Dutch and Swiss support heroin on prescription

Dutch MPs have agreed to launch a pilot study for providing heroin on prescription as part of a strictly controlled medical experiment. The move came as a referendum in Switzerland gave overwhelming backing for the government's three year old scheme to provide heroin to addicts.

Researchers have shown that crime levels among Swiss drug misusers taking part in the scheme have fallen by 60% since the scheme started. The Swiss government signalled that it might expand the programme, which at present covers only longterm drug misusers who have repeatedly tried to give up.

The Dutch health minister, Professor Els Borst Eilers, overcame parliamentary opposition by promising MPs scrutiny of the preliminary study. The three month pilot project will be launched next March, and the participants will be 50 longterm drug misusers in one city. At the same time there will be two control groups, each of 50 misusers who will be prescribed methadone. Both injecting and smoking heroin will be studied in an attempt to compare the effect of prescribing heroin, and that of a combination of heroin and methadone, with current methadone programmes. A larger scale experiment with 750 drug misusers in seven cities will then automatically proceed if MPs are convinced that there are no unexpected “negative side effects,” such as problems of public order.

The experiment has provoked opposition because its main aim is not to stop drug misusers taking heroin but to stabilise their psychological and physical health and to end social isolation. Aspects such as involvement in crime, leisure activities, work, and nutrition will be considered.

Recruits will be sought from an estimated 8000 drug misusers for whom the current methadone maintenance programmes have proved ineffective. Typically, candidates will be aged around 40, have been dependent for 15 to 20 years, and despite methadone programmes will remain involved in crime to get heroin.

Wim van den Brink, professor of psychiatry and addiction at Amsterdam University, sees it as a “pharmacological intervention to stop a destructive pattern of behaviour.” He believes that it could provide “one small piece of the puzzle” in a range of dependence treatment.

The Independent on Sunday has launched a campaign calling for the personal use of cannabis to be decriminalised. The paper published a list of 100 supporters for the campaign which included well known names from medicine, law, business, education, and the arts.