Can't kick the quick fix

International | On heroin vote, Swiss show they're addicted to big brother

Issue: "Stand in the gap," Oct. 18, 1997

Like Zurich's time-worn streets and bridges, Project Crossline is orderly, clean, and well-appointed. The second-floor clinic is reached through the back of an oversized office building. A spacious waiting room has ample seating for patients. Two steel tables are dwarfed by large picture windows in the injection room. Hanging above the tables are tourniquets. Beside them are squeeze bottles filled with alcohol, boxes of bandages, and towels.

Those entering the injection room must first get clearance from an orderly at the counter. It's a simple identity check, matching up patients with the proper dose on a chart. The "patients," however, are drug addicts, and the medications they receive are pre-loaded syringes of pure heroin. Some come as often as three times a day and receive up to 900 milligrams of uncut heroin, a fix undreamt of outside in the dank shooting galleries of Platzspitz Park.

These fixes are free. Project Crossline is one of three clinics in Zurich and 18 across Switzerland in a government-run pilot program designed to curb drug addiction by satisfying it. The six-year-old venture has come under increasing heat, culminating in a Sept. 28 referendum to disband it.

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Organized by a coalition calling itself "Youth Without Drugs," the initiative called for outlawing "state-controlled" distribution of heroin, as well as cocaine, LSD, marijuana, and a more obscure slate of "designer drugs." It called for a restrictive drug policy aimed at abstinence and a crackdown on drug-related crimes.

Polls going into the referendum showed each side drawing 40-43 percent of voters. Youth Without Drugs seemed to have the emotional edge, as well as the moral high ground. It surpassed the 100,000 signatures needed to bring the referendum to a ballot, gathering 140,000 in less than six months.

When voters went to the polls, however, 70 percent went against the measure. Swiss voters, in overwhelming numbers, said they want to continue state-sponsored drug habits. It seems that what is unthinkable in the United States-outside of, perhaps, California and Arizona-is gaining mainstream acceptance across Western Europe.

Observers said the loss was not surprising. The Swiss cabinet and most of the parliament came out against the initiative. They were joined by the Swiss Medical Association and international organizations in favor of drug legalization. State bureaucrats and physicians connected to the program were delivering position papers to their employees and holding seminars on how to undercut the Youth Without Drugs campaign. That information gained wide circulation through Switzerland's media, while data from Youth Without Drugs was largely ignored. Only 40 percent of voters turned out for the referendum.

"Youth Without Drugs failed to carry out its mission," said Rachel Ehrenfeld, policy director for the New York-based Drug-Free America Foundation. "They did not want to rock the boat too much-that is very Swiss. They didn't want to be perceived as completely against the government."

The group was also hindered in getting the right messsage out, according to Dr. Ehrenfeld. She has done her own research showing that the government's recordkeeping on the clinics is faulty. A highly touted study released in July did not use a control group, as addicts went freely in and out of the program. There was no routine supervision of heroin injections, and some addicts were known to save heroin to sell on the street. Site visits showed that job placement and other programs promised along with heroin were not in place. Dr. Ehrenfeld said the program never reached its intended "serious addicts," and instead, 18 percent of the estimated 1,000 in the program had never regularly used heroin before entering a clinic.

"This is not a solution," Ms. Ehrenfeld told WORLD. "This is not even good for the Swiss, and Switzerland is a very small country."

Problems with the clinics have not blunted interest in the program. When parliament meets again in December, it will consider legislation to formalize the heroin clinics, moving away from pilot-project status. Voters also will consider another referendum sometime this winter. Known by its acronym, DROLEG, that proposal is a radical move to legalize all drugs.

Others countries are following. The Dutch government will open heroin clinics in January 1998 for a three-month trial. Belgium, Norway, and Germany are looking seriously at state heroin distribution. The European Union and the United Nations will be wrestling with how to certify Switzerland and other member states who want to buy heroin on the illegal market. A UN agency now issues permits for such purchases, and it recently cut in half Switzerland's allotment.

Critics see a slippery slope to an all-out campaign for drug legalization. As evidence, they cite the cheerleading of pro-legalization groups during the recent Swiss debate. These include the International Anti-Prohibitionist League, the Lindesmith Center in New York, and the Drug Policy Foundation, or DPF, in Washington, D.C.


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