Europe: Swiss Harm Reduction Policy for Heroin Results in Less Problematic Heroin Use 6/9/06

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Swiss researchers involved in 15 years of harm reduction approaches to heroin use have managed to reduce heroin use four-fold, according to results published in the British medical journal the Lancet last week. The Swiss approach includes safe injection sites, needle exchange programs, methadone or buprenorphine maintenance programs, and heroin maintenance programs.

"China White" street heroin
Critics of this pragmatic approach had warned it would attract new drug users and keep current addicts strung out longer. But in their study of more than 9,000 heroin users who underwent treatment -- including opiate maintenance -- between 1991 and 2005, Stohler and his colleague, Dr. Carlos Nordt, found that the incidence of "problematic" heroin users was declining at a rate of 4% a year.

"As a result (of heroin-assisted treatments), people can lead normal lives, go to work, not obsess about buying the drug, when they know they can relieve their craving legally," study coauthor Dr. Rudolf Stohler of the Psychiatric University Hospital in Zurich told Reuters Health.

The researchers found that half of Swiss heroin users enter an opiate maintenance treatment program within two years. They calculate that the incidence of regular heroin use has declined by 82% since 1990, when more than 800 people sought treatment. That figure was down to 150 last year.

"Heroin can be prescribed to people who have failed two former therapies," Dr. Stohler told Reuters Health. The practice is to give addicts one gram a day.

And the Swiss may have succeeded in making heroin boring, the researchers suggested. "As the Swiss population supported this drug policy, this medicalization of opiate dependence changed the image of heroin use as a rebellious act to an illness that needs therapy," Drs. Nordt and Stohler wrote. "Finally," they add, "heroin seems to have become a 'loser drug,' with its attractiveness fading for young people."

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Issue #439 -- 6/9/06

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