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Diacetylmorphine pharmaceutical heroin substitution treatment is intended for individuals with a severe heroin addiction. It is administered in specialist centres. It was first tested in Switzerland in as part of a cohort study. In the light of the positive results obtained, it was adopted as a therapeutic measure and included in the Narcotics Act in its revised version of In , some addicted persons received this treatment in 22 specialist outpatient centres and one penal institution. The FOPH is responsible for issuing licences for this treatment, for its monitoring and controlling, and for providing information pertaining to it. Further information on the various licences may be found on this page. The goals of diacetylmorphine-assisted treatment are similar to those of other substitution-based treatments:. Crime levels have been clearly reduced. Request to reduce the time limit for the dispensing of diacetylmorphine PDF, kB, Request for the exceptional dispensing of up to one month's supply of doses of diacetylmorphine PDF, kB, Notification of delegation within the framework of prescribed diacetylmorphine-assisted treatment PDF, kB, Article 3e, paragraph 3 of the Narcotics Act NarcA, Last modification Top of page. Print contact. Homepage Main navigation Content area Sitemap Search. Subnavigation Back Back Addiction counseling and therapy Substitution-assisted treatments in case of opioid dependence Diacetylmorphine-assisted heroin-assisted treatment selected. Contact information. Diacetylmorphine-assisted heroin-assisted treatment. Goals The goals of diacetylmorphine-assisted treatment are similar to those of other substitution-based treatments: to build a long-term therapeutic alliance to improve the physical and mental health of those affected and promote their social integration to facilitate low-risk use and create the conditions for permanent abstinence to distance those affected from the illegal drug scene and prevent crime associated with the supply of drugs. Diacetylmorphine-assisted treatment has been scientifically monitored and evaluated since The criteria for admission to diacetylmorphine-assisted treatment are as follows: minimum age 18 years severe heroin dependency for at least two years at least two unsuccessful treatment attempts unsatisfactory results or treatment discontinued physical, mental or social consequences of drug use. Heroin-assisted treatment in Switzerland: results of the surveys Results of , and please consult the German or French page. Legislation Diacetylmorphine-assisted treatment is strictly regulated. The legal basis is as follows:. Further information Licences for diacetylmorphine-assisted treatment Diacetylmorphine-assisted treatment is governed specifically by the Narcotics Act NarcA; RS

Switzerland fights heroin with heroin

Buying Heroin Geneve

By most accounts, Sarah lives a normal life. Twice a day, Sarah also walks down the street from her apartment to a clinic where she takes a treatment to stabilize her chronic disease. Sarah is one of 1, people who are part of a heroin-assisted treatment HAT program in Switzerland. One of those four pillars includes new and expanded treatment options for opioid users, including heroin-assisted treatment. The heroin provision was the most controversial part of the multi-prong Swiss drug policy. The Swiss, in keeping with their national stereotype, kept meticulous records. They found data to support the program through years of scientific study and strict randomized controlled trials before incorporating HAT into the law. Since then, the number of new heroin users in Switzerland has declined. Drug overdose deaths dropped by 64 percent. HIV infections dropped by 84 percent. Home thefts dropped by 98 percent. And the Swiss prosecute 75 percent fewer opioid-related drug cases each year. Meanwhile, in the United States, drug overdoses kill more Americans than car crashes, according to the Centers for Disease Control and Prevention. The number of overdose deaths in North Carolina went up in , and an average of four people overdose and die each day. The Swiss law requires that HAT patients must have at least two years of opioid dependence before starting treatment. They must have tried and failed two other addiction treatments and be at least 18 years old. The program was designed to treat the small percentage of people with substance use disorder who do not benefit from more traditional opioid substitution therapies, such as oral methadone or buprenorphine. Another substance being used to pad street drugs in Switzerland is an animal dewormer. In , more than 1, overdose deaths in North Carolina involved fentanyl, which is often cut into heroin or other street drugs. It also frees up the time previously spent finding the street product, enabling users to focus on things like housing, family and employment. There are hardly any young newcomers. When HAT programs started, 85 percent of participants were younger than Today, 80 percent are over the age of As the sun set outside, an increased flow of people arrived at the clinic for their second daily dose of heroin. They were polite, but not interested in making small talk in the waiting area outside the injection room. In Geneva, patients only have two time frames — the morning and the evening — to get their treatment. An older woman named Flor agreed to a short interview as she waited. Here, it helps me to have another life and do other things. When she was young, she studied theater in school. Now, Flor says she been able to get back into acting. The program also gives her peace of mind, because unlike in the streets, the product is always the same, she said. Sarah, the English woman, came in after Flor, looking equally jittery. Her eyes appeared slightly glazed, but she was more upbeat and ready to walk with her dog to a cafe across the street and chat with a reporter. Over coffee she explained her erratic journey with drugs — both heroin and cocaine — and how she found stability and comfort in the HAT program. Sarah tried heroin for the first time at age 18 but said it was too expensive. Her heroin use became consistent in the late s, when she was in her 30s and heroin was cheap. For the first six months, she used heroin off and on. For the next five years, she divided up her weekly stash into daily packets and managed to keep her full-time job and care for her small children. So she went to rehab and stayed four months. She tried rehab again, this time for a whole year. Sarah says she was lucky to have supportive friends, family and an apartment to come back to after. She found another job, but after a few months went back to using. Sarah set boundaries and rules for herself while using heroin. She would not use at work or in a public bathroom. Instead, she used the drug consumption room during her lunch break. But all the self-discipline went away with cocaine. But had I spent another two months on the street, that would have been it. And if I had done that, I felt like I could never get up again. She said it acts as an antidepressant for her. She frequently goes back to England to visit her mother for holidays and takes oral morphine instead. The randomized controlled trials included 1, participants in 17 places, including new and existing opioid substitution clinics and prisons across Switzerland. The European Monitoring Centre review found some promising trends. HAT program participants use less street heroin and illegal drugs than in the control groups treated with oral methadone. The annual cost per HAT patient ranges from 12, euros a year in Switzerland to 20, euros in the Netherlands. These are much higher than the annual cost of oral methadone treatment, which is 3, euros per patient in Germany and 1, a person in the Netherlands. The increased cost is due to the high staffing need at heroin treatment facilities. Most HAT programs require multiple staff members present at all times. And most programs do not allow the same take-home dosages allowed with other opioid substitution programs. So clinics must be open days a year for extended morning and evening hours. However, Switzerland changed the law in to allow two days of oral heroin take-home doses for stabilized patients. The European Monitoring Centre determined that HAT programs result in significant savings to society, particularly in the reduction of costs from criminal justice proceedings and incarceration of drug users. Beck, the medical director of the heroin-assisted treatment program in Zurich, said that when he goes to conferences in North America, his U. There will always be moral objection to these kinds of programs, Beck said. There are people in Switzerland who hear all the evidence and data for HAT but will not support it. Rita Annoni Manghi, medical director of the the HAT program in Geneva, said she, her colleagues and patients met with community members at coffee shops to explain what they were doing. Neighbors around the HAT facility were scared of the program and thought it would lead to more drug use, she said. This work is very important to change the minds of people. So these countries created spaces for them. Republish This Story. Taylor Knopf writes about mental health, including addiction and harm reduction. Knopf has a bachelor's degree in sociology with a minor in journalism. Been trying to contact you to voice several issues having to do with different manifestations and problematic dynamics, all having to do with what appears to be an endless slew of government tactics that will never positively influence our horrific addiction epidemic and number of associated deaths. Sadly, those sanctioned to make a difference are few and operate exclusively from self-derived, ill-informed understanding. By continued reliance upon inexperienced paradigms, the collective closed mind of an empowered few will sustain or worsen the nightmare. Change will come from minds that become open to acknowledge and accept the truth, best-told by experienced addicts and their families. Yep, I fully agree with the sentiment that harm reduction has been overwhelmingly proven as the most sensible and effective treatment for long term chronic opiate addiction. Skip to content Read all of our joint coverage with The Charlotte Ledger here. Staff worker at the heroin-assisted treatment facility in Geneva prepares injectable heroin before the patients arrive. She has a substance use disorder, and her treatment includes injectable heroin. So it started supporting them. Thilo Beck, psychiatrist and medical director of the heroin assisted treatment facility in Zurich, holds a bottle of medical-grade heroin as patients go into the glass doors on the left to inject. Photo credit: Andy Specht. People walking to work one early November morning in Geneva, Switzerland. An injection space inside the heroin-assisted treatment facility in Geneva. Photo credit: Taylor Knopf. Republish our articles for free, online or in print, under a Creative Commons license. Taylor Knopf. Next Proposed rule would require licensed daycares to test for lead in their water. Excellent article, thanks for expanding our vision of new treatments to try. This is excellent reporting on important steps being taken elsewhere. Thank you, Ms Knopf. 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Buying Heroin Geneve