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June 22, 2016

Switzerland to Get New Supervised Injection Facility in 2017

Legislators in Lausanne hope to open the Swiss city’s first supervised injection facility (SIF) in 2017. The facility will provide people with a space to self-administer pre-obtained intravenous drugs under medical supervision.

SIFs are safe spaces that provide sterile injection equipment, information about reducing the harms of drugs, treatment referrals, and direct access to medical staff. Since the opening of the world’s first SIF, in Bern in 1986, over 80 more have emerged. They have been proven to reduce HIV and hepatitis C transmission among people who use intravenous drugs, decrease public injections and discarded syringes, prevent overdose deaths, and increase the number of people who enter drug treatment.

Oscar Tosato, municipal councillor of the Socialist Party – the dominant political party in the Vaud canton, where Lausanne is situated - told the Swiss newspaper 24heueres that the SIF will be specifically aimed at helping the most destitute. There are an estimated 500 people in Lausanne who use injecting drugs, yet the SIF would only be able to hold eight people at any one time.

Lausanne’s pilot project has been four years in the making, and will be run by the Accueil à Bas Seuil (ABS) trust. The facility will benefit from the knowledge and experience acquired from the 12 other facilities across Switzerland, which all opened during the past 30 years.

Of the 26 cantons in Switzerland, Vaud is the only one in which the population voted against the opening of a local SIF in a 2007 referendum. Given Switzerland’s long-standing history of SIFs, what has taken Lausanne so long to catch up?

According to Tosato, the rhetoric around the issue has changed as the country’s Public Health Agency now perceives SIFs as a principal measure in reducing the risk connected to drug misuse. Additionally, instances of public drug use have increased; among the estimated 4,000 people who inject heroin in Vaud, a quarter do so publicly. Martine Monnat, a Vaud doctor, condemned the current “unacceptable conditions” in Vaud that expose people who use drugs to severe health and hygiene dangers.

This rhetoric from public officials corresponds with the Swiss people’s acceptance of such measures. In November 2008, a national referendum passed advocating the “four pillars policy”: policing, prevention of drug use, treatment of drug use, and harm reduction. The official implementation of this health-oriented policy has been practiced in many Swiss cities to counter the issues associated with problematic drug use.

Lausanne’s SIF has two objectives: to reduce health risks and reduce drug use. The SIF would reduce health risks by offering a safe and hygienic space for people to inject drugs, and would reduce drug use by enhancing access to healthcare. Jacques Besson, an addiction specialist and physician at Lausanne University Hospital’s psychiatric community service, welcomed the plan - emphasising how people who use drugs problematically will have greater access to health services.

Although the opening of Lausanne’s SIF is supported by the Socialist Party, it faces hostility from the Swiss People’s Party – the nation’s strongest party. Meanwhile, the Free Democratic Party of Switzerland, the second largest party in Vaud, has expressed guarded openness to the project. It remains unclear how much backlash Vaud’s first SIF will have to face, but a heated debate is to be expected.

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