What would happen if the U.S. government announced a new obesity-fighting initiative whereby every chronically obese person in the country was given up to two federally-funded Big Macs a day? That’s basically the plan of attack Switzerland is taking with its heroin addicts. The BBC reports that the Swiss have passed a “radical” health policy that allows long-term addicts to receive the drug at government clinics, free of charge.
A whopping sixty-eight percent of voters supported the policy, which would allow addicts to inject the drug up to twice a day under medical supervision. Granted, the scheme has some benefits: it increases control of needle use and disposal, provides incentives for addicts to come into clinics regularly and be treated for other medical or psychological problems, and removes the need for them to resort to crime to pay for their habit. Part of the bill’s popularity also comes from the fact that the scheme has already been underway in Zurich for 14 years, and many consider it successful.
Still, at the end of the day, the bill is exactly what it sounds like: a plan to have the government pay to shoot its citizens up with expensive and extremely dangerous drugs.
It’s hard to imagine that lesser alternatives, like offering free methadone instead of a syringe full of Harry Jones, wouldn’t be a better plan, even for the worst addicts. And it would be interesting to see whether Zurich has seen any unintended consequences from its free heroin policy, such as an increase in the number of heroin users who cross the line to addiction or a migration of hardcore addicts in search of a free and unlimited source of smack.
And for the day’s big dose of irony, in another referendum vote at around the same time, 63 percent of the country voted against de-criminalizing cannabis. Where to even begin on that one.
December 1st, 2008 at 4:33 pm
You are wrong to compare drug addiction to obesity, as you need to look at the background: a lot of the problems with drug addiction are caused by what can best be described as “prohibition” – the War on Drugs; while obesity is usually caused by eating too much.
Also you have contradicted yourself: you admit it reduces the crime rate, ensures that the stuff that people inject is safe and encourages them to come for treatment but then go on to say it’s a bad idea.
In any event, heroin is neither “expensive” nor “dangerous”.
Heroin is obtained from poppies which are really cheap to cultivate and extract chemicals from. The “expense” is due to the fact it’s illegal which creates higher risks due to the criminal penalties involved, which then inflates the price. In any event, the Swiss trial has shown that by providing it legally you actually save money due to the drop in crime rates.
If you look at the “dangers” on Wikipedia’s entry on heroin, you will see that they are due to the fact that usually it’s obtained illegally, i.e. from a black market. As a result, you do not have any quality control and so you do not know how strong it is or what impurities are in it. Having it provided by the government will ensure that it is of a good and regular quality.
As for providing methadone, unfortunately it doesn’t always work – it makes a lot of people sick.
I would recommend that you look at the Transform blog for further information.
December 1st, 2008 at 6:46 pm
This author is typical of the ignorance that surrounds the war on drugs. Drug prohibition creates problems, and those problems are then used to justify more prohibition. It is insanity and stupidity at its finest. The majority of people in switzerland approved this program because they have seen it work at reducing crime, disease, and addiction. If only we were so smart.
December 1st, 2008 at 9:18 pm
I have to disagree with the author, and I think their perspective on this reveals a fundamental ignorance and misunderstanding of drug addiction.
First of all, diacetylmorphine (heroin), like most other generic compounds not bound in the patent system, is not expensive and can be easily produced in mass quantities. The “expensive” part comes from the underground trafficking in our modern prohibitionist society. Secondly, diacetylmorphine (heroin), although long demonized in the media, is no more “dangerous” than thousands of other compounds. Even within the opiate family, it is not really any more powerful or addictive than many widely prescribed drugs as such as morphine, oxycodone, meperidine, levorphanol, etc. In fact, prescribed drugs like hydromorphone and oxymorphone are much stronger, and the compound fentanyl itself is multiple orders of magnitude more powerful. Many of these drugs are routinely given by I.V. in a hospital setting, the very same mechanism as a heroin user on the street, albeit with sterile instruments and under medical supervision. My intent is not to justify or encourage drug abuse, but I do think it is important to dispell these misconceptions and just provide the facts.
This Swiss program is basically just an extension of the historical methadone and the newly created buprenorphine intervention programs in the united states. It is nonsensical and counterproductive to claim they somehow “encourage” drug abuse. The beneficiaries are long-term addicts that have attempted various other recovery programs and who would otherwise be using on the street, with all the associated social ills such as crime, spreading of HIV and Hepatitis, etc. These programs do NOT provide a “free high” to addicts, in the Swiss program they are heavily regulating the dosage offered so that the person can be free of withdrawal symptoms and intense cravings and learn how to function in society while they work towards becoming sober. For the most at risk, hard-core heroin addicts, this program is no long-term panacea and should not be seen as such, but combined with counseling and a number of other measures, it has a legitimate function in the short-term to both reduce drug-related crime and to prevent the spread of HIV and hepatitus while providing medical assistance and counseling to addicts.
More importantly, for the larger problem of the millions of discrete opiate addicts — the more typical individuals that are much less “inner city I.V. heroin user” and much more “soccer mom with a vicodin problem”, a different method of intervention is more appropriate. Here in the United States there is a somewhat newer program that began less than a decade ago for these individuals for which the existing methadone structure was not desired or appropriate. Initiated by the recent “Drug Addiction Treatment Act of 2000″, the “suboxone” program allows opiate addicts to receive care from a local family practice or other qualified physician that has undertaken a short, one-day licensing course. Unlike the prior methadone program, it doesn’t require the patient to go through the (embarrasing) daily routine of visiting a far-away methadone clinic, usually in a dangerous area of town. Instead, they simply go to a traditional (private) doctors appoinment once a month where their receive one-on-one care from a familar physician that can follow their progress in the program. Here, they are given a periodic medical exam and drug test followed by a 30-day prescription for a newer drug called suboxone (buprenorphone HCL and naloxone) that will last until their next appointment. Unlike heroin, methadone, and most other prescription opiates, buprenorphone is an unconventional, long-acting, partial-agonist opiate whose characteristics make it much less prone to abuse. Because of it’s unique chemical profile, it is able to ward off the intense withdrawal symptoms and drug cravings associated with opiate addiction, while not providing a strong euphoric “high” to opiate dependent patients. It’s characteristics also make it nearly impossible to overdose on the drug with it paradoxically acting as an opiate receptor antagonist at high doses, in effect canceling itself out. It comes in pill form and is dissolved under the tongue (sublingua) by the patient. Additionally, most forumlations of buprenorphine also include naloxone, a strong opiate antagonist (think anti-opiate) that is further used to discourage illicit abuse or diversion of the drug. This naloxone is not absorbed when the drug is taken correctly, but In the event the drug is insufflated or injected, the naloxone will be absorbed and will lead to intense, immediate withdrawl symptoms. Although the program is still small and there are some obstacles to overcome like the incredibly high cost of suboxone, the program has been much more successful than anything of it’s type and should continue to be pursued and expanded.
Drug addiction is a complex issue and there no one single long-term solution. It is going to require a tremendous effort, through both public and private funding of treatment, counseling, 12-step, and yes even pharmaceutical intervention to get a handle on the epidemic .Despite changing attitudes and the progress made in the past quarter century towards providing new methods of treatment and prevention, it is all too often still seen as a criminal problem and not a social one; a scourge of inner city poverty instead of the reality of a mainstream societal epidemic that affects millions regardless of race or socioeconomic class. Fundamentally, emphasis needs to be placed on recognizing addiction as the social and medical problem it is, one that is not caused by moral failings but a true medical condition that has a clearly recognized physiological basis in the brain and one that in many cases is caused by or exasperated by existing mental illness and other conditions.
Although it can certainly appear otherwise based on their self-destructive and often paradoxical behavior, most addicts desperately want to get clean and sober. And despite the long history of marginal progress and the seemingly intractable nature of the problem, there is hope for the vast majority of addicts, both soccer mom and homeless junkie, to be helped and returned to a fulfilling life in recovery.
- recovering addict
December 2nd, 2008 at 12:47 am
It’s nice that ‘most addicts’ want to get clean but I still don’t want my tax dollars paying for it.
As for legalizing weed…. wow US prisons would be emptied out. Not to mention the upheaval that would sweep through the religious community. Government pricing on marijuana would probably start putting packs of joints on gas station shelves for $200 a pack of 20. There’d probably be a ‘limit’ on how much pot you can ‘consume’ before DUI tickets start flying out. Overall, imo, usage and crime rates would not be affected.
I’d be the first in line to place my vote of approval on it though
Legalize
December 2nd, 2008 at 12:00 pm
It is widely proclaimed that there are genetic factors at play in both obesity and addiction. Obesity may be a greater comparison than that of diabetes, which is so often used. The safer injection practices and decrease in crime rate is something for people to expect in this scenario. It is not something to be praised, but instead is an obvious outcome, just as a decrease in bank robberies would result if anyone wanting to rob a bank were given a large sum of money when they asked for it, a scenario to which I feel most people would definately see differently, although the result would be the same. The way to measure the success of this program is to record the change in the number of heroin maintenance patients who find employment after getting into the treatment, and whether the population of heroin users increases, decreases, or is uneffected as a result of instituting heroin maintenance treatment. There is no cause to use a decrease in crime rate as a goal to be achieved through the use of heroin maintenance. For that to be a goal would open the door to legalizing any illegal activity for the same result. The benefit definately does not outweigh the risk there…
December 13th, 2008 at 2:11 pm
This piece is so uninformed that the author should apologize to her readership.
Fortunately, drug policy in Switzerland is based on facts, rather than on the imagination of a deputy web editor who could not even bother to look up the research that underlies this policy.
Instead of this half-baked nonsense and stupid analogies, she could have invested some time and looked up the landmark Nordt and Stohler article in the Lancet (http://www.ncbi.nlm.nih.gov/pubmed/16753485) or the preliminary results when this policy is applied in other countries (for a press report http://www.swissinfo.org/eng/front/detail/Swiss_heroin_model_reporting_benefits.html?siteSect=105&sid=7032610&cKey=1157366472000)
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