Drug treatment in Switzerland: harm reduction, decentralization and community response.

This paper first outlines the history of illicit drug issues in Switzerland, and then describes drug treatment services and shifts in treatment concepts. In the last 15 years the drug treatment system in Switzerland has expanded considerably. In particular there has been an unprecedented growth of the non-residential sector and of low-threshold programmes, including methadone treatment, the establishment of injection rooms and controlled drug-prescription pilot projects. In the second part, the paper considers some selected factors that promote or impede changes in drug treatment systems, such as treatment policy and the public response to treatment measures. This is manifested in the influence of community action groups on local programme development.