DR. HORST BOSSONG,

Representative for drug issues

of the Senate of the Free and

Hanseatic City of Hamburg

Federal Republic of Germany

Baltimore, November 1993

With 1.6 million inhabitants, Hamburg is Germany's secondo lagest city. It is estimated that there are round about 10.000 users of narcotic drugs, Thereof 90% are intravenous users of heroin. Some 1.400 narcotic addicts are in maintenance treatment, either on methadone or on di-hydro-codeine. Another 1.000 addicts are in various drugfree treatments, either residential or on an outpatient basis. Some 5.000 addicts are more or less frequently keeping in touch with unconditional harm reduction services which provide needle exchange, hygiene care, food and counseling. It seems that all together between 70% and 80% of the addicts population in Hamburg have some contact to the helping services.

On the other hand there are problems with 300 to 500 miserable and homeless street addicts who evoke nuisance in the community. These addicts hang out predominantly in the central station area and the surrounding neighbourhood. These "rock bottom" addicts usually reject rehabilitative services. Possibly they exchange needles and drop in harm reduction facilities to have a coffee and meet other addicts. While these junkies depend on criminal offences, prostitution, offensive begging and drug dealing in the streets to make a living, it is, of course, also their behaviour no criminal court sanction can possibly change.

Since 1989 we have attempted new strategies in Hamburg to cope with the drug problem. Hamburg was the first German state to start motions in 1990 to alter the penal code in drug legislation. Core objectives were:

1. To clarify that methadone is legal and needs uncomplicated prescribing regulations for this purpose. IN earlier days there was a fiery controversial debate about methadone maintenance in Germany, one had to face many burocratic obstacles. Today it is much easier to practise methadone maintenance treatment.

2. To bring about a factual depenalization of drug takers. today charges of possession of small amout for own use, or passing of small amounts to other users can be dropped by the public prosecutor without a court trial. However drug trafficking is prosecuted and sentenced as before. In spring 1993 a guideline was edited by Hamburg's highest prosecutor stating, that drug users should only charged in cases of taking drugs openly on children's playgrounds, in school yards and other places where children are around. The guideline also tells prosecutors not to press charges for possession of less than three grams of heroin, one gram of cocaine and less than a matchbox of cannabis.

3. To legalize needle exchange schemes for intravenous users. In Hamburg, 2.8 million needles were exchanged by the drug services over the last year, an average of 8.000 one-way-needles per day.

4. To facilitate the diversion of addicts to drug free and maintenance treatments instead of imprisonment. The basic idea is that addicts should not be in jail because jail is indeed the worst of all ways in view of their rehabilitation. An in fact, due to our legislative initiative, this aim has been reached in the meanwhile.

The government of Hamburg also succeeded in passing another very important motion in the second Chamber, the "Bundersrat". This motion strives for the legalization of heroin maintenance treatment, but also maintenance programs with coacine and other so-called hard drugs. All german states which currently have a social democratic government approved our motion. The federal government does however not approve it. Our objective is, at first, a five-year research project to explore the effectiveness of maintenance programs involving heroin and other drugs in relation to traditional approaches and with respect to reaching out to addicts and to providing them with social services. The idea is, of course, to improve their health status and to prevent chronic damages. If the test run proves effective, heroin should - in the future - be applied in the same manner as methadone is today. We suppose that many addicts will perhaps prefer heroin to methadone, but could later change to methadone. Eventually they will be li

kely to stop all drug use at some time or other.

The philosophy of our new strategies is quite simple: We believe that drug use cannot be banned from society. But, we can learn to dela with drugs und drug users in a more rational manner than we did in past. We should give drug users medical and social support instead of labeling them as criminals, which drives them in all that social misery. We believe that traditional drug policy has failed world wide. Problems became even larger, that is, the misery of users had been steadily increased. Aids is the alarm signal. Also, trouble for the general population increased, caused by street crimes. The costs of repressive law enforcement agencies and rehabilitative services became enormously high: they exploded, while the outcome is rather moderate. Hamburg spends some 60 million dollars for drug law enforcement and drug social services, but there is not even a reduction of the problem in sight. There fore we need to spped up the turn away form traditional concepts in drug policy - a turn which we began, with alrea

dy some remarkable results, in the year 1989.

In the beginning of this year, I succeded in setting up a coordination group of representatives from all German states with a social democratic government plus some social democratic members of parliament (called Bundestag). A few weeks ago we finished a report with the following conclusion:

"The need for reform of drug policy results from recent research findings suggesting that:

- abstinence oriented counseling arrived at its limits to attain addicts, in particular longterm addicts. Thus there is a necessity for unconditional supportive services which provide help for those addicts who are in acute distress;

- traditional long term abstinence treatments have limited effectiveness. Thus multiple services with different goals and subgoals are required;

- misery and mortality risk increased. Therefore survival support is needed without the request to stop drug use;

- innercity open drug markets are persisting; in some parts brutality is increasing. Deterioration of public security cannot be tolerated for long. Such a situation calls for radical new considerations suggesting decriminalization, medical dispensation of drugs and diverse substitution settings;

- commercial illegal drug trafficking is increasing steadily and becoming more brutal. Traffickers have available international networks and organizational structures on different levels, and they make enormous profits. This calls for intensification and improvement of police action against organized traffickers."

The majority of the members of the coordination group share the opinion that full legalization should at present not be considered an option. The value judgment inherent in drug legislation, namely the idea of the basic illegitimacy of non medical drug use, should not entirely be given up and must be retained. But the idea should be reformed. Intensive non-prejudiced discussions on this subject are needed: but also on possible alternative regulations. This does not lead, s it is claimed by others, to public confusion, but to more profound knowledge and informed judgement about the drug problem.

It is true that some members of the coordination group, with the cannabis problem in mind, want to go a step further; they believe that the idea of illegitimacy of non-medical drug use inherent in our present penal code should be renounced today. They argue that this is necessary in order to establich a trustworthy dialogue on prevention. In other words: Socialdemocratic administrations in German states and the socialdemocrats in parliament do want a discussion, free of prejudice, on the legalization issue and the questions related to it, but they do not want to start a legislation-motion right now. It should be understood that a motion cannot be started by one nation alone, it would need concerted aciton by many nations.

In my opinion there is no real reason to retain the status quo of drug policy. There are many arguments in favour of a radical change which can be achieved by international cooperation.

This century has begun with the prohibition of drugs which had the disastrous effects we could observe. We should now work to begin the next century with a better drug policy. Instead of struggling over and over again to ban from this world all drug cultivation, drug trade and drug consumption by means of police and military forces we should endeavour to set drug use free from illegality and design rational laws which regulate it.

As you probably know, those drugs which cause the most concern in the world, heroin and cocaine, have been invented in Germany at the end of the 19th century. Therefore there is an oblitagion for Germany to work towards a better drug policy. The United States of America were the driving motor at the turn of the century which pushed forward world wide prohibition. I think, therefore, that we germans share this special resposibility in drug policy with the u.s.. government. Hence both of us should take the lead to work towards a more rational drug policy for the upcoming century.