Drug Abuse in the Global Village
Switzerland
EXTENT, PATTERNS AND TRENDS IN DRUG ABUSE
Extent of Drug Abuse
The estimated number of persons abusing illicit drugs on a daily basis is the highest for cannabis (150,000 in 1989), followed by benzodiazepines and minor tranquilizers (100,000 in 1986), heroin (18,000 in 1989), cocaine (16,000 in 1989), amphetamine type stimulants (1,200 in 1989) and hallucinogens (450 in 1989) (U.N. 1990).
Two studies carried out in 1981 and 1990 concluded that 10 per cent of the 15 to 16 year olds and a quarter of the 15 to 24 years old have used cannabis at least once prior to being surveyed. Three per cent of those aged 15 to 24 years abused heroin and cocaine at least once prior to being surveyed (Sieber,Angst and Binder, 1981 and IUMSP/IPSO, 1990).
Abuser Characteristics
More men than women abuse drugs according to survey results (see table 1). For both men and women, cannabis abuse is more prevalent among those 21 to 25 of age (37 per cent for men and 21 per cent for women). The male to female ratio of opiate and cocaine abuse is 2 to 1. Opiate use is found more in the 26 to 30 year old group for both sexes (IUMSP/ISPO 1990).
Survey data shows that cannabis consumption appears more prevalent with increased degrees of education (26 per cent to 29 per cent for those educated at school level compared to 34 per cent for those with university education). No significant differences were found in the correlation of education with abuse of opiates and cocaine (29 per cent for schools and 31 per cent for universities) (Office fיdיral de la santי publique 1990).
Table 1. Life prevalence of drug use in the 17 to 30 year old age group (1987-1989)
and the 31 to 45 age group (1989) by age and sex in percentages.
Age range 17-20 21-25 26-30 31-45#
Male
Cannabis only 28 37 32 14
Opiates, cocaine 2.0 4.8 6.4 2.8
Female
Cannabis only 17 21 17 7
Opiates, cocaine 1.5 2.2 1.7 0.7
TOTAL
Cannabis only 22 29 25 11
Opiate, cocaine 1.8 3.5 4.0 1.8
Source: Le problטme de la drogue - en particulier en Suisse - considיrי sous son aspect social et prיventif. Rapport יtabli א la demande de l'Office fיdיral de la santי publique. Lausanne, aot 1990.
# Supplementary sample in 1989 of 31 to 45 year olds.
Regional Variations
Switzerland is a federal state of 26 cantons. According to police arrest data, the largest numbers of persons convicted for drug consumption offences are found in 6 of the cantons (Berne, Vaud, Zurich, Aargau, Geneva and St Galen) (Police 1992). Drug related deaths in 1991 were also the highest in these cantons (Vaille, C. 1991).
A survey by the Federal Public Health Office carried out in cantons in 1989 found that LSD abuse was of concern in 23 canton, albeit to a decreasing extent and in small amounts (13 cantons reported a decrease in use, 5 to 6 stable and in 2 an increase), amphetamines abuse in 18 cantons, MDMA in 7 and solvent abuse in 14 (stable and rare) and crack abuse in none of the cantons (CM0 1990).
Trends
Survey data show that occasional abuse of illicit drugs by young people under 15 years of age has remained stable in the last ten years (Office fיdיral de la santי publique, 1990). According to cantons' estimates, the number of cannabis and heroin/cocaine abusers doubled since 1985 (WHO 1992). Arrests for drug consumption has increase by 37 per cent between 1991 and 1992. Drug related deaths increased from 405 in 1991 to 419 in 1992 (Police 1991, 1992). Consumption of synthetic drugs and crack is marginal (Office fיdיral de la santי publique 1990). Multiple drug abuse (cocaine and heroin and use of alcohol) increased according to a study among abusers in treatment (Switzerland 1991).
Mode of intake
Injection of heroin, cocaine, methadone and various medical preparations are common (Switzerland 1991).
COSTS AND CONSEQUENCES OF ABUSE
The economic costs of illicit drug consumption in Switzerland in 1989 is estimated between 490 and 535 million swiss francs . Approximately half is attributed to loss of earning and productivity relating to mortality and morbidity, one third of the cost to supply control, 17 per cent to medical care and only 3 per cent to prevention and research (including documentation and coordination) (table 2).
Table 2. Estimated cost of consumption of illicit drugs, 1989.
Millions of swiss francs Minimum Maximum
Medical Cost 73.3 100.4
Morbidity and 240.0 256.0
mortality
Cost of repression 159.4 162.2
Cost of prevention 8.9 10.0
Cost of research 4.7 6.2
Total 486.3 534.8
Source: Le problטme de la drogue - en particulier en Suisse - considיrי sous son aspect social et preventif. Rapport יtabli א la demande de l'Office fיdיral de la santי publique. 1990
Drug related deaths. Some 419 drug related deaths were reported for 1992, compared to 405 in 1991 and 280 in 1990. Of these, 82 per cent were males and about half older than 27 years. Approximately 88 per cent of the deaths were by overdose, mainly of heroin. In most other cases, multiple drug abuse was the cause of deaths (Police 1990, 1991, 1992).
HIV/AIDS. Of the number of AIDS cases recorded in 1993, 38.3 per cent were intravenous drug abusers (AIDS Surveillance in Europe, 1993).
NATIONAL RESPONSES TO DRUG ABUSE
National Strategy
Each of the 26 "cantons", has its own parliament, government and laws and is, to a large extent, responsible for its own drug strategy. The Confederation assumes activities with respect to legislation, coordination and finance. The Confederation decided in 1991 to become more active in the field of prevention and aims at reducing drug abuse by 20 per cent by 1996 (Switzerland 1991).
LEGAL, ADMINISTRATIVE AND OTHER ACTION
TAKEN TO IMPLEMENT THE INTERNATIONAL
DRUG CONTROL TREATIES**
Treaty adherence
Switzerland is Party to the 1961 Single Convention on Narcotic Drugs.
DEMAND REDUCTION ACTIVITIES
Primary Prevention
Education and information programmes on drug abuse are carried out in all "cantons" and are aimed at schools but also parents, youth and those responsible for young people. Programmes vary from one canton to another. Ministry of Health complement activities at the canton level through health education, using publications and mass media campaigns.
In view of increasing HIV infections rates among drug abusers (42 per cent in 1991 compared to 28 per cent in 1988), a large scale STOP-AIDS campaign was launched in 1989. Needle exchange schemes are operating in most of Switzerland (Switzerland 1991).
Treatment and Rehabilitation
Switzerland's policy regarding treatment calls for harm minimization. Accordingly, the harm of AIDS and hepatitis is reduced through needle exchange programmes and vaccination campaigns for hepatitis.
Treatment approaches, including psychotherapy, behavioral therapy, and family and social therapy aim for abstinence. Increased attention is given to improving drug abusers quality of life through the provision of street kitchens, working opportunities, health care centres, residential centres and "stations" where injecting may be done under surveillance (Fixerrהum, now operating in Bגle and Berne).
The following facilities were reported: outpatient centres (170 in 1991), inpatient facilities (65), detoxification centres (57), survival programmes (street kitchen, stations, etc., 38 in total), aftercare institutions (69) and centres for involuntary treatment (35), methadone programmes (4,754 abusers in such treatment in 1989) (Switzerland 1991).
SUPPLY REDUCTION ACTIVITIES
Arrests, Convictions and types of Offences
A total of 30,860 drug related offences were reported for 1992 (23,470 in 1991 and 18,880 in 1990). Eighty four per cent of these were committed by males in the 18 to 24 age group. Thirty nine per cent of these offences were by non nationals (Police 1990, 1991, 1992).
Seventy four per cent of the offences related to consumption only (71 per cent in 1991 and 68 per cent in 1990), 6 per cent to trafficking (5 per cent in 1991, 4 per cent in 1990). The remainder related to both consumption and trafficking offences. Offences relating to consumption have increased by 37 per cent from 1991 and those for trafficking have increased by 47 per cent (Police 1990, 1991, 1992).
The number of abusers convicted for the first time increased by 15 per cent since 1991, making up 38 per cent of the total consumption offences. The number of those previously convicted has increased by 50 per cent. Sixty one per cent of those convicted for consumption were drug addicts, a 65 per cent increase from 1991. Sixty nine per cent of consumption offences relate to heroin in 1992, followed by herbal cannabis (68 per cent) and 24 per cent for cocaine. For the first time, heroin consumption offences surpassed herbal cannabis offences (15,325) (see table 3) (Police 1991, 1992).
Table 3. Offences related to consumption of illicit drugs, 1990 to 1992.
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1990 1991 1992
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Cannabis type 13,224 14,701 16,395
Opium 38 56 19
Morphine
heroin base 42 83 110
Heroin 7,493 11,079 15,923
Cocaine 4,097 5,081 5,598
Crack 18 24 19
Amphetamine 45 48 75
LSD 216 235 229
Other
Hallucinogens 48 46 323
Methadone 272 356 344
Other 167 231 203
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Source: Statistique Suisse des Stupיfiants, 1990, 1991 and 1992, Ministטre Public de la Confederation, Bureau Central Suisse de la Police.
(Each offence appears as many times as there are types of drugs consumed)
Drug trafficking offences committed by non Suisse nationals make up 83 per cent of the total, an increase of approximately 50 per cent from 1991. The number of Suisse nationals convicted for trafficking offence has increased by 21 per cent since 1991 (Police 1990, 1991, 1992).
Thefts from pharmacies and doctors increased (691 in 1992 compared to 612 in 1991 and 254 in 1981) (Police 1990, 1991, 1992).
Seizures
Cannabis makes up the bulk of drugs seized in Switzerland (almost 2.5 tonnes in 1992), followed by cocaine (329.9 kg in 1992), heroin (243.3 kg in 1992), amphetamines (1 kg in 1992) and LSD (902 units in 1992) (see table 4 for 1986 to 1992 seizures) (Police 1990, 1991, 1992).
Table 4. Seizures of illicit drugs 1986 to 1992.
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Year Heroin Cannabis Cocaine Amphetamone LSD
(kg) (kg) (kg) (kg) (doses)
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1986 81.6 377.8 101.9 0 933
1987 69.9 597.4 112.9 0.024 5,290
1988 42.9 1,230 226.1 0.726 1,705
1989 50.4 883.2 306.1 0.353 1,492
1990 186.2 513.8 339.3 14.8 2,207
1991 81 838.2 333.4 0.025 752
1992 243.3 2,434.8 329.9 1 902
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Source: Statistique Suisse des Stupיfiants, 1990, 1991 and 1992, Ministטre Public de la Confederation, Bureau Central Suisse de la Police.
Supply Source of Drugs
Heroin originates from Turkey, India, Thailand and Africa, and cocaine from Latin America. Cannabis originates from the Netherlands, Spain and North Africa (Police 1992).
References and Notes
** The Legal, Administrative and Other Action Taken to Implement the International Drug Control Treaties section was prepared by the Secretariat of the Commission on Narcotic Drugs based on Annual Reports Questionnaires for the years .... (not available by January 15th 1994).
Police 1990,1991,1992. Statistique Suisse des Stupיfiants, 1990, 1991 and 1992, Ministטre Public de la Confederation, Bureau Central Suisse de la Police.
Office fיdיral de la santי publique, 1990. Le problטme de la drogue - en particulier en Suisse - considיrי sous son aspect social et prיventif. Rapport יtabli א la demande de l'Office fיdיral de la santי publique. Lausanne, aot 1990.
U.N. 1989,1990. Replies to the UNDCP Annual Reports Questionnaires for the years 1989 and 1990.
CMO 1990. Reply to the questionnaire concerning the seven targets of the comprehensive Multidisciplinary Outline of Future Activities in Drug Abuse Control (CMO), 1990.
Switzerland 1991. National Report of Switzerland to the First Pan-European Ministerial Conference on Illicit Drug Abuse Problems, Oslo, 9-10 May 1991.
AIDS Surveillance in Europe, 1993. Quarterly Report Number 38, June 30 1993.
WHO 1992. ESDA, First European Summary on drug abuse, WHO 1992.