Heroin use drops in Switzerland.

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Heroin use in Zurich and, by extrapolation, in all of Switzerland, appears to have dropped by 82% since its peak in 1990, reported Carlos Nordt, Ph.D., and Dr. Rudolf Stohler of Psychiatric University Hospital, Zurich.The researchers attributed this striking decline to Switzerland's liberal drug policy, which provides "safe" rooms where users can consume heroin, treatments during which users are sometimes provided with free heroin, needle exchange services, and virtually unrestricted access to methadone programs.Before this policy was implemented, the estimated incidence of heroin use in Zurich was comparable with that in Italy and in New South Wales, Australia. Of those three regions, only Zurich adopted a liberal drug policy and only Zurich has shown a precipitous decline in heroin use, the investigators said (Lancet 2006;367:1830-4).They performed a series of statistical analyses of data pertaining to drug treatment programs rather than to determinations of the prevalence of actual heroin use. Using data on 7,256 patients in Zurich who sought substitute treatment with methadone or buprenorphine between 1991 and 2005, the researchers estimated that heroin use peaked in 1990 at 0.73 users per 1,000 residents and fell dramatically to fewer than 0.2 users per 1,000 in 2002.These findings probably reflect the experience with heroin in all of Switzerland, because Zurich includes about 25% of all of the country's heroin users and because incidence trends do not differ between urban and rural areas there, Dr. Nordt and Dr. Stohler said.The "medicalization" of drug dependence has "changed the image of heroin use as a rebellious act to an illness that needs therapy.... [H]eroin seems to have become a 'loser drug,' with its attractiveness fading for young people," they added.