Swiss injection rooms lead the way
By Imogen Foulkes
BBC News, Berne, Switzerland
An independent panel of experts has called for heroin injection rooms – where users could legally inject drugs – to be trialled in the UK.
This may be a radical idea in Britain but in Switzerland such rooms have become standard.
They were first introduced in the late 1980s and early 1990s in response to rising levels of HIV infection among intravenous drug users and as an attempt to control Switzerland’s notorious “open” drugs scene, where heroin addicts took their drugs in city parks and squares.
The Swiss government also has a strong drug abuse prevention programme, but says the injection rooms are there to help the addicts for whom everything else has failed.
Berne’s heroin injection room is in the heart of the city, and it is a busy place.
At the entrance is a counter dispensing needles, syringes, sterile water, and antiseptic swabs.
“We give out 1,500 needles every day,” explains Ines Buerger, the social worker in charge of the injection room.
“And people bring their used needles back.”
As she speaks, one woman arrives and dumps at least 30 used needles and syringes into the disposal bin.
Addicts don’t have to take their heroin in the injection room however, they can just pick up clean needles and leave again. But they are encouraged to use the room rather than go back on the streets.
Three people at a time are allowed into the room, which means a queue often forms between it and the needle dispensary.
Inside a nurse is on hand; she will help addicts find a vein if they need that, but she is also there to offer medical advice and treatment.
Some of these addicts have already tried more than 10 times to come off heroin. They need their drugs, and they can’t stop just like that
Drug-injecting rooms backed
“We are here to offer treatment for all the different ailments addicts get,” Ms Buerger said. “A doctor comes once a week too.”
In fact, injection room is not really the right way to describe the facility, it is actually more of a centre.
Addicts can get a shower, there is a small restaurant providing nutritious food, and even a corner with comfortable armchairs and table football.
But perhaps the most important thing the centre provides, apart from the clean needles, is psychiatric support.
Most doctors who treat long-term addicts agree there is always a point when an addict is ready to give up heroin, and there are staff here to watch for those signs, to counsel, and to refer patients for therapy.
“We know all the clinics in the region which have vacancies,” Ms Buerger explained. “So we can advise addicts on the best place for them, and refer them.”
Addicts can deposit used syringes, and get food and counselling
But Ms Buerger admits that getting people off drugs is not the primary aim of the centre; instead the real goal is harm reduction.
“Of course it is great if we can refer people to a rehabilitation clinic,” she said.
“But the point is some of these addicts have already tried more than 10 times to come off heroin. They need their drugs, and they can’t stop just like that.
“We know from experience that if we weren’t here they would still take heroin, but out on the streets. What we are trying to do is help them survive this phase of addiction.”
There are injection centres in nearly every Swiss town and city now. Smaller villages often have dispensing machines with clean needles and syringes, and many chemists will also exchange clean needles for used ones.
Initial public concern that the policy was tantamount to official support for drug abuse has virtually evaporated in the face of evidence that HIV infection rates among drug users have stabilised.
In addition, neighbourhoods once blighted by the open drugs scene were largely cleaned up as more addicts began to use the injection rooms.
The Swiss police support the policy too; they are under orders to prosecute addicts injecting openly in public but will also point heroin users in the direction of the nearest injection room.
So while other countries continue to debate the pros and cons of injection rooms, in Switzerland they seem here to stay.
For many ordinary people the biggest argument in favour of them is that they have proved they contribute to something very dear to Swiss hearts: social order.
BBC [23rd November 2009]