 In the late 1980s, Switzerland witnessed a huge increase in injecting drug use and was hit hard by the harms associated with it, such as HIV, overdose and crime. From this short movie by the HCLU, you can learn how the country successfully resolved these problems through the introduction of an innovative national drug policy. In the beginning, when the first large open drug scenes emerged in big cities such as Zurich, the situation seemed desperate. In that needle park it became absolutely a misery, a misery. Thousands of people injecting there, people were living there, it was full of dirt and shit. A lot of overdose, the mortality rate was extremely high, criminality was very high. In the beginning we tried to handle it along with police law enforcement, but it was obvious that it was not working anymore. The main indicator of how the old system didn't work was the large proportion of injectors being not in any kind of treatment. Ironically the open drug scene helped because that way you got media exposure and it was one of the main topics in the whole country. So the political system had to do something, the politicians had to do something, solutions had to be found and they started to build alliances between the different sectors involved. Everybody realized this is going nowhere and something has to be done. And this was the starting point for private initiatives. Also civil servants who on their own initiative started some harm reduction approaches without formal consent, even under the threat of becoming punished. One of the most important new interventions was the distribution of sterile needles and syringes among drug users to stop the sharing of injecting equipment and to prevent blood-borne infections such as HIV and hepatitis. The municipal authorities opened supervised injection sites to create a safer and more hygienic environment to avoid street drug use and to increase their ability to intervene in the case of overdose. Besides the scaling up of access to abstinence-oriented treatment and prevention programs for those who could not stop doctors prescribed opioid drugs like methadone in order to improve their social and health situation and to reduce crime. For whom no other forms of treatment worked, doctors started to provide medical heroin to get them off the streets, save their lives and improve their situation. Our authorities and police did not crack down on these first initiatives but they waited. They wanted to see what's coming out of it. We tried to work together with other departments, especially the social one, and we developed a new strategy. It's called the Four Pillars Strategy. The Four Pillars of the Swiss Drug Policy are prevention, treatment, repression and harm reduction. What was the reaction of international organizations, UN, INCB, to the new methods you started to use? More than skeptical. They didn't like it. INCB warned against doing that in other countries and still at the same time they allowed us to import the necessary amount of morphine to produce the heroin to prescribe because otherwise we had no heroin in the country. WHO was different. WHO set up an international expert group from the very beginning and they did a very good job in acknowledging the positive outcomes. The Swiss Drug Policy was carefully evaluated several times and the numbers speak for themselves. Heroin use was reduced significantly. The annual number of new heroin users declined from 850 in 1990 to 150 in 2002. Between 1991 and 2004, the rate of drug-related deaths declined by more than 50%. Levels of new drug-related HIV infections were divided by 8 within 10 years. According to a 1999 study, the country witnessed a 90% reduction of property crimes committed by drug users. About 70% of our injectors are in some kind of treatment and the majority of those in substitution treatment. There is no more need for those to go to the illegal market and to engage in criminal activities for getting the money to get their heroin. It was one of the concerns when we started heroin-assisted treatment that people, when they get the heroin, they will stay on it forever. They will never stop. The fact is that the average time of participation in a program is something less than three years. People find a job, people find new contacts, social contacts outside the drug scene. Many of these who had a long history of fighting between their families and themselves get some new relation to their families. More than 60% go to another treatment. And the majority of those who go to another treatment go back to method of maintenance. And it's about one fourth of those who leave. In effect, try detoxification and drug-free treatment. My unit runs four contact centers in Zurich with safe injection and safe consumption rooms for drug users. So in four of my facilities founded by the city I paid the taxpayers money every day, yesterday, today, tomorrow about two to three kilos of illegal cocaine or heroin are consumed. If you want to run such a system you have to have a very good cooperation on a very operative level. How does this cooperation look like in everyday life? Well, we are on the street and those are the social street workers who are on the street and they see each other daily and they talk to each other and we really cooperate. And if they see something that's not working they call us and those on the other hand we call them and so it's really a cooperation. I run four contact centers. One is just opposite the stock markets and opposite the art museum. And it works. It works because of our good cooperation because we run these institutions together with the neighborhood. How would you summarize the key principles behind the success of the Swiss drug policy? Well, I think one of the major factors was the high visibility of the problems and the size of the problems. So everybody could see something has to be done. The main thing is implementation and for good implementation at the local level you need good collaboration. Stop the fights between police forces, social workers, street workers we had beforehand and work together. We have excellent collaboration with the medical world, medical associations because we couldn't have this high coverage in substitution treatment without private doctors participating in it. In fact 60% of methadone maintenance is office based in private practice. In Switzerland we have direct democracy as an important element of the political system. These new strategies were attacked by some political groups but then there was a vote and it was confirmed by the people. So the whole four pillar strategy has a very high legitimacy because they received large majorities in these referendum votes. What would you recommend for other countries who are struggling with the same problems? The situation in Switzerland, the example of Zurich, shows that it's really in other ways possible and I recommend all of them just have a look at it, come and look at Zurich, how we do it. If you would like to learn more about Swiss drug policy read the new report of the Open Society Institute entitled From the Mountain Tops, the evolution of drug policy change in Switzerland and its lessons for the world.