Swiss drug policy should serve as model: experts

Countries whose drug policy remains focused on punishing offenders, including Russia and much of Eastern Europe and Central Asia, should learn from a Swiss strategy based on "harm reduction" that protects both users and communities, they said.

Even Iran and China -- while far from espousing Switzerland's system of direct democracy -- have copied its methadone substitution programs, they added.

The Alpine nation's experiment succeeded because Swiss political leaders adopted a pragmatic attitude toward an "uncontrollable" open drugs scene, according to a report "From the Mountaintops: What the World Can Learn from Drug Policy Change in Switzerland," by the Open Society Foundations.

Soaring HIV infection rates, the highest in Western Europe, sparked alarm among the conservative public in the late 1980s and early 1990s, when up to 1,000 drug users gathered daily in Zurich's infamous Platzspitz park, dubbed "needle park."

"We had to change perspective and introduce the notion of public health. We extended a friendly hand to drug addicts and brought them out of the shadows," Ruth Dreifuss, a former Swiss president and interior minister (1993-2002), told a briefing.

Swiss authorities authorized experiments such as syringe exchange programs and safe injection rooms offering a shower, bed and hygienic conditions under medical supervision, said Dreifuss, who led the campaign to reform narcotic drug policy.

Some 70 percent of the 20,000-30,000 opiate or cocaine users in Switzerland now receive treatment, one of the highest rates globally, said Dr. Ambros Uchtenhagen, who helped pioneer heroin substitution and chairs the Research Institute for Public Health and Addiction at Zurich University.

"The number of drug injectors with HIV has been reduced by over 50 percent in 10 years. Overdose mortality among injectors has been reduced by over 50 percent in the decade," he said. "Delinquency related to drugs has been reduced enormously."

Family doctors now prescribe about 60 percent of opiate substitution treatment in Switzerland and the Internet was vital in informing users about access to treatment, Uchtenhagen added.

"I'm really impressed with the policies Switzerland has put in place, which are based on sound science and grounded in good global health policies and human rights," said Dr. Michel Kazatchkine, executive director of the Global Fund to Fight AIDS, TB and Malaria. "Switzerland is clearly a pioneer."

Up to 10 percent of all new HIV infections worldwide every year occur through injecting drug use, he said. An estimated 3 million of the 33.4 million people living with the HIV virus inject drugs, he said. "So it is a huge problem."

The AIDS epidemic is spreading faster in the Eastern Europe and Central Asia region than anywhere else, led by drug users, according to Kazatchkine. "We are still facing huge societal, political and cultural resistance to implementing evidence-based policies for intravenous drug uses," he said.

He said Russia, home to nearly 1 million people living with HIV, more than half of them drug-users, was especially reluctant to abandon its drugs policy based on law and order.

"Russia is totally closed to the idea, it is impossible to open a dialogue," Kazatchkine said.