A new World Health Organisation (WHO) commissioned evaluation of the
Swiss heroin trial has cast significant doubt over previous claims
about the benefits of the trial.
The WHO report entitled Report of the External Panel on the Evaluation
of the Swiss Scientific Studies of Medically Prescribed Narcotics
to Drug Addicts, found that some of the findings of the
study' conducted by the Swiss Government have been somewhat
over-interpreted as favourable to heroin maintenance treatment'.
The evaluation pointed to the fact that the Swiss trial included comprehensive
social and psychological services.
Given the provision of the non-drug treatment and support, it cannot
be concluded that prescribed heroin contributed to the improved the
health and welfare of participants.
The report said that with the absence of a control group it was not
clear if the same results could have been achieved without the prescription
of heroin.
In other words, the improvements recorded in the health and well being
of participants could have been due to the intensive non-drug treatment
they received.
Significantly, the evaluation found that there is not convincing evidence
that heroin prescription generally leads to better outcomes than methadone
treatment, even for hard core users.
The report also found that while reported criminal activity declined
no data was provided to indicate the frequency or financial costs
associated with these offences, or to back up claims that reduction
in criminal behaviour persisted after dropping out from treatment.
Heroin prescription trials occurred between 1994-96 in Switzerland
for addicts with at least 2 years of heroin use who had attempted
other treatment more than once.
The WHO evaluation is particularly significant given that the 1997
annual report of the International Narcotics Control Board (a United
Nations publication) expressed the Board's firm belief that no
further experiments should be undertaken until the Swiss project had
undergone full and independent evaluation.
The International Narcotics Control Board said in it's 1997 report:
"The Board is concerned that the announcement of those results
(the Swiss Government's own evaluation released in July 1997)
and a subsequent national referendum on the Swiss drug policy have
led to misinterpretations and hasty conclusions by some politicians
and the media in several European countries."
It also stated:
"The Board regrets that, before the evaluation by WHO of the
outcome of the Swiss experiment, pressure groups and some politicians
are already promoting the expansion of such programmes in Switzerland
and their proliferation in other countries."
Now that we have the evaluation, the caution urged by the International
Narcotics Control Board has proved justified because the WHO has raised
real questions about the validity of many of the claims made about
the Swiss trial.
With regard to the views of the Australian Government, the WHO evaluation
confirms our doubts about the true value of the Swiss experience,
and provides no reason to change our opposition to heroin trials.
If a trial were to be held in Australia it would send exactly the
wrong message to the community, and would work against our education
efforts.
In light of the new doubts raised through the WHO, a heroin trial
remains a risky proposition that is unacceptable to the Federal Government.
The assistance provided under the Federal Government's Tough
On Drugs strategy which has already directed more than $60 million
to treatment and rehabilitation services is of far greater long term
benefit to drug users and will save far more lives than a heroin trial.