«The vision on which the Confederation is focused is the reduction of drug problems in Switzerland. This vision must be achieved by achieving three objectives: «– Reduce drug use – Reduce negative consequences for drug users» – Reduce negative consequences for society as a whole. «In implementing its drug policy, the federal government will continue to base its overall strategy on the four-pillar model: «Prevention helps to reduce drug use by making it more difficult to enter drug use and preventing the development of drug use.» – Therapy helps to reduce drug use by enabling users to free themselves from their dependence and free themselves from it, or at least keeping this option open for them. In addition, it promotes the social integration of those treated and contributes to improving their health. «Harm reduction helps to reduce the negative consequences of drug use for the user and, indirectly, for society by providing individually and socially less problematic patterns of drug use.» – Law enforcement authorities implement the prohibition of illicit drugs through appropriate regulatory measures, thus helping to reduce the negative consequences of drug use for society as a whole. Here is an overview of how Switzerland manages magic mushrooms and other medicines. Even natural forms of DMT, including ayahuasca, are considered highly illegal here. There is currently no movement in Switzerland that wants to change these laws. The increase in HIV infections, overdose deaths and the public nature of the drug problem have led the Swiss to fundamentally change the way they deal with illegal drugs and drug addicts. To combat addiction, French look beyond drugs to care for the person The multi-pronged approach included some controversial measures – such as legalising drug consumption rooms and heroin treatment facilities – but in the end, statistics show it was successful. Age of onset distributions (Fig.
3; Table 2) showed that tobacco, alcohol and cannabis had the earliest age of onset (median age of onset ∼15 years). Indeed, more than half of young people had consumed alcohol or tobacco before the legal age of 16 in Switzerland: 67.4% for tobacco and 68.9% for beer/wine/alcopops. Of the participants, 53.8% had consumed alcohol before the age of 16 and 87.2% before the age of 18 (i.e. the legal age for the sale of spirits in Switzerland). Forty-two percent of participants had smoked cannabis before the age of 16 and 63.6% before the age of 18. The age of onset of cannabinoids other than cannabis was higher (Fig. 4a; Table 2): 3.8% of participants had used CBD before the age of 18 and 1.7% had synthetic cannabinoids. Switzerland took a risk by thinking outside the box when it came to dealing with drugs. Its four-pillar approach (prevention, treatment, harm reduction and enforcement) has proven effective in reducing crime, overdose, HIV and substance abuse.
The legalization of a substance eliminates all penalties and fines and creates a legal market. The state no longer persecutes the user. In summary, a high percentage of adolescents who used an illicit substance at age 20 did so before the age of 18. The age of onset of legal substances peaked between 1.3 (tobacco and beer/wine/alcopops) and 2.7 years (alcohol) before the legal retail age, and more than 2 in 5 adolescents had used cannabis by the age of 16. For correlations between ages of onset, see online supplement 3. Supplement 4 online shows what percentage of people who took a substance at age 20 started using that substance at age 16 or 18. The results show that for several illicit substances such as ecstasy, amphetamines or 2C drugs, almost half of those who used this substance by the age of 20 had started using it at the age of 18 or younger. «For the group of individuals who were treated continuously for four years, a sharp decrease in the incidence and prevalence rates of the overall criminal impact was noted for intensive and moderate offenders. With regard to the nature of the offence, similar reductions were observed for all types of offences related to the use or acquisition of narcotics. Not surprisingly, the largest decline was observed for heroin use and possession.
Based on self-reported and clinical data (Blaettler, Dobler-Mikola, Steffen, & Uchtenhagen, 2002; Uchtenhagen et al., 1999), analysis of police records suggests that program participants also have a strong tendency to significantly reduce their use of cocaine and cannabis, likely because program participants significantly reduced their contact with the drug community when entering the program (Uchtenhagen et al., 1999) and were therefore exposed to fewer opportunities to purchase drugs. As a result, their need for money is reduced not only for heroin, but also for other substances. Thus, the decrease in commercial crime, such as drug sales or property crime, is also remarkable and is related to all types of theft such as shoplifting, vehicle theft, burglary, etc. Detailed analysis showed that the decrease observed was related to an actual reduction in criminal activity rather than a more lenient recording practice of police officers towards program participants. On 19 April 2022, the FOPH approved the first pilot test of an adult cannabis purchase programme in Basel, northern Switzerland. This is expected to provide data on the way forward to regulate the purchase and consumption of recreational cannabis. The program is expected to last 2 years and will include 400 adult volunteers whose health will be constantly monitored. The 6-year program in development was discontinued for legal reasons, but the Narcotic Control Act was amended in 2021 and allowed to continue in August of the same year. Four cannabis strains will be made available and 2 hashish strains will be available for licensed volunteers in 10 Basel pharmacies manufactured by Pure Holding A.G. Program participants must be warned not to share their cannabis with non-participants, otherwise they may be excluded from the curriculum.
[27] Alcohol and tobacco were used more frequently by males than females, but prevalence among females was still high (>80%) (Figure 1b). In addition, almost all groups of illicit substances were more commonly used by males than females, including cannabinoids, stimulants and hallucinogens, but not opioids (Table 1). One in 3 men (compared to 1 in 5 women) had consumed CBD. One in 5 men (compared to 1 in 7 women) reported using codeine for non-medical purposes. One in 6 men (compared to 1 in 8 women) had used ecstasy. One in 7 men (vs. 1 in 10 women) had used cocaine. For example, more than two-thirds of women had used cannabinoids by the age of 20. After Bonferroni`s corrections, significant sex differences persisted in cannabis, CBD, and LSD/psilocybin (pcorr < 0.05).
Among illicit substances, particularly the lifetime and 12-month prevalence of cannabis use, our study was significantly higher than previous representative Swiss surveys [36, 37] and the European average [38]. A direct comparison of male prevalence rates at the same age between our study and the C-SURF study revealed significantly higher rates in the z-proso sample for all substances compared. χ2 tests comparing overlapping substance prevalence rates between male z-proso participants only with male C-SURF conscripts confirmed significantly higher rates in the z-proso sample (corrected Bonferroni p-values <0.0001). It should be noted that C-SURF was made 7-8 years before z-proso. However, it is less likely that the very large differences in prevalence rates can only be explained by the evolution of substance use in Switzerland over time. According to Swiss Addiction Monitoring, lifetime prevalence and past year prevalence increased by 6.1% and 2.3% respectively between 2011 and 2016 [36], while our study comparison showed a difference of 22.6% for life and 31.4% for prevalence last year. The situation is similar for the other substances examined. It could be argued that C-SURF measured more participants from rural than urban areas (41% vs. 59%) and that substance use is over-represented in urban areas, as assessed by z-proso.
In the case of C-SURF, however, rural-urban differences in the prevalence of substance use were surprisingly small [57]. Although wastewater analyses reflect the entire age spectrum and not just substance use among young people, the high prevalence rates of cocaine and MDMA in our sample are consistent with current wastewater tests showing that concentrations of benzoylecgonine (the main metabolite of cocaine) and MDMA in some Swiss cities, including Zurich, are among the highest of European cities [40]. «The incidence of regular heroin use in the canton of Zurich started with about 80 new users in 1975, rose to 850 in 1990 and fell to 150 in 2002, reducing it by 82%. Incidence peaked in 1990 at levels similar to those in New South Wales, Australia or Italy. But it was only in Zurich that a fourfold drop in the number of new heroin addicts could be observed in a decade. This decrease in incidence is likely to affect Switzerland as a whole because the number of patients on substitution treatment is stable, the age of the substituted population is increasing, drug-related mortality is decreasing and heroin seizures are decreasing. In addition, the evolution of the incidence did not differ between the urban and rural regions of Zurich. This finding suggests a more similar spatial dynamics of heroin use for Switzerland than for other countries. The prevalence of CBD – which is available for free in Switzerland – but also synthetic cannabinoids was surprisingly high.