Swiss voters will go to the polls November 30 to decide whether to approve marijuana decriminalization and the government's ongoing "four pillars" drug strategy, which includes the prescription of heroin to hard-core addicts. A Swiss Broadcasting Corporation poll late last month showed the decriminalization effort in a virtual dead heat, leading 45% to 42%, with 13% undecided, while the referendum on the broader strategy appears headed to easy victory, with 63% in favor, 20% opposed, and 17% undecided.

The referendum on marijuana policy envisages its legalization for personal use, with its cultivation and sale being regulated by the state. It comes a decade after Swiss voters narrowly rejected a similar proposal. An attempt to decriminalize through parliament failed in 2004.

While the vote on decriminalization looks to be close, the effort is supported by a 1999 government advisory committee report and the governing coalition, and it is picking up some unexpected allies. Regulation would protect young people, argued the Social Democrats. Somewhat surprisingly, the effort is also supported by the center-right or libertarian Radical Party and the respected daily Neue Zurcher Zeitung, which described both the decrim effort and the amended drug law as steps in the right direction.

"A policy which is only based on abstinence, bans and repression ultimately leads to more spending on welfare. It also is against the spirit of liberalism and leaves no room for people to take responsibility for themselves," the newspaper editorialized.

But not everyone is jumping on the decrim bandwagon. The rightist Swiss People's Party remains staunchly opposed. "Switzerland would become the drug Mecca of Europe," said People's Party parliamentarian Andrea Geissbühler.

The government's four-pillars drug strategy appears much less controversial, especially after a decade of pilot heroin prescription programs that have proven effective. Even the grassroots of the rightist parties approve, according to the poll.

"The number of drug-related deaths per year dropped from 400 at the beginning of the 1990s to 152 last year," said Felix Gutzwiller, a Zurich Radical Party senator, adding that each year some 200 addicts graduate from heroin maintenance to methadone maintenance. "It is telling that drugs issues are no longer top of the list of public concerns, unlike 20 years ago," he said.

Like the rest of inner city America, Bridgeport, Connecticut's 130th District has for decades been ground zero in the war on drugs. Mostly black and Latino, like other majority minority neighborhoods across the land, it has suffered the twin ravages of drug abuse and drug prohibition. Now, a former drug-fighting Navy officer turned drug reformer is seeking to change all that with a bold vision and an upstart bid for the state House of Representatives.

Sylvester Salcedo (2nd from right)

"Narcotics use and abuse is our problem here at home," he wrote at the time in a letter sent to Clinton. "The solutions should be applied here and not in Colombia or elsewhere. To spend this additional amount of money overseas is wasteful and counterproductive."

Fast forward eight years and little has changed. The war on drugs continues apace, drug arrests and drug war prisoners reach new highs every year. The violence associated with drug prohibition continues to plague cities like Bridgeport. And Salcedo has had enough.

"The war on drugs is one of our nation's longest wars, at home and abroad," he said as he announced his candidacy May 29. "It is senseless, wasteful and counterproductive. It is highly discriminatory on a racial and economic basis. I said so on the steps of the US Congress in Washington, DC flanked and supported by Minnesota Republican Congressman Jim Ramstad and California Republican Congressman Tom Campbell in the summer of 2000," he said.

"Eight years later, the conditions are the same, if not worse, especially for the isolated and abandoned residents of ethnic minority enclaves and neighborhoods like the 130th District," Salcedo continued. "I want to win this State Representative seat to be a leader of change. I want to lead the way to peace, understanding and cooperation, not through the politics of fear, and racial and ethnic discord and conflict. This senseless war on the poor and the voiceless must end."

Salcedo is not one for half-measures. He is proposing turning the 130th District into a sort of mini-Amsterdam, a zone of drug tolerance replete with safe injection sites, opiate maintenance facilities, and taxed and regulated marijuana sales. "I'm floating around this idea of the Covenant of the 130th District, which is to declare the district as a zone of tolerance," he said.

"I want to borrow from models like Amsterdam or Frankfort," he elaborated. "I'm not pushing legalization legislation, but acknowledging the fact that the 130th is a high drug trafficking and consumption area, from marijuana to heroin to cocaine. I want to try those approaches here. If you live in the district and are a heroin addict, we would work with you, whether it's a treatment and rehabilitation regime or a maintenance regime. If you select maintenance, you get the level of pharmaceutical grade heroin you need. In either case, you get medical, psychological, and social services, an intake exam, a social worker and a drug counselor to work with you. But this won't be a coercive or punitive program; instead it will be designed to develop the relationship with the addict."

Citing Bridgeport's chronically under-funded schools, libraries, and other services, Salcedo also called for regulated marijuana sales as a revenue raiser. "I want to open up a number of marijuana coffee shops in this district," he said. "They could be city sponsored, or they could be a joint private-public project. If people want to come here and imbibe, we will welcome them, let them pay the market price, and tax their purchases. The profits can go to the city general fund, or, if it's a joint venture, a share to the entrepreneurs," he said. "We will follow the experience of Amsterdam, with the police working collaboratively, so they're not arresting people coming from the coffee shops."

Salcedo's will undoubtedly be an uphill battle against the entrenched Bridgeport Democratic Party political establishment and to convince skeptical voters that more of the drug war same old same old is not the solution. But he has already passed the first hurdle by getting 290 district residents to sign his nominating petitions. Now he has to raise $5,000 by August to show he is a viable candidate and qualify for another $20,000 in primary funding from the state of Connecticut. At least 150 Bridgeport residents must donate to his campaign for him to qualify. (That doesn't mean people from outside Bridgeport or Connecticut cannot donate -- they can.)

He can do it, Salcedo said. "The primaries are eight weeks away, and nobody expected me to even get the required signatures, but I did. And I met every person who signed my nomination papers. I think I can meet this challenge, too."

He's going to need some help, from the drug reform community at large and from Connecticut activists in particular if he is to have a chance. One prominent Connecticut drug reformer, Efficacy founder and 2006 Green Party gubernatorial candidate Cliff Thornton is among the first to step up.

"I'll definitely be going down there and doing a few things for Sylvester," said Thornton. "I have to help the reformer."

One thing he will advise Salcedo to do is put his drug reform message in the background. "We'll try to sharpen his message," Thornton said. "He doesn't have to lead with drug policy. He's already known as the drug reformer, and he won't have to talk about it because people are going to ask him about it.

Another thing Salcedo can do is try to tie drug reform into other issues facing the community, Thornton said. "We're spending somewhere between $600 million and $800 million on prisons in Connecticut every year," he said. "If we took that and put it toward health care, we could take care of everyone in the state. That's the kind of connection we need to be drawing."

It would be a good thing if national drug reform organizations provided more than token support, Thornton said, looking back at his 2006 campaign. "When it came to actually supporting that run, everybody disappeared," he said. "The flagship organizations sent a few bucks here and there, but not enough to make a difference. And that's a shame. We are starting to elect good drug reform politicians, like Roger Goodman in Washington state and Chris Murphy here in Connecticut. Their opponents attack them as soft on drug policy, and they go up in the polls. We can elect people, if we support them," Thornton said.

Salcedo could use the help, he said. "Right now this is basically a one-man campaign, and I have a full-time job."

Still, he said, he may be able to pull off a surprise victory. "This is going to be a low turnout election, no other issues on the ballot here, and the only reason people are likely to go to the ballot box is to vote for me for change or because they're tied to one of the establishment candidates," he said. "In this district in this election, maybe 200 or 300 votes can win it. I'll be beating the bushes and talking face to face with people. I'll do everything I can, and then it's up to the voters.

(This blog post was published by StoptheDrugWar.org's lobbying arm, the Drug Reform Coordination Network, which also shares the cost of maintaining this web site. DRCNet Foundation takes no positions on candidates for public office, in compliance with section 501(c)(3) of the Internal Revenue Code, and does not pay for reporting that could be interpreted or misinterpreted as doing so.)

Every day for 15 months, Vancouver heroin addict Rob Scott Vincent, 36, went into a nondescript building on the city's Downtown Eastside where a nurse would hand him a syringe loaded with pharmaceutical grade heroin. Sitting at a sterile, stainless steel counter, Vincent would inject himself with the drug, then sit in an equally sterile waiting room for awhile as the drug took hold before heading out to do his daily business.

Hastings Street, on Vancouver's East Side (courtesy VANDU)

In the program, which was limited to long-time addicts over 25 who had failed to kick the habit at least twice in previous treatment tries, participants used treatments of oral methadone or injected heroin. A small percentage received a pharmaceutical opiate called Dilaudid. Participants also received counseling and other support services. The Canadian federal government (then under control of the Liberals) funded the project with $1.8 million and agreed to allow the importation of pharmaceutical heroin for the project.

Similar pilot opiate maintenance projects in Switzerland, Germany and the Netherlands produced results showing reductions in criminality, drug use, and economic costs to society, and increases in health, stability, and employability among participants. NAOMI researchers and supporters are hoping it will produce similar results. While the final research report from NAOMI is not expected until the fall, preliminary results suggest the findings will be similar to those in Europe.

In a March briefing paper, NAOMI reported that 85% of participants taking injected heroin had stayed with the program for 12 months, that the treatment had proven to be "extremely safe," and that there had been no security issues or evidence that NAOMI had had a deleterious impact on the neighborhood. The paper also suggested that the program would show a positive economic impact.

Canada estimates that each heroin addict costs the country $45,000 a year. The studies of European opiate maintenance programs report that they save host countries $20,000 a year for each participant.

"What we know now is that we were able to recruit people with long-term dependence on heroin who repeatedly failed other treatments and who had many health and social problems when they entered," said Dr. David Marsh, one of the co-investigators and lead clinical physician for the study. "From a doctor's perspective, whether they were treated with methadone or heroin, many of them improved dramatically. We'll know from the formal research results how much and in what ways they improved."

The provision of methadone or heroin was only part of the treatment, Marsh said. "The medication is a component of a broader package of primary care, mental health care, addiction counseling, and case management to provide participants with access to a range of welfare and other benefits," said Marsh. "We work with people to try to manage the negative consequences of their drug use and help them improve their lives."

Vincent had been addicted to opiates for nearly 15 years when he decided to participate in NAOMI. "I wanted to see if it could better my life, and it did," he said. "It helped me slowly wean down. I'm still using, but not even one-third of what I was using."

Vincent's stint in NAOMI ended in March. Since then, he has had to return to the streets to find his drugs. "It's not too bad," he said. "I mostly use morphine pills, and I pick up a pill for $5 bucks every morning and I'm good for the day." Vincent pays for his fixes by collecting and recycling cans. But sometimes, he can't find what he wants and has to spend time searching for a substitute opiate -- heroin, dilaudid, whatever is around. "It's usually readily available," he said, "but sometimes I have to scrounge around."

Getting participants completely off opiates wasn't the be-all and end-all of the pilot program, said Marsh. "Patients benefit in a lot of ways," he said. "Some were able to stop taking illegal opiates, and in my view, if a patient is prescribed methadone and is using it properly, I consider that a success. Methadone treatment has been available for many years, and there are thousands of studies showing its benefits."

The Vancouver Area Network of Drug Users (VANDU) was one of the key supporters of NAOMI, despite its complaints about the restrictiveness of the standards for qualifying for the study. The program needs to continue, VANDU said.

"Regardless of the parameters they set that made it tough to qualify, this is a badly needed service and it's a shame it's just a pilot project and is not continuing," said VANDU president Richard Utendale. "I've talked to a lot of people who have been helped by it. They were able to improve their day-to-day lives by not having to struggle to feed their drug habits. NAOMI provided a safe place and support, and participants didn't have to worry about being jacked up by the police or ripped off or sold inferior products or dope with adulterants."

The Downtown Eastside, where both VANDU and NAOMI are located is the epicenter of one of the largest hard drug scenes in the hemisphere. The program had an impact on the area, said Utendale. "I think NAOMI also improved the neighborhood, with less street and property crime."

There was a downside to NAOMI, though, said Utendale. "The drawback is that when people are finished with the program, they have to go back on the street and resort to the same old means of getting their drugs. That's why this needs to be permanent."

Vincent said he wished the program could continue. "I would most definitely participate in a permanent program," he said. "It was very, very helpful. It's a lot easier to quit or reduce my intake with pharmaceutical grade heroin. Most of the stuff on the street is cut with other things -- that's why I like to use morphine. I can't see any reason for not keeping this open," he said. "NAOMI is a medical facility, just like Insite [the Vancouver safe injection site]. They should not shut it down."

But that is what is going to happen at the end of this month. Last November, doctors appealed on compassionate grounds to extend the program on behalf of five participants. So far there has been no agreement from either Health Canada or the regional health authority.

"Dreams are free," Utendale sighed, "but the way things are looking right now, this isn't going forward without some changes in Ottawa."

Marsh said it was "premature" to try to predict what would happen. "But I'm optimistic we'll find funding and get the regulatory approval at some point to apply the lessons we've learned from this study," he said.

But given the current Conservative federal government's ideological opposition to harm reduction, as evidenced by its losing battle to shut down Vancouver's safe injection site, it is going to take a new national election before there is any chance that Canada will follow the Europeans' lead and make heroin maintenance part of a broader public health policy.