“Every truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.” Arthur Schopenhauer, German Philosopher, 1788-1860

by Donald MacPherson on April 24, 2010

The quote above reminded me of a moment recently while discussing drug policy issues with the Chief of the Drug Squad for the Zurich Police Department. I had traveled to Zurich because I had never been there before (I had been to other places in Switzerland to study their drug policies) and in the world of Drug Policy, Zurich is a special place. Special because it is the birthplace of innovations in harm reduction that the City of Zurich implemented in the mid 80’s to address a disastrous open drug scene in the streets and parks of the city and to tackle high overdose death rates and an HIV epidemic among injection drug users.

Sitting in the office of  Captain Beat Rhyner of the Zurich City Police I was explaining to him the continued opposition by many within the policing community in Canada against Vancouver’s supervised injection site. He looked at me and rolled his eyes. “Within the police that debate has been over here since 20 years” he said. Of course in the beginning there was opposition but as people saw how the programs worked they moved on to focus on other important issues. The Zurich Police, City agencies and the community in general all support the “low threshold” programs that Zurich initiated in the mid-80’s. Why, because they work. Also because there is an understanding among the Swiss that all sectors of society need to be able to co-exist in urban centres which always attract those those with drug problems. These programs which have inspired similar initiatives in Germany, the Netherlands, Spain, Norway, Australia and of course Vancouver, Canada are an attempt to provide basic survival services for extremely marginalized populations of drug users. Zurich’s Drug Policy states:”The harm reduction concept is intended to reduce the risk and damage caused by drug use. In practice, harm reduction is applied rationally and realistically: the goal is to help drug users survive drug abuse with as little damage as possible. At stake are the life, the health and the future of those concerned.”

Zurich has 6 low threshold programs that are run by the City of Zurich. In much of Europe the cities are responsible for the low threshold programs as they have the best vantage point to develop these programs. City staff work closely with the police and various community interests like business organizations, neighbourhood groups and NGOs in the field. More specialized addiction and mental health programs are operated by regional health authorities. Cities are closer to the ground and as people move into the health care system the health people take over. An interesting model given the tensions between municipal and provincial governments in Canada when responding to these same issues. Of the six “low threshold” programs four of them have a full range of services including, a drug injection room, an inhalation room for drug users who smoke heroin and cocaine, a room for tobacco smoking, a kitchen, a laundry facility, and a room for medical examination should users need urgent assistance. One of the low threshold facilities is for street alcoholics where they can bring their own alcohol and drink it rather than in the parks. The last program has no alcohol and drug services and is for other marginalized individuals.

An important point regarding Zurich is that at this time there is very little homelessness (perhaps 200 or so) which makes it a lot easier to focus on services for the 800 problematic drug users that need these kinds of services. The City of Zurich prides itself on its “urban drug policy”. From Zurich’s drug policy document – “Zurich’s open drug scene brought the city worldwide notoriety. The experience gained in that dismal period let to the development of a coordinated drug policy. The new strategy was based on four “pillars”: prevention, law enforcement, harm reduction, and therapy. Yet Zurich also came to realize that if a drug policy is to be successful it cannot focus solely on users and dealers. A prudent urban drug policy must also take seriously the population’s need for peace and quiet, public order, and safety.” More on the ethos of experimentation and compromise in the development of Zurich’s drug policy in the next post.

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