By Gary Younge

STATE-SANCTIONED DRUG SCHEME

New Ways of Treating Drug Addiction in Zurich and Amsterdam

Mattheus has a lid on things. Every morning he wakes up in a flat he has kept for years, to a steady job and a long-term relationship. The health authorities in Zurich are keen to make sure that he stays that way. So at 8 o’clock every morning, on his way to work, and then at six every evening on his way home, he drops off at a local clinic so the state can provide him with heroin.

Without it Mattheus, a long-term addict, says he couldn’t function. He would spend his entire time looking for drugs or the money to buy them. With it he says he has the "rest and a regulated lifestyle" he needs and is out of the drugs scene altogether. The regular doses of heroin which he gets from the state, he says, even makes him feel healthier. Within two years he hopes to be drug free.

Switzerland, a country notorious for its soporific purity, is experimenting with drugs again. The nation’s largest city, Zurich, is once again at the forefront. Mattheus is one of some 200 long-term heroin addicts in Zurich who has benefited from a national programme of giving a small number of addicts the drugs they need to get through the day - a scheme which has slashed crime rates and increased employment in the city among a group which until recently had been written off.

"We still believe that a life dependent on drugs is not a good life," says Rosann Waldvogel who is the head of the town’s heroin project. "So the aim is not to encourage dependency. But these are a very specific group of people. They have been addicts for a long time and all other attempts to wean them off drugs have failed. We don’t just hand out heroin either. In order to get it they have to come in for other forms of help as well. There are meetings with social workers, nutritional advice, therapy and so on. And this helps them lead a more regular lifestyle and takes drugs off the streets." The results have been impressive. The number of those who took part in the scheme with permanent jobs rose from 14 per cent to 32 per cent; unemployment dropped from 44 per cent to 20 per cent; and the share of those involved in theft and drugs plummeted from 69 per cent to 10 per cent. "It means these people don’t have to steal to get money. It gives them time to settle themselves and to get involved in other projects. It works well for a very specific group of people," says Norbert Klossner of the Zurich police department.

Eveline Gugger, who has been a heroin addict for 11 years and has been getting her supplies from the state for four years, has reduced her intake by two-thirds, moved off the streets and into a flat and got a job in the kitchen of a restaurant.

"This scheme has saved my life," she says. "As well as taking less heroin, I’ve given up cocaine and I can live a life I never lived before." The same targeting might work in Britain. The Swiss model is partly based on the experience of a similar project in Liverpool which produced less dramatic but encouraging results, but was not taken up nationally. Most of the UKP4 billion of drug-related crime in Britain is caused by about 200,000 addicts. But the project in Switzerland was a political experiment as much as a medical one. For such a scheme to work it demands that authorities acknowledge, as a starting point, that some people will take drugs regardless of prevention programmes and stiff sentences - an approach increasingly adopted on the continent.

Britain, however, has chosen to follow the American route of zero tolerance, which blurs the lines between soft and hard drugs and treats most attempts to co-opt drug addicts as a tacit acceptance that the war has been lost. More than 60 per cent of the annual drugs bill is spent on law enforcement, compared with 13 per cent on treatment programmes and 12 per cent on education.

Part of the success, says Professor Gutzwiller, the professor of preventative medicine at the University of Zurich, has been the scheme’s ability to target those most in need. "These are the people who are the sickest and in social terms the most problematic: people with no relations outside of the drugs scene who are the most desperate and therefore the most likely to resort to theft and prostitution." "It’s just much safer now. When you have a park full of addicts in the middle you have no idea what will happen," said a local woman, Mrs Scheneider. "It got so you didn’t want to bring your children into town. I voted to change the law because I thought anything must be better than what we had before and the problem is not just going to go away." The programme also appears to have helped steer many away from hard drugs altogether. More than half of the 1,146 people who have been involved in the project have opted for another type of treatment. Just under 10 per cent have stopped taking heroin to pursue a course of abstinence, according to the findings of the institute for social and preventative medicine in Zurich. They are also less likely to die than those following other courses of treatment.

It has also freed up resources in other drug programmes for less severely dependent addicts. Programmes previously spent much time and energy on trying to rehabilitate users who were never going to come off drugs through orthodox methods. "Before, you only had the choice of prison, abstinence, or therapy, and that did not suit some people," says Peter Sumpf, the head of Frankental clinic, which does not give out heroin. "Now there is an alternative we are all able to give better quality care." The last time Zurich adopted an innovative approach to its drugs problem things did not go so well. During the nineties the city had a policy of trying to contain open drug use in a confined area so that it could be treated more easily and would be forced out of the underground. The result was a disaster known throughout Europe as Needle Park: a small stretch of grass behind the Landes-museum which attracted around 2,000 people a day to come and trade in drugs with that number doubling at the weekend. Inside, addicts used to lie inert on the ground, spattered with blood and strewn with needles. Outside men would wait for young women who would prostitute themselves so that they could get their next fix. Just yards away the police looked on, their bosses annoyed by the obvious failure of this "political experiment." "I think a lot of people came to Zurich from abroad during this time because it had a big open drugs scene. Needle Park got a reputation that drew people in from countries with more repressive drugs policies," she says.

Switzerland also finds itself inconveniently poised on the end of the opium trading route that starts in Afghanistan, Pakistan and Iran and passes through the Caucasus, Albania, Romania or Hungary before arriving in a land more renowned for Emmenthal and cuckoo clocks and making it a lucrative terminus for dealers from all over the world. Of the 362 dealers arrested in Zurich in 1993, fewer than a third were Swiss.

Little wonder then that the latest policy, launched in 1994, proved to be controversial. A group called Youth Without Drugs challenged the plan, preached abstinence and gathered 100,000 signatures to put the question to a referendum. Drawing on the failure of Needle Park which has since been cleared, renovated and returned to its former serenity in the middle of lake Zurich - the campaigners" message was simple: "You can"t fight drugs by giving them away free," said one leader.

But the referendum, in September of last year, delivered a crushing defeat to the nay-sayers with 70 per cent backing the new plan. "I have been in this job 11 years and I cannot explain why we won by so much. I was shocked. I thought maybe we would win but not by this much. We even won in rural areas where people are more conservative and don’t have much of a drugs problem. I think people saw that it was a complicated issue and recognised that it needed a complicated response," says Waldvogel.

The programmes do not hold the sole responsibility for this. The culture of drug dealing has also changed over the last decade. From shady deals on ill-lit streets to deliveries ordered by mobile phones and pager requests.

While the new policy has reduced the number of addicts coming to the city there is little evidence yet that it has actually reduced the number of addicts in Zurich. Its proponents say it is not supposed to: "It is part of a four-point plan, along with therapy, prevention and repression. What it has done is closed down the open drugs scene, made drugs less generally available and removed what was a real problem for the general public," says Waldvogel.

Almost. An evening trip to the tramway stop where Langstrasse meets Limatplatz will suffice to show that there are still individuals dealing openly in the streets of Zurich. There are young men walking around in purposeful circles, stopping for quick conversations with individuals roaming equally aimlessly and then either moving on or disappearing up an improbable alley only to appear from the shadows again 15 minutes later and start circling again.

But compared to the brazen nature of the bad old days, the nocturnal scenes at Limatplatz show a marked improvement, local experts say. So marked, in fact, that the authorities in Amsterdam - a group who have dabbled in inventive drugs policies for so long one would have thought there was little more they could learn - are about to follow suit.

Once again they will concentrate on long-term addicts - although not quite as long-term as the Swiss - who have not responded to other forms of therapy. But unlike the Swiss, fashion is helping to regulate the Amsterdam drug scene all by itself. "Young people are not interested in heroin anymore. They see it as a loser’s drug for old men and one that doesn’t fit in very well with the music scene. They prefer cannabis or Ecstasy and with these two drugs addiction is not really a problem," says Roel Kesemakers, the spokesman for Yellineck drug clinic.

"It is partly a sign of the failure of countries" attempts to control the drug market," says Kesemakers. "You can get as high quality drugs elsewhere now as you can in Amsterdam so why travel," he says.

With the Ecstasy testing kits in nightclubs, and cafes with names like Mellow Yellow, officials in Amsterdam also believe their liberal attitude towards softer drugs has helped stop those who take soft drugs being led astray and wandering nonchalantly into addiction with the harder variety. "Here, if you want cannabis you go to a coffee shop. In other countries if you want it you have to go to a man who might try to sell you heroin or cocaine as well. It separates the two scenes completely," says Von Brussels.