Many thanks to Hans Koeppel for this overview of the last 20 years of drug
policy and a current update from Switzerland. Interesting how the Swiss
government declares its heroin distribution program a “success.”
The retention in the program is good because who wouldn’t want to stay in it
and get free heroin…. The employment rate improves because the government
creates jobs for the addicts. Their overall health improves because the
government provides regular healthcare for them. Their housing situation
improves because the government provides housing for them. I suggest that
all of these things could be provided without providing the heroin but
instead providing abstinence based treatment to get them drug free and they
would be MUCH better off. The fact that addicts, aged 50-60, are being sent
off to retirement homes for the elderly, due to their declining health, is
just plain sad. Their lives are being wasted on drugs, compliments of the
government. Most people (who don’t use drugs) remain healthy and active
well into their 80s these days.


The Four Pillar Drug Policy in Switzerland – 20 years after

Hans Koeppel, M.D.
Swiss Physicians against Drugs, June 2012

In the 1980s, Switzerland had a drug policy consisting of three pillars: Prevention, Therapy, and Law Enforcement. At that time, as the number of heroin addicts increased to tens of thousands, the authorities in several cities tolerated so-called “Needle Parks”. An open drug scene was established where thousands of addicts injected heroin in public, slept in parks, dealt in all drugs, and lived in slum-like misery, most of them in poor health. Several overdosed every day. The media published hundreds of reports on this scandalous situation and, eventually, the police were forced to close the parks and send addicts back to their own region.

In order to cope with the increasing number of heroin addicts, methadone programs were expanded. More than 17,000 heroin addicts were included in those programs which previously were very strict. Concomitant heroin or cocaine use was sanctioned by exclusion. Thenceforwards addicts received unusual high dose of daily methadone. Positive urine tests of heroin and cocaine had no consequence; nobody was excluded because of breaking the rules. Injection rooms were installed. Most of them still exist and they recently celebrated their 20th anniversary. During this time period, the concept of harm reduction was created. Drug liberalizers proposed to add it to the national drug policy as a fourth pillar. In this context, drug use was seen as a lifestyle – a human right. Harm reduction meant providing substitution programs for the majority of heroin addicts, which included the distribution of methadone as well as heroin. To introduce heroin distribution, a so-called trial was established. Although it failed to help addicts stop drug use, the maintenance of 70% of the addicts on these programs was celebrated as a success. As a result, the health authorities set up these so-called heroin-assisted treatment programs in several cities.

These events were accompanied by thousands of articles in newspapers to promote drug liberalization. Each article started with the sentence: “The drug war has failed”. “Law enforcement criminalizes sick people.” Pictures of people injecting heroin, needles and syringes or joints, were part of the message to habituate the public on drug paraphernalia. The continuous media campaign had a big impact on prevention and therapy.


As a consequence, drug use skyrocketed. The consumption of marihuana, ecstasy, heroin, and cocaine was seen as a recreational activity. The Green Party, which started a referendum to legalize marihuana, claimed drug use as a human right.

The media praised the positive effects of the high evoked by drug use, while deriding those who warned of its dangerous effects on body and mind. These people were described as hard-liners, sectarian, or extreme right, by the media

All jobs in the field of drug prevention and counseling, among health authorities and social workers, were occupied by advocates of the drug liberalization movement. They became the experts in all drug issues and other opinions were excluded. Eventually, information about the harmful effects of drug use, was no longer distributed.

The prevailing opinion among members of the younger generation was that it was only a matter of time before marihuana and other drugs were legalized. Fortunately, the voters rejected any form of legalization of marihuana in two referendums, the last in 2008.

The drug problem is no longer publicly discussed and has vanished from the political agenda. In some sense, the establishment of heroin distribution has had a positive effect on drug prevention. Heroin is no longer attractive, but is now seen as a “loser drug”, therefore, very few young people ever start using heroin.

Unfortunately, the young generation is not so worried about recreational use of cocaine, ecstasy, and marihuana. At weekend parties, all these drugs are excessively used. During these parties, drug counselors limit their intervention on organizing laboratories testing the purity of illegal substances.

Drug prevention, which means informing people to avoid drug use because of the harmful effects, no longer exists. The health authorities prefer to emphasize the dangers of eating disorders, smoking, gambling, and other addictions. Despite this situation, the perception of marihuana has changed, and more people now realize the negative consequences of drug use.

Drug use in Switzerland is an interesting and evolving situation. Unfortunately, no continuous monitoring exists, therefore casual studies, such as the following, provide insight into what is happening.

Cannabis Monitoring in 2008

The study shows the changes in Marihuana use, comparing 2004 and 2007. The diagram relates to young people between 13 and 29 years of age. The lifetime prevalence went down from 46.1% in 2004 to 43.5% in 2007 (total of former and present users of Marihuana). In 2007, 11.2% used Marihuana in the six months before questioning. In 2004, the figure was 13.3%.