Delegation of Switzerland

Statement with regards to the INCB report of 1999

CND, 43rd session, march 2000, Agenda item 6b

Mr. Chairman, distinguished delegates

Switzerland, too, would like to thank the INCB for its annual report which is always an excellent source of information with regards to the developments that have taken place around the world during the past year. We would like to comment on one particular issue of the report: the drug injection rooms as referred to in paragraphs 176 and 177 of the report.

As far as we can see there are the different aspects to the questions that arise with regards to drug injection rooms:

the legal aspect,

the policy aspect and

the field experience.

In this statement I would like to briefly comment on all three of these aspects.

Concerning the legal aspect two key questions need to be addressed:

Are injection rooms in conformity with the respective national law?

Are injection rooms in conformity with the international treaties?

In order to clarify the first question a Swiss law professor (Prof. Schulz) made a legal expertise in 1989. He came to the conclusion that "injection rooms are essentially providing socio-medical care and survival assistance to long-term drug addicts. These addicts can be permitted - under the supervision of medically trained staff and in good sanitary conditions - to inject themselves drugs which they have brought with them. They are by no means permitted to purchase drugs on the premises, as all forms of dealing and trafficking are strictly prohibited and the police are prepared to suppress such activities at any time."

It was on the basis of this analysis that in Switzerland injection rooms started to operate in the early nineties.

With regards to the conformity with the international treaties we took note of the position expressed by the INCB. However, we asked for a second opinion on the matter by inviting the Swiss institute of comparative law to examine the question. Their conclusion is somewhat different to the one of the INCB. Let me just quote one of the conclusive sentences of the expertise:

"The texts oft the relevant international conventions do not provide any guidance on the essential question of whether or not public injection rooms are in fact conducive to the rehabilitation and social reintegration of drug addicts in the short term and to the reduction of human suffering and the elimination of financial incentives for illicit traffic in the long term."

I do not want to quote the expertise in detail, since our delegation will make available the entire document to any delegation that is interested.

We realize that there seem to be different interpretations of the respective texts of the Conventions and would therefore strongly encourage an in depth analysis of the legal aspects of the question.

The second aspect concerns the policy of each country. Whether or not injection rooms should be established depends in our view very much upon the network of assistance which exists in a particular country. As the four Conventions mention, countries should take "all practicable measures" in order to provide "treatment, education, aftercare, rehabilitation and social reintegration" to drug abusers.

Over the years, Switzerland has built up a very highly developed network of facilities and services for drug addicts. Our estimates tell us that probably about two thirds of the Swiss addicts are in some kind of treatment. Experience in our country has shown that no matter how large and differentiated our system of assistance might be, there will always be a small group of addicts whom we cannot integrate into one of the existing treatments. It is for them that services with a very low threshold like injection rooms can be the only chance of staying in contact with any kind of sanitary or social services. In our opinion it is therefore necessary to look at the whole network of services offered to drug addicts in a certain country before judging individual projects and specific approaches.

To conclude let me mention the third aspect: the specific experience in the field. Switzerland has more than five years of experience with injection rooms. During all those years that injection rooms have existed in Switzerland we have not been able to observe any negative effects on drug trafficking, on prevalence or incidence of substance abuse or on the average age of consumers. The institutions operate according to very strict rules and regulations. The police do not tolerate trafficking in the institutions or in the neighbouring areas and exchange of information between police and social services as well as the discussion of particular problems within the institutions are institutionalized.

From a public health point of view the facilities have without a doubt significantly contributed to improvements in the health of drug addicts. Indicators like HIV infections, deaths caused by overdose or the general physical health of drug addicts show significant improvements over the years. Moreover, injection rooms have contributed to clear reduction of the public disturbance caused by drug addicts especially in the cities. We have evidence that drug injection rooms are an important element in the overall concept of our drug policy and that they can be operated without interfering with the tasks to be accomplished by the police.

Switzerland is interested to share its experience in this field with other countries and to learn from the experience made elsewhere.