ONE ANSWER

IF you go to Hamburg these days you can't miss the Blue Goals. They
form a modern art masterpiece for the World Cup - 120 fluorescent
blue goals on buildings all over the city. When the battle for the
Jules Rimet Cup is in town, Hamburg will host three matches,
including a quarter final. Frank Jerke says he can't wait. He'll be
glued to the television and may even try to get a ticket for one of
the games. Time was when that would have been unthinkable. Less than
three years ago, Jerke was down-and-out, homeless, and hopelessly
hooked on heroin.

It was around 7am when I first saw him on Hoegerdamm Street on the
outskirts of Hamburg city centre. He's a big man. He stumbled off the
bus and muttered "Morgen", as he passed me at the top of the steps.
Downstairs he rang the bell at the Hamburg heroin clinic. Inside, he
took a breath test to prove he hadn't had any alcohol and then he
went next door into what they call the application room. There, under
medical supervision, he was given a syringe with chemically pure
heroin - diamorphine - diluted in water. He got up on a bed, dropped
his trousers and injected it into his thigh. Head back and eyes
closed for a few minutes then he got up, left the clinic and went to
work in one of Hamburg's ship-repair yards. Same as he used to do all
those years ago before the smack got him. "Everything is good now,"
he says. "I've got a nice flat of my own and a good job. Better." He
laughed as he left. These days his teeth would be a credit to any
toothpaste manufacturer.

Jerke is one of 500 drug addicts in Germany who are on the heroin
pilot programme being conducted in seven cities across the country.
Hamburg's is the biggest trial. German doctors looked at the success
of heroin on prescription in Switzerland and the Netherlands and,
after years of debate, the Bundestag accepted a pilot scheme should be set up.

The project began three years ago and was based on comparing heroin
maintenance with methadone maintenance: 500 or so users were given
heroin - they had to have failed on methadone in the past - and 500
were given methadone. The results were published recently. On almost
all counts the heroin group did better than the methadone group.

Dr Christian Haasen is the research director of the German trial. In
his office, at the University of Hamburg he tells me in a matter of
fact manner: "The differences between the heroin group and the
methadone group are statistically significant. Those on heroin stayed
in treatment longer and the drop out is less than the methadone
group. They had much less illicit drug use, using street heroin and
cocaine, and so have better health records."

He says he knew from the Swiss and Dutch trials that there would be
differences but even he was surprised at the improvements made by
those on heroin.

These positives also affect employment prospects. At the Hamburg
clinic, 40 of the 90 clients going there for heroin are in work.
Ludovic Leblanc, 32, is a waiter in one of the best Italian
restaurants in the city. His take-home pay, with tips, is UKP2400
(UKP1800). He's got a good flat in the city centre and looks every
inch an aspiring head waiter when he's kitted out for work. Not bad
for 15 years on heroin.

Leblanc goes to the clinic twice a day: before work and during his
afternoon break. His employer knows. But in his kitchen 13 storeys
above the River Elbe, I put it to him that, remarkable as his
progress has been, he's still stuck on heroin. "No, I hope to be
drug-free by this time next year," he asserts. He's on a quarter of
the daily dose of heroin he took when he started at the clinic two
years ago. "I couldn't have dreamed of that on methadone. After a
year and a half on methadone the dose stayed the same and I would go
to get street heroin almost every night."

DOCTORS at the Hoegerdamm clinic say one in 10 patients is on a
sufficiently decreased dose to be described as "moving towards
abstinence". But the study 's preliminary figures don't show any
great difference between heroin and methadone in the numbers that end
up drug-free. Drug deaths, however, are different. Since 2001 drug
deaths in Germany have fallen by 40%, according to Haasen.

A policeman made the same point about Hamburg. Chief Superintendent
Norbert Ziebarth is head of youth protection for the Hamburg police.
At the rather imposing Polizeiprasidium HQ in the north of the city,
he tells me that since the heroin clinic was set up, drug deaths in
Hamburg have fallen from 101 in 2001 to 61 last year. The clinic, in
a way, also allowed a police crackdown on what used to be Hamburg's
open drug scene. There are no shooting galleries in parks or
congregations of druggies in the central railway station on the scale
there used to be. The police back the trial and its extension. "It
works for the worst heroin users. We support it," says Ziebarth.

Not everyone is of the same view. The heroin clinic experiment was
introduced by the Social Democrat government of Gerhardt Schroeder.
Now the conservative CDU, led by Angela Merkel, are in power. They
are altogether less enthusiastic about heroin on the state. I found
that out when I met the Hamburg state minister of health, Dietrich
Wersich. He disputes some of the findings of the German study and
questions the costs of heroin on prescription - thus far three times
greater than methadone.

"The results for the heroin group were only slightly better than
those of the methadone group," he says, "and they may have been due
to other factors than solely the prescription of heroin, like better
social services support and things like that."

Wersich is also dubious about what he describes as the state becoming
in effect a licensed narcotics dealer. "For us to give patients a
daily kick on heroin cannot be seen as a permanent solution. Instead
we have to work to get them drug-free and how can you say that's
being done if the government is giving them a kick on heroin every
day ... and besides, will the taxpayer be prepared to pay for this?"

This weekend The Lancet medical journal published a research study of
the Swiss heroin clinics which have been running for 10 years. The
study suggests the Swiss model is responsible for reduced heroin use
in the long-term, and Swiss drug deaths have plummeted in the last
decade. The Lancet editorial points out that in the same time the UK
has had the highest drug deaths every year of any European country.

The last official figures for drug-related deaths in Scotland was 356
for 2004. That was almost 50% higher than a decade ago. So, is it now
time for Scotland to follow Germany and other European countries and
introduce heroin clinics to give our worst addicts drugs on prescription?