Countries around the world are starting to implement new approaches to drugs and the problems that they can generate, many of which have been great successes.
Swiss Heroin Clinics
Switzerland is the harbinger of the ‘heroin clinic’, a safe environment where addicts go to be prescribed and inject pure heroin, as opposed to its sometimes ineffective substitute, methadone. Initially, this programme was met was scepticism, but the Swiss public were persuaded of the benefits of heroin-assisted therapy (HAT) and endorsed it twice in nationwide votes. This new found confidence in HAT was primarily due to cost benefit analysis estimating that the benefits rewarded were double that of the cost.
Drugs, within most countries’ policies, are married to crime. Addicts need money to curb their habit, so they commit theft. However, by prescribing addicts heroin, analysts have seen a 90% reduction of crimes against property committed by drug users. Treating people who are addicted to heroin with methadone only curbs their withdrawal symptoms, so they still commit crimes to fund the ‘high’, whereas treating them with heroin itself gives them no need to partake in illegal activity. According to estimates, a similar programme being implemented in the United Kingdom has resulted in crime costs falling by £16.1m in the first year, and £11.3m during the second.
Treating an addict rather than just imprisoning them, where they will more likely be exposed to an even deeper criminal lifestyle, allows a cured patient to make a positive contribution to society. After 18 months on treatment for heroin addiction, one third of addicts have steady jobs, while the others are crime free and have some form of work. Imprisonment is a burden on society, whereas treatment is an investment. Also, by replacing addicts with valuable members of society, Swiss casual users found it difficult to make contact with sellers of heroin, lowering the chance that they will become ‘fresh’ addicts.
Needle Exchanges and Injection Sites
Blood-borne diseases plague drug-consuming populations, primarily due to the swapping of used needles. Needle exchange programs are a method to reduce the risk of spreading HIV or AIDs, by providing addicts with clean apparatus to inject with.
A comprehensive study by the World Health Organization (WHO) in 2004 stated that there is a “compelling case that NSPs substantially and cost effectively reduce the spread of HIV among IDUs and do so without evidence of exacerbating injecting drug use at either the individual or societal level.”
The Center for Disease Control estimates that every HIV infection prevented through a needle exchange program saves an estimated $178,000, as well as an overall estimate of 30 percent or more reduction in HIV cases in reported injection drug users.
It is easily demonstrable that countries which operate needle exchange programs, such as the UK, Australia, the USA (in 2009 a ban on federal funding for Needle Exchange Progams was finally lifted), and others have a lower rate of blood-bourne disease transmission, and typically higher rates of injecting drug users entering treatment.
Supervised injection sites, such as Insite in Vancouver, are a further step along in harm reduction. Such facilities provide a safe location for people to inject drugs and connect to health care services – from primary care to treat disease and infection, to addiction counselling and treatment, to housing and community supports. These centres minimise deaths by drug poisoning, and also provide the maximum possible support and incentive for injecting drug users to stay disease free and attempt treatment.
Drug Testing in the Netherlands
The Netherlands, in its tradition of pragmatic and harm-reducing approaches to drugs, provide a free and instant service for drug users to have their drugs tested for safety and purity. The results are kept for data analysis, and the drugs are given back. Dangerous contaminants or inconsistent dosing is a serious problem with pills.
The testing concept is extremely effective in stamping out rogue pills. By keeping the market “clean” the producers and dealers keep demand stable. “There’s nothing like a rumour of bad pills to mess up sales,” said one. If contaminated pills do get on to the market, the producers, dealers and users join ranks to find the culprit who, as Matser puts it, is dealt with faster and far more effectively than he would ever be by the police.
That the Dutch system is successful is clear from the very small incidence of Ecstasy-related deaths.
The reported number of deaths linked to the use of drugs in the Netherlands, as a proportion of the entire population, is together with Poland, France, Slovakia, Hungary and the Czech Republic the lowest of the EU. The Dutch government is able to support approximately 90% of help-seeking addicts with detoxification programs. Treatment demand is rising.