THE CASE FOR HEROIN MAINTENANCE
The big surprise they found in Switzerland was that it also reduced heroin addiction for the people involved. Once they had a legal supply that they could afford (it was not free but a legal price that was 1/100th of the illegal price), they were able to focus on the problems in their lives -- jobs, family, housing, school -- and when they made progress on those fronts they did not need their heroin crutch anymore so many sought treatment to get off heroin (because even when you have a legal source being an addict is not an easy lifestyle).
The Swiss call their program "heroin assisted treatment" as a result of this important reality. Heroin maintenance would be a gigantic win for everyone, especially the addicts and the police. It could be started as a pilot project, impact of the program on participants could be measured for effects on crime, housing, employment, AIDS and overdose.
Baltimore Sun - Heroin maintenance programs seek to lure addicts into treatment, not act as a replacement for it, Reuter said. Some researchers believe that once addicts are removed from the drug lifestyle, they can realize the need for help.
Medical professionals treat addicts like patients, distributing doses of heroin in a sterile, clinical setting. In the Netherlands, where the drug is largely smoked, heroin is distributed in small groups. Users remain at the centers while intoxicated but must leave once they have recovered from their dose. In Switzerland, drug users must have failed several treatment options to be accepted into a heroin maintenance program. They also receive weekly counseling sessions and help finding jobs and housing.
In Germany, trials done from 2002-2006 measured the average number of days a participant was involved in crime at the start and end of the 12 month program. The average dropped from 15.6 days to 2.5.
In Switzerland, a 2001 study followed up with 2,000 addicts who had left a heroin maintenance program. It found that about 60 percent of them sought treatment. Of those, 60 percent went into a methadone program and 40 percent into an abstinence program.
Among the programs' shortcomings is that they enroll a small number of addicts - in Switzerland, just 5 percent of the estimated total. Also, crime declines in the Netherlands were small, not any better than with a good methadone program.