24 May 2006

Heroin Harm Reduction.

Britain is considering the Swiss model of providing heroin addicts, even those in prison, with a safe context in which to take the drugs, rather than criminalizing addicts, an approach known as harm reduction.

The approach is not full fledged legalization:

Participants had to meet strict criteria: age 20 or older; addicted to heroin for at least two years; a history of failure with other types of treatment; adverse effects of drug use on health and social relationships.


It works, according to a study conducted by the Swiss government evaluating the program:

In the first six months of treatment, the number of crimes committed by participants dropped about 60 percent.

The percentage of those with permanent employment more than doubled, from 14 to 32 percent.

Participants saw improvements in physical health and a decrease in psychiatric problems, including depression. Babies born to addicted mothers were normal and healthy.

After withdrawal from the program, addicts' use of illegal drugs increased somewhat "but remained clearly below the initial level." By the end of the first two years, 83 people had decided to give up heroin and switch to abstinence therapy.


In 1994 when the program was commenced in clinical trials, Switzerland had about 400 deaths from drugs themselves and about 300 AIDS deaths of drug addicts. By 1998, the number of deaths from drugs had dropped to 200, the number of AIDS deaths of drug addicts had fallen to 75, and the disruptive illicit use of heroin in public places which was the driving force behind the program had ended.

Drug use appears to be similar to that in other Western countries:

According to the State Department's latest report on global drug trends, marijuana is by far the most commonly used drug here yet is smoked by less than 8 percent of all Swiss -- a rate not out of line with other Western European countries and the United States.


There are a lot of people who believe that a public health/decriminalization orientation can work for marijuana, but not for "harder" drugs. The Swiss experience suggests that this belief is empirically incorrect.


Hat Tip to Talk Left.

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