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EXPLAINED: What is Switzerland’s heroin distribution programme?

For the past 27 years, Switzerland has been dispensing heroin to addicts. How does this innovative project work?

EXPLAINED: What is Switzerland’s heroin distribution programme?
A needle exchange package. Image Wikicommons

A stickler for law, order, and rules, Switzerland can’t be called “unorthodox”. And yet, when it comes to certain aspects of its drug policy, the country has proven to be quite liberal and innovative. 

This description concerns specifically its pioneering heroin-assisted treatment program (HAT), which consists of supplying pure, industrially produced heroin under medical supervision to a limited number of addicts.

Why did Switzerland implement the HAT project?

The origins of the programme go back to the 1980s and early 1990s, when Zurich’s Platzspitz park was a notorious open drug scene. As addicts used to congregate there and inject drugs in full view, the site became known as a ‘Needle Park’.

Drug scene at Platzspitz. Photo by Stadt Zürich

As the number of drug overdose deaths and HIV rates climbed, officials recognised that repression was not effective in stopping the most hardened heroin users.

Instead, they decided to include prescription heroin as a “therapeutic measure for individuals with a severe heroin addiction”, according to the Federal Office of Public Health (FOPH).

Since 1994, HAT consists “of the strictly regulated and controlled administration of diacetylmorphine [heroin], accompanied by medical and psychosocial care. In the light of the positive results obtained, it was adopted as a therapeutic measure”, FOPH said.

André Seidenberg, a Zurich doctor who participated in the government’s heroin trials, told The Local that by adopting this pragmatic approach, “Switzerland has overcome hypocrisy and offered a safe and adequate supply of heroin to addicts, without moralising”.

READ MORE: Cannabis: What are the rules in Switzerland?

What is the goal of the programme?

Originally, it was meant to keep addicts off the streets and reduce crime.

But the programme goes beyond that. The government convened expert scientific and ethical advisory bodies to devise an alternative to “zero-tolerance” drug policies practiced elsewhere, focusing instead on prevention, harm reduction, medical care and counselling for the most severely dependent addicts, and eventually their reintegration into society.

As FOPH explains it, HAT’s goal is “to improve the physical and mental health of those affected and promote their social integration; to facilitate low-risk use and create the conditions for permanent abstinence; to distance those affected from the illegal drug scene and prevent crime associated with the supply of drugs”.

READ MORE: Drugs and alcohol: Just how much do the Swiss consume?

However, since strict supervision is required, the programme is only open to a small number of addicts: in 2019 — the last year for which data is available —1,700 people received this treatment in 22 specialist outpatient centres and one prison.

This covers only about eight percent of addicts, according to FOPH.

Who is eligible for the HAT programme?

The selection criteria is strict: FOPH considers only those with severe heroin dependency for at least two years who have had at least two unsuccessful treatment attempts, and who display physical, mental or social consequences of drug use.

For those who are not part of the HAT programme, several Swiss cities offer safe and clean ‘injection centres’ with sterile material and trained staff.

Has the HAT programme been successful?

FOPH says it has been a success. 

“The results show clearly a constant improvement in the addicted individuals’ mental and physical health, as well as in their social situation. Crime levels have also been reduced”.

The programme has been “the main game changer in Switzerland’s drug policy”, Seidenberg pointed out.

“Since a quarter of a century drug addicts live a normal life in Switzerland, with nearly normal life expectancies, and almost no more deaths from AIDS or overdose”, he added.

How does the public feel about this programme?

As HAT is government-run — that is, funded by taxpayers — it was necessary that Swiss public be on board before the project could get off the ground.

In a 1997 referendum, 70.6 percent of voters turned down proposals from conservative groups to scrap the government’s liberal policy on illegal drug use.

And in 2008, when it was time to renew the heroin distribution program, 68 percent of voters approved its continuation, because they saw it as an effective way to keep addicts off the streets and reduce crime.

Do other countries have similar programmes?

While in the 1990s Switzerland was a trailblazer in heroin distribution, since then a handful of other countries, including the UK, the Netherlands, as well as Canada and Australia, copied the concept, adjusting it to their own requirements.

Last but not least: what happened to Zurich’s Platzspitz?

It morphed from the needle and garbage-strewn drug hub to a clean recreational area popular with Zurich families.

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Five beautiful Swiss villages located less than an hour from Zurich

Live in Zurich and want to get away but don't have too much time? These five beautiful villages are less than an hour away, making them perfect for a day trip.

Five beautiful Swiss villages located less than an hour from Zurich

Just a few kilometres from the financial capital of Switzerland there are little gems to be discovered in every season.

These five villages are members of the association “Les plus beaux Villages de Suisse” (The most beautiful Villages in Switzerland), which aims to protect and promote those villages that have a distinct architectural, landscape and historical beauty.

A pleasant journey through these lovely villages, to discover in just one day or combining them together, awaits you!

Grüningen (ZH)

In the green meadows of the Zurich countryside lies this picturesque little town with its typical local architecture and a lovely castle.

There is also a botanical garden here that is unique in Switzerland. Today, this small town in the Zurich Oberland offers a variety of cultural attractions.

No fewer than three museums, including the castle museum.

A second exhibits over 10,000 pewter figures in miniature dioramas and the last, free museum is dedicated to the world of beekeeping.

There are also several traditional markets in the off- season and a famous Christmas market.

Must see: The beautiful castle and the unique botanical garden.

READ MORE: Six beautiful Swiss villages located near the Austrian border

Bremgarten (AG)

Old churches, medieval towers and an impressive wooden bridge make this little town, enclosed between two bends of the Reuss river, an unmissable destination.

Bremgarten captivates with its intimate and poetic atmosphere.

But this Aargauer town is also exuberant, especially at carnival time, when it is invaded by the Guggenmusik of brass bands, or at the Christmas market, one of the most famous in Switzerland.

The Easter and Whitsun markets are also very popular and remind us that Bremgarten has always been a place of festivities and conviviality.

Must see: The impressive wooden bridge and the busy Marktgasse.

The Swiss village Bremgarten (AG). Photo: Association “Les plus beaux Villages de Suisse”

The Swiss village Bremgarten (AG). Photo: Association “Les plus beaux Villages de Suisse”

Diessenhofen (TG)

Only an old covered wooden bridge lies between this ancient little town and Germany.

Let yourself be seduced by the beauty of this place and embark on a boat trip on the Rhine.

The river here flows in all its glory, forming here one of the most beautiful river landscapes in Europe.

The symbolic covered bridge majestically spans the river over a length of 85 metres with the German-Swiss border in the middle. Excursions from the Schifflände allow you to explore this unique region with its vineyards and medieval castles.

On your way back to the historic centre of Diessenhofen, don’t miss the beautiful Siegelturm.

Must see: The old covered bridge and the Siegelturm.

The Swiss village Diessenhofen (TG). Photo: Association “Les plus beaux Villages de Suisse”

The Swiss village Diessenhofen (TG). Photo: Association “Les plus beaux Villages de Suisse”

Gersau (SZ)

The former independent republic is known as the ‘Riviera of Central Switzerland’ thanks to its almost Mediterranean climate and the exotic plants that can be found here in abundance.

Today, Gersau is an idyllic village on the shores of Lake Lucerne at the foot of the ‘Queen of the Mountains’ the Rigi (1798 metres).

Chestnut, fig and palm trees thrive here to such an extent that the traditional village in the heart of the national territory has an enviable southern atmosphere.

Gersau is the starting point for excursions on the lake and panoramic hikes up the ridges of the Rigi.

Must see: The museum about its rich history and the beautiful garden by the lake.

The Swiss village Gersau (SZ). Photo: Association “Les plus beaux Villages de Suisse”

The Swiss village Gersau (SZ). Photo: Association “Les plus beaux Villages de Suisse”

Lichtensteig (SG)

The jewel of Toggenburg is a small town founded around 1200, which lies in its crescent shape on a rocky outcrop above the Thur.

A unique historical core is complemented by a dense network of hiking trails in the surrounding hills. The view is impressive from the station as you cross the railway bridge into the centre.

You may enter Lichtensteig via the central street, which is lined with half-timbered town houses and arcaded passageways that recall the town’s former vocation as a trading town that long dominated trade in eastern Switzerland.

Must see: The lovely arcades in the central street and the Toggenburg museum.

The Swiss village Lichtensteig (SG). Photo: Association “Les plus beaux Villages de Suisse”

The Swiss village Lichtensteig (SG). Photo: Association “Les plus beaux Villages de Suisse”

All of these villages and many more feature in the Les plus beaux Villages de Suisse free app available in English for iOS and Android.