands that authorities
acknowledge, as a starting point, that some people will take drugs
regardless of prevention programmes and stiff sentences - an approach
increasingly adopted on the continent.

Britain, however, has chosen to follow the American route of zero
tolerance, which blurs the lines between soft and hard drugs and treats
most attempts to co-opt drug addicts as a tacit acceptance that the war has
been lost. More than 60 per cent of the annual drugs bill is spent on law
enforcement, compared with 13 per cent on treatment programmes and 12 per
cent on education.

Part of the success, says Professor Gutzwiller, the professor of
preventative medicine at the University of Zurich, has been the scheme's
ability to target those most in need. "These are the people who are the
sickest and in social terms the most problematic: people with no relations
outside of the drugs scene who are the most desperate and therefore the
most likely to resort to theft and prostitution." "It's just much safer
now. When you have a park full of addicts in the middle you have no idea
what will happen," said a local woman, Mrs Scheneider. "It got so you
didn't want to bring your children into town. I voted to change the law
because I thought anything must be better than what we had before and the
problem is not just going to go away." The programme also appears to have
helped steer many away from hard drugs altogether. More than half of the
1,146 people who have been involved in the project have opted for another
type of treatment. Just under 10 per cent have stopped taking heroin to
pursue a course of abstinence, according to the findings of the institute
for social and preventative medicine in Zurich. They are also less likely
to die than those following other courses of treatment.

It has also freed up resources in other drug programmes for less severely
dependent addicts. Programmes previously spent much time and energy on
trying to rehabilitate users who were never going to come off drugs through
orthodox methods. "Before, you only had the choice of prison, abstinence,
or therapy, and that did not suit some people," says Peter Sumpf, the head
of Frankental clinic, which does not give out heroin. "Now there is an
alternative we are all able to give better quality care." The last time
Zurich adopted an innovative approach to its drugs problem things did not
go so well. During the nineties the city had a policy of trying to contain
open drug use in a confined area so that it could be treated more easily
and would be forced out of the underground. The result was a disaster known
throughout Europe as Needle Park: a small stretch of grass behind the
Landes-museum which attracted around 2,000 people a day to come and trade
in drugs with that number doubling at the weekend. Inside, addicts used to
lie inert on the ground, spattered with blood and strewn with needles.
Outside men would wait for young women who would prostitute themselves so
that they could get their next fix. Just yards away the police looked on,
their bosses annoyed by the obvious failure of this "political experiment."
"I think a lot of people came to Zurich from abroad during this time
because it had a big open drugs scene. Needle Park got a reputation that
drew people in from countries with more repressive drugs policies," she
says.

Switzerland also finds itself inconveniently poised on the end of the opium
trading route that starts in Afghanistan, Pakistan and Iran and passes
through the Caucasus, Albania, Romania or Hungary before arriving in a land
more renowned for Emmenthal and cuckoo clocks and making it a lucrative
terminus for dealers from all over the world. Of the 362 dealers arrested
in Zurich in 1993, fewer than a third were Swiss.

Little wonder then that the latest policy, launched in 1994, proved to be
controversial. A group called Youth Without Drugs challenged the plan,
preached abstinence and gathered 100,000 signatures to put the question to
a referendum. Drawing on the failure of Needle Park which has since been
cleared, renovated and returned to its former serenity in the middle of
lake Zurich - the campaigners" message was simple: "You can"t fight drugs
by giving them away free," said one leader.

But the referendum, in September of last year, delivered a crushing defeat
to the nay-sayers with 70 per cent backing the new plan. "I have been in
this job 11 years and I cannot explain why we won by so much. I was
shocked. I thought maybe we would win but not by this much. We even won in
rural areas where people are more conservative and don't have much of a
drugs problem. I think people saw that it was a complicated issue and
recognised that it needed a complicated response," says Waldvogel.

The programmes do not hold the sole responsibility for this. The culture of
drug dealing has also changed over the last decade. From shady deals on
ill-lit streets to deliveries ordered by mobile phones and pager requests.

While the new policy has reduced the number of addicts coming to the city
there is little evidence yet that it has actually reduced the number of
addicts in Zurich. Its proponents say it is not supposed to: "It is part of
a four-point plan, along with therapy, prevention and repression. What it
has done is closed down the open drugs scene, made drugs less generally
available and removed what was a real problem for the general public," says
Waldvogel.

Almost. An evening trip to the tramway stop where Langstrasse meets
Limatplatz will suffice to show that there are still individuals dealing
openly in the streets of Zurich. There are young men walking around in
purposeful circles, stopping for quick conversations with individuals
roaming equally aimlessly and then either moving on or disappearing up an
improbable alley only to appear from the shadows again 15 minutes later and
start circling again.

But compared to the brazen nature of the bad old days, the nocturnal scenes
at Limatplatz show a marked improvement, local experts say. So marked, in
fact, that the authorities in Amsterdam - a group who have dabbled in
inventive drugs policies for so long one would have thought there was
little more they could learn - are about to follow suit.

Once again they will concentrate on long-term addicts - although not quite
as long-term as the Swiss - who have not responded to other forms of
therapy. But unlike the Swiss, fashion is helping to regulate the Amsterdam
drug scene all by itself. "Young people are not interested in heroin
anymore. They see it as a loser's drug for old men and one that doesn't fit
in very well with the music scene. They prefer cannabis or Ecstasy and with
these two drugs addiction is not really a problem," says Roel Kesemakers,
the spokesman for Yellineck drug clinic.

Since the early eighties the number of registered heroin addicts has almost
halved in Amsterdam and every year the average age of the addicts gets
older. "By keeping the heroin addicts alive longer through methadone, a lot
of the young people now have the chance to see what they look like and they
don't want to look like them," says Von Brussels, a doctor with the
Amsterdam drug department.

From the coffee shops around the city centre, most of which are filled with
young Americans, Brits and Germans enjoying a country where certain
premises are legally permitted to sell cannabis, it is clear that a form of
drugs tourism still brings many people to the city. But the days of
Amsterdam acting like a magnet for the flotsam and jetsam of the
continent"s failed rehabilitation attempts have long gone. The city is
treating the lowest number of foreigners for drug related problems since
1979, said one official.

"It is partly a sign of the failure of countries" attempts to control the
drug market," says Kesemakers. "You can get as high quality drugs elsewhere
now as you can in Amsterdam so why travel," he says.

With the Ecstasy testing kits in nightclubs, and cafes with names like
Mellow Yellow, officials in Amsterdam also believe their liberal attitude
towards softer drugs has helped stop those who take soft drugs being led
astray and wandering nonchalantly into addiction with the harder variety.
"Here, if you want cannabis you go to a coffee shop. In other countries if
you want it you have to go to a man who might try to sell you heroin or
cocaine as well. It separates the two scenes completely," says Von Brussels.

Sit in the Fibo snackbar where the Neumarkt runs into Zedijk street and you
will see the heroin and cocaine sellers out in force. Around this area of
the red light district drugs change hands within seconds of a police patrol
passing. "They know it happens but I think that so long as there is no
trouble and people don't actually use them in the streets then they are
prepared to let it go," says one barman. "Maybe that's better or maybe it's
just easier for the police. It doesn't make for a big problem here either
way. There's no fighting, shooting or violence and no people laying around
the next morning in the street. The police are strict about that." By
providing heroin itself, the authorities in Amsterdam, as in Zurich, hope
to transform the problem into part of the solution. One more way, officials
say, to push the hard drugs pushers even further into the backstreets.