Proceedings of the Special Committee on
Issue 13 - Evidence (morning meeting)
OTTAWA, Monday, February 4, 2002
The Special Senate Committee on Illegal Drugs met this day at 9:06 a.m. to reassess Canada's anti-drug legislation
Senator Pierre Claude Nolin (Chairman) in the Chair.
The Chairman: I call to order the meeting of the Special Senate Committee on Illegal Drugs. It is a pleasure to
welcome you today, colleagues. I would like to take this opportunity to welcome those who have travelled to be present
at this hearing, as well as those listening to us on radio, television or on the committee's Internet site.
I would like to introduce my colleague Thelma Chalifoux, from Alberta, who is with us on the committee today. My
name is Senator Pierre Claude Nolin, and I am part of the Quebec contingent in the Senate of Canada. Sitting beside
me are the Clerk of the Committee, Mr. Blair Armitage, as well as the Committee Research Director, Mr. Daniel
The mandate of the Senate Special Committee on Illegal Drugs is to study and to report on Canadian policies
concerning cannabis in this context: to study the efficiency of those policies, and the approach, the means, as well as the
controls used to implement them. In addition to its initial mandate, the committee is required to examine the official
policies adopted by other countries. Canadian international responsibilities with regard to the conventions on illegal
drugs, to which Canada is a signatory, will also be examined. The committee will also study the social and health
effects of Canadian drug policy on cannabis and the potential effects of alternative policies.
The committee must table its final report at the end of August 2002. In order to carry out its mandate properly, the
committee has adopted an action plan based on three major thrusts. The first is knowledge. In order to meet this
challenge, we will hear from many Canadian and foreign experts representing the academic, police, legal, medical,
social and government communities. These hearings will be held mainly in Ottawa, and occasionally, if necessary,
outside the capital.
The second thrust is the sharing of knowledge. This is definitely our most noble objective. The committee wants all
Canadians to become informed and share the information we collect. Our challenge will be to plan and organize a
system to ensure that the knowledge is available and distributed. We would also like to hear what people think about
this knowledge. In order to do this, in the spring of 2002, we will be holding public hearings in various parts of Canada.
Finally, the third focus of the committee is to review very carefully the guiding principles upon which Canada's
public policy on drugs should be based.
Before I introduce the distinguished experts for today's hearing, I would inform you that the committee maintains
an up-to-date Web site that is accessible through the parliamentary Web site at www.parl.gc.ca. All the committee's
proceedings are posted there, including the briefs and the appropriate support documentation of our expert witness.
We also keep up-to-date more than 150 links to other related sites.
I would like to say a few words about the room where we are holding this morning's meeting. This room, called the
Aboriginal peoples' room, was designed by the Senate in 1996 to pay tribute to the people who were the first to occupy
the territory of North America and who continue to participate in Canada's development today. Five of our
colleagues, including Senator Chalifoux, represent these people with pride and dignity.
Today we are examining the issue of drugs in Switzerland. To assist us in our work, we will be hearing from Ms
Diane Steber Büchli, Head of the International Drug Affairs Unit at the Swiss Federal Office of Public Health, and Ms
Françoise Dubois-Arber, from the University Institute for Social and Preventive Medicine. This afternoon we will be
hearing from the head of the Criminal Police of the Canton of Zurich, Mr. Georges Dulex, and finally, from the
Addictions Research Institute, Professor Ambros Uchtenhagen.
Ms Steber Büchli, I welcome you and thank you for having accepted our invitation as well as for the interest you
have shown in our work. With respect to how this morning's meeting will proceed, we will begin with your
presentation, and following that there will be a question period.
If, in order to be rigorous in our work, the committee researchers want to ask you additional questions, I will send
them to you in writing. I hope you will answer them. These questions and answers will also be posted on the
committee's Internet site. Ms Steber Büchli, you have the floor.
Ms Diane Steber Büchli, Head, International Drug Affairs Unit, Swiss Federal Office of Public Health: On behalf of
the Swiss Federal Office of Public Health, I should like to thank you for the interest that you are showing in our Swiss
drug policy, and for the invitation to speak to you today.
My presentation will be divided into two parts. The first part will deal with the general drug policy in Switzerland. In
the second part, I will be elaborating on the revision of our federal law on narcotic drugs and psychotropic substances.
The first part of my presentation raises several questions. First is the question: What were the determining and
driving forces that led to the Swiss drug policy of today? What are the objectives and the strategy?
As you know, Switzerland is a small country surrounded by countries and member states of the European Union.
We have approximately 7 million inhabitants, and a political system that is based to a large extent on consensus and
compromise. Seven elected ministers represent the government. They are elected by the parliament. The parliament
grants each of our four major political parties at least one seat in the government. All major political forces are
represented, which makes our government a multi-party system that shares power and influence, not one with a
political party being in power and other parties being in opposition.
Our drug policy was not created by a commission or in cabinet, it has taken shape over several years. It was a
process that proceeded with much struggle and controversy.
An influencing factor in the drug policy was public debate. The Swiss can vote on almost any subject that arises. If
certain people dislike a subject, or if some people believe that a subject should be discussed at a broader level, they can
call for a referendum. They can even call for a referendum on a bill that has been passed by the parliament. All they
need do is collect 50,000 signatures and the referendum will be held.
We have had several public debates. For example, in September, 1997, a referendum was held on the Youth Without
Drugs initiative which called for a strict abstinence-oriented drug policy based primarily on law enforcement and
abstinence. In a majority vote of more than 70 per cent, the Swiss population rejected that policy. Almost one year
later, there was another initiative calling for a reasonable drug policy. The proposed policy was almost the reverse of
the initiative of September, 1997. The population, again, rejected that, with a majority of more than 70 per cent.
In June, 1999, Parliament passed a bill to allow heroin-assisted treatment to become a regular part of our
therapeutic measures. Some more conservative parliamentarians disapproved of this decision and collected the
required number of signatures for a referendum. The issue came to a vote and heroin-assisted treatment was accepted.
The Swiss have very emotional public debates, and our public is well-informed on drug issues.
The other factor of influence was the visibility of the open drug scenes. I am sure you have heard of the famous
Zurich ``Needle Park.'' Not only Zurich, but also other cities such as Bern and Basel had open drug scenes. These open
drug scenes forced the population to realize what was going on. It was not possible for people to close their eyes to this
problem and it caused them to reflect and to develop opinions.
Media communication is another factor of influence. The media had been reporting on drug issues for several years,
as well as the initiatives that had been taken. With the media reporting on these issues, politicians had to take a
position. During elections a question that was always raised was: What is your opinion on drug policy? The public was,
over the long period of time it took to form these policies, also influenced by experts other well-known professionals in
The open drug scenes caused local pressure to deal with the situation. It was not the national government that first
faced the problem of drugs, it was the people in the cities and the areas of the drug scenes who were saying that they
could not accept the situation. A force came from the local and regional governments to the national government.
When cities and cantons said they could not cope with an entire country's problems, the national government took a
leadership role. Drug addicts did not stay in the mountainous areas in our country, they were to be found in the urban
areas. The cities had to face huge drug problems. Not only did they have to deal with their local drug addicts, but they
also had to deal with those from the surrounding areas. Our national government took a leadership role and started to
coordinate the various cantons in the various regions and made information available. Another driving factor was the
realization that AIDS had struck hard in the population using IV drugs.
One of the guiding principles that we elaborated on is consensus, not only on a political level, but also between the
various professionals. Once that consensus was reached, it had to be worked on at all times, and it meant an exchange
of arguments and differences of opinions that created heated debates. There was serious reflection on what has been
done and an analysis of the results of the actions that had been taken.
Cooperation was rather easy to establish between the various professionals from the health and social fields. It was
more difficult to achieve cooperation between the police on one side and the health and social professionals on the
other side. This was done by generating cooperative projects, by listening to the needs of the other side, and by
integrating the various demands of both sides to try to work out their disagreements. An effort was made to integrate
all of their needs.
Pragmatism is one of the guiding principles in our drug policy. Ideology does not work. It is a question of trying new
approaches to see what can be done in the field and of being honest enough to say that, if a certain approach does not
work, we will stop it. Therefore, our projects are evidence-based and they are evaluated. We try to implement only
projects that have been evaluated and are evidence-based. The facts and figures, the results, of these evidence-based
projects are distributed to the political arena.
We have several examples of innovative programs, but the best examples of innovation are heroin-assisted treatment
and the opening of safe injecting rooms.
Next, I will discuss the objectives of our policy, which speak for themselves, to reduce the number of new drug users
and to increase the number of people quitting addiction. If we cannot manage that, then the objective is to reduce the
health damage and the social marketing of the addicts; to protect society from the negative impacts of drug problems;
and to fight criminality. With these objectives in mind, we have a four-fold approach to implementation that is based
on prevention. The four-fold approach presents a struggle for balance, with the changing of drug abuse habits. If that
proves to be unsuccessful, then we have therapy, rehabilitation, re-socialization, harm-reduction measures, repression
control and law enforcement.
In respect of the key element of prevention, we have several projects underway. The main aim is to integrate people
into their settings. We try to involve schools, families, sports clubs, et cetera. We have a large prevention program in
sports clubs that includes coaching trainers in their approach to youth when there is a suspicion of substance abuse.
We also try to increase the life skills of young adults and we promote empowerment and health. We have begun
work in schools to increase the realities of health and what health promotion should be about. We have lessened our
focus on the substance and have directed our efforts on health promotion and prevention.
The second key element is therapy. We have a wide range of therapeutic measures available in Switzerland,
including residential and rehabilitation therapy. There is methadone treatment, heroin-assisted treatment and
outpatient treatment, without substitution. Of the approximately 7 million inhabitants in Switzerland, some 30,000 are
considered to be heavily addicted drug abusers. Of these 30,000, we estimate that slightly more than two-thirds are in
some kind of therapy treatment. Of these, there are approximately 1,500 addicts in residential therapy. Almost two-
thirds of the addicts in therapy receive methadone treatment, 1,100 receive heroin-assisted treatment, and
approximately 2,000 addicts are in receipt of outpatient treatment services.
The third key element is harm reduction and, in that regard we have various ongoing projects. Harm reduction was
first mentioned in 1991 at the federal level in our measures package to deal with drug problems. In 1991, we held the
first national drug conference, where harm reductions were discussed. One example of our harm reduction measures is
the needle exchange program that includes safe injecting rooms. There are also job programs for users who are able to
work on a daily basis. It is difficult, perhaps, to understand this about a country such as Switzerland, but there is the
need for shelter programs which would include the so-called ``slip-ins,'' where drug addicts can stay overnight, and
contact centres that are low-threshold places. Addicts can go in and ask for advice or help whenever needed.
The fourth key element is repression, control, law enforcement. We have strict control of psychotropic substances.
In accordance with United Nations conventions, we have an import and export authorization in order to ensure that
none of these substances will be diverted into illegal channels. There is control of drug trafficking, organized crime and
money laundering. Switzerland has a money-laundering law.
There are referrals to centres for drug addicts. This goes back to the time when drug addicts were going into the
cities and the cities could no longer cope with the situation. They opened referral centres so that mountainous or other
regions would recognize that they, too, had a drug problem although their residents with this addiction were moving
into the cities. A drug addict not coming from the city will be brought into a referral centre and then taken home to the
area where he or she resides.
I have given you a synopsis of our drug policy. I did not say, however, that our government would implement the
drug policy because its implementation is up to the cantons. We do have differences in the regions. For example, the
south of Switzerland or the western, French-speaking part of the country will implement that policy in a different way
from the way it will be implemented in the German-speaking part. There is a wide range of harm reduction measures in
the German-speaking part. For example, they have drug injecting rooms whereas there is, currently, only one drug
injecting room in the entire western part of the country. That room is in Geneva. The southern part of our country has
none. This demonstrates the different implementation practices of the cantons.
As a result of our drug policy, the number of heavily addicted people has remained more or less the same. However,
we have a high number of people in treatment. We have managed to increase the number of people in treatment during
the past 10 years.
We have realized that it is a continuous struggle to ensure cooperation and a balanced approach. In fact, it is never
achieved; it is something that we must work on constantly.
As well, a balance between the interests of the general population and the needs of drug addicts must be found. It is
a delicate balance.
We have also realized that it is not a matter of having only one measure in place, that is drug policy, but it is a
matter of combining that with activities and general projects in order to make a difference. It is the combined results of
all of these measures that help.
I should now like to touch to our revision of our federal law on narcotic drugs and psychotropic substances from
The cannabis situation as it presents itself today in our country is quite unsatisfactory. Under our law today,
narcotic drugs may not be cultivated, imported, produced or brought on to the market. Amongst other drugs, it
specifies cannabis, which means that only when cannabis is produced as a narcotic drug does it come within this
section. A producer will say that the cannabis is not being produced as a narcotic drug but as industrial cannabis for
whatever reason. Then it will not be prohibited under this section. For example, pillows with a high THC content were
sold as pillows and, therefore were not covered by this section. However, it was obvious that the people who bought
these pillows would cut them open and use the contents as a narcotic drug. We had ruling by the Federal Court, which
is the highest court in Switzerland, which held that it is not the product and the use of the product but the THC content
that shall determine whether or not it is a narcotic drug. Nonetheless, legally, we are not in a very satisfactory situation.
Since the last revision in 1975, there has been an increasing number of drug addicts, but there are shortcomings in
prevention and therapy. We have introduced harm reduction measures. At this point in time, they are not part of our
law, but they have become a key element. The heroin-assisted treatment mandate will expire in 2004. By bringing it into
the law, it will be accepted as a therapeutic measure.
Some experts question whether criminalizing consumption will reduce the spread of drug consumption.
I would also mention that there are different prosecution practices in the cantons.
All of these things that I have mentioned will extend the overall scope of our law. However, the focus will no longer
be on controlling trade in narcotic drugs and combating drug-related crime, it will be on public health. Protection of
the health of the individual and protection of the population from health-related consequences of addiction-based
problems will be the centre of concern.
The law also adapts to the reality of the slightly more than 7 million people in Switzerland. We estimate that 500,000
people consume cannabis, either on a recreational or regular basis.
My other points deal with the decriminalization of cannabis consumption, which I will address later, and feasible
regulations for cultivation, production and trade in cannabis products. It is also important in this context to improve
and enhance the protection of the young.
A further objective in Switzerland is the concentration of law enforcement on organized crime, money laundering
and public order, as well as nation-wide uniform implementation.
The best known of our revisions is the partly new orientation proposed for addressing the various issues concerning
cannabis. There are several reasons for the idea of giving cannabis and its products a special status compared to other
narcotic drugs. We consider that scientific proof that cannabis is a gateway drug is still missing. We also have new
research results confirming that the adverse affects of cannabis consumption, compared to alcohol and tobacco, are
less damaging to health. As well, hemp has been re-discovered as an agricultural product. Textiles, pillows, as I
mentioned before, and beauty products are being produced from this substance. The cultivation of industrial hemp is
not subject to any control. This gives rise to the problem of distinguishing between industrial production and illicit
production. Illicit production would be hard to detect and hard to control.
There is also the question of the therapeutic use of cannabis. Only small trials are underway in Switzerland
regarding the medicinal use of cannabis. I know there are medicinal cannabis licences available in Canada. There are
trials in Great Britain regarding cannabis therapeutic use and we are looking forward to their results.
As for the decriminalization of the consumption of cannabis that is suggested in the draft of the federal council, it is
planned to exempt the purchase, possession and consumption of cannabis for personal use from prosecution and
punishment. Prosecution of these acts currently places a burden on prosecution authorities that is out of proportion to
the damage that is done to public health caused by these acts.
You may want to ask why cannabis and its products should be treated differently from other products such as other
narcotic drugs. Cannabis is the most widely used illegal substance in Switzerland, as I stated before. Cannabis has a
lower addiction rate and risk potential than heroin, cocaine and amphetamines, as well as alcohol and tobacco. This,
however, should not mean that the consumption of cannabis is in any way played down. It will remain one of the
objectives of our prevention work to ensure that the message will be that, although consumption will be de-
criminalized, any consumption of psychoactive substances is undesired and never without risk. We have expertise
elaborated on behalf of our office that shows there is no connection between restrictive law and prevalence of cannabis
With the decriminalization of cannabis consumption, special attention is given to protection of the young. A
working group that has been set up came to the conclusion that the most important objective was the protection of the
young against use and abuse of substances, as well as against addictive behaviour in general.
The political message, as I said before, will need to be that consumption of cannabis, although not punishable
anymore, is unwanted and undesired. The recommendations of the working group were taken into consideration when
elaborating the draft of the federal council. There are special provisions in the law for the youth. For example, the
concerns of the youth shall be taken into special consideration when applying the law. There is a special article for an
early assessment system to detect youth at risk, and their counselling will be enhanced. A harsher punishment is
foreseen for people making drugs available to youth under the age of 18. In order to enhance these preventive
measures, to evaluate their effectiveness and for flanking research, the federal council has suggested an investment of
approximately 1.2 million Swiss francs over the next five years.
Regarding cultivation trade in and production of cannabis, this is by far the most complex issue of our revision. Due
to the loopholes I have mentioned at the beginning, a feasible regulation for the cultivation and production trade must
be found. We would like to introduce clear guidelines in order to define with respect to cultivation of cannabis and
trading in cannabis products. These guidelines have to take into account the present situation with regards to cannabis.
They must be uniform for the whole country and they must guarantee a univocal application of our law.
Although cannabis consumption will be decriminalized, cannabis remains a forbidden drug. Its cultivation, trade
and, in particular, related cross-border activities will continue to be grounds for prosecution and punishment.
However, the obligation to prosecute should be restricted with respect to cultivation and direct small-scale training in
the domestic market.
The law, as proposed now, will enable the federal council to define clear priorities for the prosecution of drug-
related offences according to a framework stipulated in this law. In other words, the federal council has the competence
to define in an ordinance under which conditions prosecution can be waived. Generally, the mentioned activities
remain criminal offences, but similar to the regulations in the Netherlands exemptions from the prosecution are
You may wonder what is the content of the foreseen regulation. The conditions for the sale would be an accurate
accounting of the supplier and retailer, no sale to persons below the age of 18, no advertising, strict control that only
sale to Swiss residents will be made, and no disturbance of public order.
Conditions for the cultivation and the manufacture stipulated in the ordinance as being elaborate at present could
be the definition of THC content and limit for the various products, making credible that the producer only sells to the
Swiss market and an obligatory registration for cultivation.
The possible schedule for the revision is that at present we are elaborating the text and the explanatory report for the
cannabis ordinance; this will take until April. In May and June, we will be having discussions with experts and
cantonal administration. In the winter session, which is in November, we expect consultation between the federal
offices and the federal departments, and in December we hope to be able to open the consultation procedure by the
With regard to the schedule for the time frame of the revision of our law, we hope that in June or in August the
Commission for Social Security and Health, CSSH, of the national council will be debating on this issue. We hope that
in the fall session the national council will make the decision and that during the winter session we can reach a
consensus between the two councils, being the council of states and the national council. If that were feasible, then we
would have some time mid-December the period for a referendum, which is when the collection of 50,000 signatures
would start. They have 100 days in which to collect these signatures, which would make it around the beginning of
April. That is approximately the time schedule that we have.
The Chairman: Do you speak French?
Ms Steber Büchli: Yes, a little.
The Chairman: I would like you to give us some statistics on drug use in general and by type of drug. Do you have
Ms Steber Büchli: I do not have statistics here concerning the various issues. In 1998, research was done into
whether young people had consumed any drugs — and I have that here. We have an increase of the use of ecstasy and
cannabis products. In general, we think that the consumption of heroin has remained more or less stable, and we do
have an increase of cocaine.
The Chairman: Have you noticed a decline in the use of heroin since the creation of new programs such as injection
Ms Steber Büchli: No. We have had a relatively stable population of intravenous drug users, regardless of drug-
injecting rooms. The drug-injecting rooms were opened in the late 1980s. We have seen a strong decline of HIV/AIDS
The Chairman: That is a positive result, but the injection rooms did not stabilize use?
Ms Steber Büchli: Drug-injecting rooms are generally harm-reduction measures. We do not purport to have any
influence on people who want to start consuming drugs. The purpose is to maintain the health of those who are already
in this circle and to reduce their social marginalization.
The Chairman: The mandate of this committee is primarily to study cannabis use, but we also look at other drugs.
Will you explain to us how this treatment program works?
Ms Steber Büchli: Mr. Uchtenhagen will speak to you about heroin-assisted treatment this afternoon. To return to
your earlier question, the safe injecting rooms have their own rules. One of the rules is that no so-called ``first timers''
are allowed in the safe injecting rooms. Therefore, safe injecting rooms have no link with people starting consumption.
With regard to therapy, there is a wide range of ways through which a drug addict will get into drug therapy. It
could be via a safe injecting room, because there are people at the safe injecting rooms offering counselling. The other
possibility would be the contact centres that I have mentioned as a harm-reduction measure. Addicts can simply drop
in there and be referred to a centre after discussion about the best alternative.
The Chairman: There are many similarities between Switzerland and Canada with respect to the structure of the
State, which is a federal structure, and with respect to the provinces in Canada and the cantons in Switzerland. In your
national strategy, how integrated are the governments at the federal, canton and municipal levels? Are you aiming for a
better integration of these levels of government?
Ms Steber Büchli: There are several commissions at city level and cantonal level on which our office is represented.
Through these commissions, the cantons get together to exchange information and discuss problems they may have.
The implementation of the law is a cantonal matter. By providing facts and figures and coordinative measures, we hope
to get the most widespread implementation of our law.
The Chairman: One of the guiding principles you mentioned earlier on was evidence and relatively constant
information. Who is responsible for gathering, updating and redistributing that information?
Ms Steber Büchli: Our office has overall responsibility, but we mandate other institutions to scientifically follow-up
on our projects. The information is distributed by our office into the various channels, be it the commissions I have
mentioned or on a request basis. There are various channels for distribution.
The Chairman: Is the Federal Office of Public Health independent from the federal government? Is it like the
``observatoire'' in French?
Ms Steber Büchli: No.
The Chairman: It is integrated into the government?
Ms Steber Büchli: That is right.
The Chairman: You are in charge of doing what is done by other ``observatoires'' in Europe?
Ms Steber Büchli: That is right. That is why we do not have such good data. We have just opened an ``observatoire''
like the focal points that the European Union member states have. They collect the data. We collect data as well, but
we do not have indicators as the European Union has.
The Chairman: What is the level of independence you have with the government in performing those objectives?
Ms Steber Büchli: We are a governmental office.
The Chairman: That means that you are subject to decisions made by people above you in the hierarchy of
government. They could decide tomorrow to cut your budget?
Ms Steber Büchli: They could, yes.
The Chairman: Therefore, there is no ``observatoire'' in Switzerland? You fulfil that role?
Ms Steber Büchli: Yes.
The Chairman: You look after inquiries and funding for them. My first question was about the use of drugs in
Switzerland, and you look after that. How does that operate?
Ms Steber Büchli: Our unit, which is called Substance and AIDS, has a budget that is approved by the government.
Within this budget, we have programs evaluated.
The Chairman: Is it your responsibility to disseminate the information to the general population, or is that done
through another service of your department?
Ms Steber Büchli: Yes, we disseminate information. That is one of our main aims. We make available information,
facts and figures, not only to the cantons but also to politicians in order to guarantee that the debate is based on the
The Chairman: Why has your country not ratified the 1988 convention?
Ms Steber Büchli: It was a time problem. Parliament had actually started its parliamentary debate on the accession
to the 1988 convention when the first initiative was handed in. With that initiative, the government decided that it
should postpone the deliberations on the accession to see the result of the national vote. There was another national
vote a year later. The question again arose and parliament decided to postpone its deliberations yet again. While
waiting for the national vote on the second initiative, the federal council gave our office the mandate to start revising
the federal law.
With this revision, again they saw that cannabis and the decriminalization of cannabis could be an issue, so
parliament yet again postponed its deliberations. The question was this: Do we have to make some reservations; if so,
which ones? That is why it is still pending.
The Chairman: That probably relates to the pragmatism as one of your...
... guiding principle...
You will ensure that the ratification of the convention will relate properly to your new act?
Ms Steber Büchli: Exactly, yes.
The Chairman: Referring to the act, section 19(b) puzzled me. I have the French text here, which says:
A person who limits drug use to himself or allows a third party to use the drugs at the same time as him after
having provided the drug free of charge is not punishable if the amounts are minimal.
That is the law of your land already. Is that correct?
Ms Steber Büchli: Yes.
The Chairman: If I understand it correctly, it means that if I grow and prepare marijuana and you are a guest and we
smoke it together, there is no problem; that is to say, no one will charge you or me. Is that the way I should read
Ms Steber Büchli: Not really, because section 19(b) refers to section 19(1), which states that it is punishable for those
who cultivate or produce narcotic drugs in any way.
The Chairman: I, too, read section 19. After that, I read 19(b). Let us read it in English: ``Any one who merely
prepares narcotics for personal use or for shared use with others at no charge is not punishable where the quantities
involved are minimal.''
It is quite clear.
Ms Steber Büchli: With the exception of cannabis, yes; the other narcotic drugs, no.
The Chairman: Section 19(b) relates only to cannabis?
Ms Steber Büchli: No, it does not relate only to cannabis, but the exemption from being punishable relates only to
The Chairman: That means that personal use and recreational use are permitted?
Ms Steber Büchli: It is not allowed of narcotic drugs.
The Chairman: Marijuana is a narcotic drug?
Ms Steber Büchli: Yes.
The Chairman: If I read section 19(b) correctly, it means that it is not punishable if I merely prepare a narcotic for
personal use and share it with friends. There is no charge.
Ms Steber Büchli: There is no charge for cannabis, yes.
The Chairman: It means that it is not punishable?
Ms Steber Büchli: Yes, for cannabis.
The Chairman: Tell me about prevention in schools. How is it done? Who is in charge? Is it the police? How much
money is involved in that strategy?
Our research is telling us that, between 1991 and 1995, the average annual cost for prevention is between 30 and 35
Swiss francs per year, which is relatively the same in Canadian dollars. How much money is involved in prevention in
schools and how does the program operate?
Ms Steber Büchli: Prevention in schools has changed quite a bit. It used to involve police officers going with
different powders into schools and telling the children what they are and why they are dangerous. Today, we are
moving away from the substance only, toward health-promotion activities.
Schools are within the competence of the cantons. We work closely together with the cantons in order to get so-
called health-promoting schools. These schools, as they police themselves, have health-promoting activities going on.
We help them by giving them information and ideas, but it is not up to the federal government.
We do have a project on early intervention that is being evaluated. The idea is to get young people who show risk
behaviour into a project. Such risk behaviour includes non-compliance with school rules, the danger of dropping out of
school, parents who are not getting alone or are unable to control the child, shoplifting and alcohol. These kinds of
risky behaviours will get the young adults into the program. The program lasts an average of six months, but it can be
between four and nine months.
The basis of the research design is to see whether self-esteem can be improved, whether a young person's ability to
deal problems, to discuss and to talk things out increases with help, compared to youngsters who have not been taken
up in these programs. That is the research that we started. The first one began in 1999. Since 2000, we have 14 centres
altogether. The program goes until 2003 or 2004.
The Chairman: In the statistics for 1998 that you referred to earlier, you have use of drugs in the category of 12 and
Ms Steber Büchli: We have 14 and 15, boys and girls.
The Chairman: Can we have access to that information?
Ms Steber Büchli: Yes, you may have that information.
The Chairman: Do you have in that information statistics on alcohol and tobacco also?
Ms Steber Büchli: Yes. We have a question as to whether they consume alcohol, tobacco and other drugs such as
ecstasy and cannabis products.
The Chairman: Do you witness in Switzerland a multi-consumption of drugs — that is to say, taking not just one
drug but involved in poli-intoxication?
Ms Steber Büchli: Yes.
The Chairman: You are witnessing the same thing?
Ms Steber Büchli: The consumption pattern has changed. It is going more towards a poli-toxical situation.
The Chairman: Do you have studies made by your organization analyzing those findings?
Ms Steber Büchli: Not that I know about, but I can check that.
Senator Chalifoux: Thank you for an interesting presentation on what Switzerland is doing.
I have several questions regarding organized crime. In Canada, organized crime is becoming more prevalent and
young people are being recruited into the drug scene. Do you know what is happening in Switzerland? Are you doing
any studies on that issue? Organized crime is becoming an important issue across the world. What is Switzerland
Ms Steber Büchli: One of the ideas for this complex prosecution question that is being changed in the law is to have
the limited resources of the police focus on what we consider to be the more important activities, which include
organized crime related to, amongst others, drug use.
The federal office of police is working closely with the cantons. They have established several new means of
coordinating with the cantons, and they are working on it. We have a population of traffickers and we are trying to get
a grip on that.
Senator Chalifoux: Do you find that the organized crime in Switzerland is related to the other organized crime
syndicates around the world, for example, Hells Angels or the Medellin cartel in Colombia?
Ms Steber Büchli: I cannot answer that from the police side, but perhaps Mr. Dulex, who is from the canton police,
can answer that this afternoon.
Senator Chalifoux: In Canada, we are finding a large increase in chemical addictions, especially among young
people, to ecstasy, crack cocaine and that type of chemical substance. Are you finding an increase in the use of those
chemicals in Switzerland? What do your statistics indicate, and how you are addressing that issue?
Ms Steber Büchli: We are finding an increase in the consumption of those substances. We are working especially on
the problem related to cocaine. We do not yet have a solution to help cocaine consumers.
With respect to ecstasy, one of the prevention programs in place is to tell young people, especially at the dancing
raves, that obviously we do not want them to take these pills in the first place but that if they do not to mix drugs, just
music; we hand out ``do not mix drugs, just mix music'' flyers at these rave parties. We have special brochures for the
organizers of these parties with respect to what they should take care of and how they can do things. That strategy
departs from the ``you may not'' and ``you should not'' and moves to ``if you must in the first place, then at least do not
do this or that.'' That is one strategy we are following.
The Chairman: Are you aware that in Amsterdam, specifically with respect to the raves and ecstasy, they have
decided to provide an ambulatory laboratory near raves just to test the pills? Are you informed of that?
Ms Steber Büchli: Yes.
The Chairman: Is it the intent of your government to get into that kind of service?
Ms Steber Büchli: We did that a few of years ago. There is a portable machine that allows for testing quickly the
content of these pills at parties. We have that as well.
The Chairman: What was the result of that experience? Was it positive?
Ms Steber Büchli: It was more to make young people aware of the dangers. If the youth were told that rat poisoning
was in these pills, perhaps they would reflect once more about whether they actually wanted to take these pills. The
machine also allowed us to determine the composition of these pills, to determine whether the composition was
dangerous or was vitamins and things that are not that potent, which it was at times.
Senator Chalifoux: In your presentation, you mentioned hemp and cannabis in one sentence. Along with some of my
colleagues, I have done research on industrial hemp, which is a distant cousin to hemp. In Canada, we have legalized
the growing of hemp for industrial use. It has a minimal content of cannabis, yet you seem to equate it with cannabis.
What is happening in Switzerland? To me, hemp is a wonderful plant because many things can be made from it. It is
resistant to drought, flood and everything else. Why are you equating them? Has Switzerland done anything to
separate the two?
Ms Steber Büchli: I am sorry if I gave a wrong impression. What I meant was that in a large field of industrial hemp
it would be difficult to detect the illegal plants with a high THC content in that field. With the rediscovery of industrial
hemp, which is not being controlled, and cannabis with a high THC content that would have to be controlled, there is a
danger of part of a field producing this other plant.
Senator Chalifoux: In Canada, we have developed licensing procedures on how to grow and control hemp. They are
strict. It might be of interest to you to see how Canada is working with that.
Ms Steber Büchli: That is one of the problems we are facing now, namely, that industrial hemp is not subject to any
control or licensing whereas cannabis with a high THC content must be. It is one of the problems that is currently
being elaborated on in the ordinance, namely, how to control the cultivation of cannabis without anything going on to
an illegal market.
Senator Chalifoux: I suggest you look at Canada.
Ms Steber Büchli: We will.
Senator Chalifoux: You might find good information.
I and many other people have always assumed that smoking marijuana could be the beginning of a stronger
addiction for a person. In your statistics, have you found anything relating to that question?
Ms Steber Büchli: That is what I meant by saying that we consider cannabis to be a gateway drug. The scientific
proof, however, is still missing. We have seen that alcohol and tobacco consumption is almost always present in an
addict to these stronger substances. However, we do not have the scientific proof that cannabis consumption comes
first and then a career in hard drug consumption.
The Chairman: Is a permit needed to grow high THC cannabis? Are you controlling that?
Ms Steber Büchli: Not at present, but with the revision, we will have to find a controlling system so that we know
how much is being produced. We are allowing production only for the Swiss market. By controlling the amount that
will be produced, we can control it so it does not go to our neighbouring countries or does not get exported.
The Chairman: What was the reaction of the neighbouring countries when you tabled the amendments to the 1951
Ms Steber Büchli: Partly because of misinformation or lack of information, they approached us and asked what
exactly we were doing. At present, our office is organizing seminars and conferences with each of our neighbouring
countries to ensure they understand what we intend to do with the revision. Most of our neighbouring countries,
especially Germany and France, are not happy with the situation because today it is being sold in so-called hemp stores
to non-Swiss residents. This will be one of the points that must be adhered to when selling cannabis in the future.
The Chairman: An obstacle to any country's change or revision of illicit drugs legislation is looking at the available
options and seeing if those options are respectful of the international conventions.
To what extent has your country studied those conventions, even though you have not ratified the 1988 convention?
If so, can we have access to those studies?
Ms Steber Büchli: We have taken into consideration the United Nations conventions, especially the Single
Convention on Narcotic Drugs, 1961.
According to Swiss and foreign expertise, our proposal conforms with the Single Convention on Narcotic Drugs,
1961. We have a constant exchange of information with the International Narcotics Control Board in Vienna, and we
believe that what we are doing is in conformity. Of the expertise that we have, three out of four are in German and they
are not translated into either English or French.
The Chairman: That does not matter, because we can deal with that.
When you are talking about respecting this convention, is that the reason you are using the word
``decriminalization'' instead of legalization?
Ms Steber Büchli: It would not be a legalization. It would never be a product that can be bought anywhere.
The Chairman: I used the word ``controlled'' legalization, like alcohol or wine.
Ms Steber Büchli: I do not think the terminology has been chosen because of the conventions.
The Chairman: You used the word ``decriminalization.'' Is it real decriminalization or de-penalization? Will it still be
illegal, just not prosecuted?
Ms Steber Büchli: Yes — only if certain rules have been adhered to.
The Chairman: What will you regulate? Will the means of control become legal? If not, will it remain illegal?
Ms Steber Büchli: Yes.
The Chairman: That is almost the same as the regulations on alcohol. Although it is illegal for me to prepare any
kind of alcohol in my basement, I can buy alcohol and consume it. Will there be a resemblance between the regulations
that you will put in place to control cultivation and use of cannabis and what you have as regulations on alcohol or any
Ms Steber Büchli: It will be much stricter. At present, there are far more people producing alcohol than there will be
with cannabis. There is the question of whether or not there will be an article in the ordinance regarding the necessity of
stores. As it stands, the cantons will have the power of saying, ``We do not need that many stores.'' They will then have
the right to have stores closed. That is different than with alcohol. At present, in the area of Basel, close to Germany
and France —
The Chairman: Are you referring to hemp stores?
Ms Steber Büchli: Yes. Right now, Basel has more stores than are necessary for providing only to Swiss consumers.
If Basel canton felt that this was too much, they could close down stores, according to what they consider necessary. It
would involve a necessity clause.
The Chairman: The same canton or municipal body cannot, at present, control or criminalize the sale of marijuana
in your country?
Ms Steber Büchli: Now they can, yes. If the THC content of the product being sold is very high, then, yes, they can.
One of our aims is to have no exportation of the drug, which occurs at present. The number of stores we have now is
directly linked to the people coming into the country from Germany or France.
The Chairman: You are using the word ``de-penalization.'' For us around the table, there is an important distinction
between whether it is the police or the tribunal that decides.
The researchers at the table have many questions, so I am hopeful that we will correspond to obtain some answers.
The Chairman: We will now hear from Ms Françoise Dubois-Arber, from the Prevention Programs Evaluation Unit
at the University Institute for Social and Preventive Medecine in Lausanne.
Ms Dubois, thank you for accepting our invitation and for the interest you have shown in our committee's work.
Your presentation will be followed by a question period, and if our researchers feel it is necessary, I will write you for
additional information and eagerly await your response.
Dr. Françoise Dubois-Arber, Member, Swiss Federal Commission for Drug Issues; University Institute for Social and
Preventive Medicine: Mr. Chairman, thank you for inviting me to appear before your committee.
I am a public health physician with training in clinical and internal medicine. For more than 10 years, I have been in
charge of the prevention programs evaluation unit at the University Institute for Social and Preventive Medicine in
Lausanne. Our unit has been mandated by the Swiss Federal Office of Public Health, which is the equivalent of your
Department of Health, to evaluate its drug policy. In the past, we received a similar mandate for AIDS evaluation. So
we have some experience in this field.
My presentation will be structured in the following way. I will start by talking about our evaluation mandate. I will
also talk about organization and the methods we use. I will also discuss our evaluation indicators, procedures and how
useful an evaluation can be as part of a drug policy.
I am a member of the Federal Commission for Drug Issues. Two years ago, the commission produced a report on
cannabis. So I will share our thoughts on that topic.
I will provide a brief overview of the Federal Office of Public Health policy in this area. The Federal Office of Public
Health is responsible for evaluating the aspects of the policy relating to health, in other words, prevention, treatment
and rehabilitation, as well as risk and harm reduction. The fourth pillar dealing with enforcement is not part of our
evaluation mandate. That is dealt with by another department in the case of the Confederation.
To complete Ms Steber's remarks, I would like to provide you with the schematic overview on how the Swiss drug
policy model differs from what is commonly found.
Imagine drug use as a continuum. Someone who does not use becomes a regular user, then a dependent drug user.
At some point, after undergoing treatment or even without treatment, spontaneously, he will come out of a period of
One of the characteristics of the Swiss model, like all other models that are heavy on harm reduction, is that there is
also a continuum in the drug use policy. In other words, there is a whole section dealing with prevention. When a
person starts to use drugs, he may still be in contact with primary and secondary prevention programs. But above all,
he will very quickly come into contact with risk and harm reduction programs. He may also very quickly enter
treatment or a rehabilitation process. So in the same way that there is continuity in the life of a drug user, there is also
continuity in the programs and contiguity, or continuity in the programs that are proposed.
Often, in models that do not include a strong risk and harm reduction component, there is a gap, a vacuum, during
which the user in what is called the honeymoon phase is not in contact with anything. There is no opportunity for
treatment or health services. That is perhaps what distinguishes our model from a more traditional model without risk
I now want to move on to our evaluation mandate. Our mandate is to assess the programs that have been designed
and implemented by the Federal Office of Public Health since 1991. We must try to determine the final results, and
above all, the evolution of the prevalence and seriousness of drug use. I say try to determine, because it is not always
possible to be one hundred per cent precise.
We also examine and follow specific aspects of the social and political environment in which this drug policy is
developing. Our mandate also involves being in constant or regular contact with the Federal Office of Public Health,
and preparing regular reports on the progress, results, conclusions and recommendations of our work.
To date, our evaluation has taken place in several stages. The first stage lasted four years, and the second also lasted
four years. We are now in about our 13th year.
What are the characteristics of this assessment? It is a comprehensive evaluation, in other words, we can also
examine aspects relating to the design of the drug policy, its implementation and results, and we do that by also
monitoring the context in which it is being used. That is what we consider a comprehensive evaluation. This evaluation
has been ongoing since 1961, but has taken place in successive phases marked by evaluation reports, and I have
brought some copies of those reports with me. They can also be found on the Internet. I will leave them for the
This evaluation is also complementary. The evaluation is not done in isolation from the policy; it is complementary
to it, and independent at the same time. The separation between the evaluation and those who implement the policy
must be managed.
This type of evaluation revolves around use. We feel that it is very important for the evaluation to take into account
the people covered by the policy, in other words, that this evaluation attempt to meet the needs of the politicians
themselves, but also those of the people in public health, even including users and the population in general. The team
that conducts this evaluation is multidisciplinary, and includes public health and social services professionals.
The evaluation is s compilation of different studies conducted on different topics that we choose with the Federal
Office of Public Health for each assessment. We then produce a synthesis report on what has occurred in terms of
research during that period.
I will say from the outset that there are a lot of researchers in Switzerland who are studying drug addiction. So the
evaluation is not the beginning and the end of all data collected in Switzerland. A good portion of our work involves
identifying existing research, extracting the best elements, synthesizing the data, and filling in the knowledge gaps, in
other words conducting our own studies in areas where there are gaps that have not even been explored by researchers
who are more academic and less evaluation-oriented in nature. We have our own studies and we also use existing data.
To date, we have had four evaluation periods. The first period was from 1990 to 1992, which was essentially an
overview of the situation to determine where we were at with the data available to us. Then we had the periods from
1993 to 1996, from 1997 to 1999, and a current period from 2000 to 2003. There were two periods in the program
implemented by the Federal Office of Public Health and, in fact, the first period went from 1991 to 1996. And then we
had the period corresponding to the second phase of the anti-drug measures program.
During the first period, the evaluation was based on context, on studies in the press on people's attitude to drugs,
and we used existing epidemiological data. Very few specific studies on the strategy of the Office itself were used.
In the second period, also at the request of the Federal Office of Public Health, we focused to a larger extent on the
activities within the Department of Health in this area. We also conducted evaluation studies on the design and
planning of their second program implementation period as well as on the innovation and anchoring of programs. As
the Office's measures program developed, we looked at other aspects of the program.
For example, in the second part of the evaluation, we looked at the actual design of each of the areas of measures.
For example, in conjunction with the Federal Office of Public Health, we conducted an evaluation of their action plan,
and on the way they view their action. That led to action theories. We specifically looked at how they perceived their
action and from the perspective of these action theories, and we identified a number of indicators to evaluate policy
That gives you a bit of an idea of what our evaluation does. In a nutshell, it involves some of our own studies and
the use of lots of existing data. Even though we do not have a monitoring centre, there is a great deal of data in
Switzerland, data that has not always necessarily been gathered in a concerted way. The indicators are not necessarily
always the same, which causes us problems in doing the evaluation, because we are not always able to extract the best
parts of the data. One of the projects of the Federal Office of Public Health is to devise a standardized approach for
collecting data in our country.
I am now going to talk about the indicators we use to monitor this policy and I am going to answer two main
questions: how can we monitor the evaluation of the number of users in our country? And how can we determine the
seriousness of the situation?
In summary, we have recourse to what we call direct indicators. There are two types of indicators. Direct indicators
come from surveys conducted directly in the general population or in certain groups of users. These indicators,
especially the ones gathered in the general population, give us figures that are representative of the population. But
there are problems with this type of survey. When we survey the general population to identify consumption habits, we
use techniques like phone surveys and face-to-face surveys. There is a good chance that part of the people we would
like to reach cannot be reached, because they are too marginalized to have a telephone.
There are limits attached to these direct indicators that we must be aware of and that are complemented using a
series of indirect indicators; in other words, indicators that do not directly measure drug use, but that give us an idea as
to what drug use may be by the way they change.
There are direct indicators that reflect the number of drug users through surveys of the general population and
where we ask people about their use of various substances. The surveys show that there are also indicators that reflect a
person's social status, their integration in professional life; if they have housing or if they are in contact with the
enforcement system. These are direct indicators of the seriousness of certain problems.
Direct indicators of how serious the problems linked to drug addiction are the state of a person's health, HIV
infection or hepatitis. We also have direct indicators of the seriousness of drug use, and more specifically of the
intensity and ways in which the drugs are used.
These are the indications we have. I will give you a few examples later on.
This data is not sufficient. As I already mentioned, these direct indicators are far from perfect, because they are
gathered from segments of the population that are for the most part healthy, and which for the most part do not use
drugs like heroin and cocaine.
We talk about estimates, because we cannot always count the number of people who use the substances. Shortly, I
will give you an idea of the estimates prepared to give you a more specific idea of how the situation is evolving.
We are looking more specifically at the evolution of a certain number of indirect indicators, indicators that do not
immediately provide information on how many people are using, but that show changes in a certain number of
problems linked to drug use.
For example, the evolution of drug-related deaths gives us both an idea as to the number of users — there is a
relationship between the number of deaths and the number of users — but above all, it indicates the seriousness of the
problems linked to drug addiction.
Using data on enforcement, data from the police and the justice system, is an indirect indicator of the number of
users. I reiterate that the indicator is very indirect. We will see the limits to that.
There are other indirect indicators on the number of users, for example, data on the age of users when they enter
treatment. There are various types of treatment in Switzerland through which we can identify, among other things, the
number of patients going into low-threshold centres for residential treatment and methadone treatment, where a
certain amount of data is collected. This data enables us to identify the age of people the first time they are going into
these institutions. In recent years, we have seen that the average age for entering these institutions has increased. Our
hypothesis is that many users are getting older, and the percentage of young drug users changes these data slightly.
These data is an indirect indicator of how the situation is evolving.
We also consider illegal drug use as an indirect indicator of how serious the problem is. We feel that there is a
relationship that we do not yet fully understand, but changes in the relationship with other legal substances can give us
information on whether or not someone is prepared to use illegal drugs. These are indicators that we review and
synthesize to get a snapshot of the situation.
I will give you an example of a direct indicator that we use. On this diagram, the blue line on the top represents
cannabis consumption over a lifetime for young people aged 17 to 30. We have data for the period starting in 1987 and
ending in the year 2000. For the segment of the population aged 17 to 30, we can see that as of 1997, more people used
cannabis than they did in the ten previous years. The indicator is 30 per cent higher now, but that is not a huge
However, WHO studies in various countries show that students aged 15 represented less than 10 per cent of the
population, in 1986, that had used cannabis in their lives, whereas in 1998, they represented more than 20 per cent of
We can clearly see that there is an increase in cannabis consumption among the young generations. This finding is
derived from our direct indicators, because the data comes directly from the people involved.
Here are some indicators concerning the life situation and the health of users in low-threshold centres, that is centres
with a very low threshold for access focusing on harm reduction and which, among other things, provide needles to
users and give them access to other services including, in some cases, injection rooms.
Here you see a whole series of indicators relating to life situation. Here you see information about where they have
lived in the previous months. Between 1993 and 2000 there was a slight drop in the percentage of those with a fixed
abode, an indirect indicator of the seriousness of the problem.
We also see that there was an increase in the percentage of those who do not have a job, another indirect indicator of
the serious consequences for users. The economic situation of our country demonstrates that it is more difficult to
absorb young users in the labour market than it was ten years ago.
On the other hand, there has been a decline in the number of repressive measures between 1993 and 2000 with
respect to police interventions involving the public.
At the bottom of the sheet you see a series of indicators relating to the health condition of intravenous drug users
questioned in low-threshold centres. Between 1993 and 2000, the proportion of those who did not shoot up dropped
slightly. In recent years we have noticed a trend for some of these users to stop injecting certain products in order to
inhale them. We are referring, for example, in the case of heroine, to the practice known as ``chasing the dragon.''
Among intravenous drug users, the weekly injection rates slightly decreased between 1994 and 2000. These are fairly
rough measurements that do not apply necessarily to all users but indicate a more general trend.
Assessments may vary because we are dealing with the total population, but a street worker or someone who is
working in a centre may observe different kinds of trends depending on the persons. We can see that injection is
becoming less common, but we also note that among some users who are starting to take cocaine, there is an increase in
the number of injections. Generally speaking, there has been some decrease in this trend.
Needle sharing among several users and the exposure to risk of HIV has also greatly increased over the past several
years. In 1993, approximately 17 per cent of the people said that they had shared their needle over the past six months.
This percentage was lower than the comparable figure for European or American countries.
We noted a decrease in needle sharing in 1994 and over the past years, needle sharing has remained at a fairly low
level. These are direct indicators of the seriousness of certain problems related to drug use.
Here are some examples in the evolution of indirect indicators. A few years ago surveys were conducted in an
attempt to estimate the number of drug addicts in our country. It was difficult to obtain a precise figure since it is an
illegal activity which people do not want to admit to or describe with any precision.
Based on the results of these different surveys, a researcher using ranges of probability made estimates of the
number of users. Using four different types of data collection, our estimate of the number of regular hard-drug users
ranges from a low of 20,000 to a high of 36,000.
In the middle of the 90s, the generally recognized estimate is that there are approximately 30,000 seriously addicted
drug users in our country. Since we do not have a precise figure, we tend to come to the conclusion that the trend is
either increasing or decreasing on the basis of indirect indicators.
For example, here you have information on the evolution of a number of drug charges and prosecutions between
1974 and 1988 for various types of substances. In white, the curve shows the increase in a number of charges for use of
cocaine. We can see that the number has significantly increased over the past several years.
The red line shows the evolution in the number of heroine offences. It reached a peak in the middle of the 1990s and
based on this kind of data, we conclude that heroine consumption, far more prevalent in our country than that of
cocaine, is declining. We also note that cannabis offences increased a great deal over the past ten years.
This gives us an idea of how certain types of drug use are evolving and generally speaking, based on the number of
charges, it could be assumed that there was a drop in the consumption of heroin over the past several years but heroin
does remain the most widely used hard drug in Switzerland. It could also be concluded that there has been an increase
in the consumption of cocaine and cannabis.
We saw the figure relating to offences. We get a clear idea of the situation when we look at the trend relating to first
offences, that is if we remove from the statistics persons charged for a second, third or fourth offence.
In the small blue columns, you can see that for all types of use, there has been little movement in first offences over
the past several years whereas repeat offences have increased. This indirect indicator is also used to maintain that there
has been a certain stabilization, and even a decrease in the number of users since some of these charges involve repeat
As for the trend in drug-related deaths, an indicator of the seriousness of the drug-addiction problem, there has been
a definite downward evolution over the past years. In red, you see the evolution of cases where drugs are the main
cause of death, usually overdoses. Since the beginning of the 90s, there has been some decrease in this type of death and
we now find ourselves in the same situation as at the end of the 80s.
The figures shown in black indicate the number of AIDS-related deaths among drug injectors. It can be seen that the
highest level was reached in the middle of the 90s before the introduction of new therapies. But there has been a strong
decrease over the past several years.
Another indicator of the seriousness of the drug problem is the number of treatment interventions. It is believed that
the more people there are in treatment, the better their chances of overcoming drug addiction and maintaining their
health during their period of use.
Thanks to the policy followed by the cantons and the Federal Office of Public Health over the past years, we have
been successful in bringing a large number of users to treatment, with the number of cases of methadone treatment
From the beginning of the 90s until the present, the number of cases of heroin substitution treatment increased
fourfold while the number of cases of residential treatment, generally a withdrawal treatment with maintenance in a
closed system with rehabilitation, has remained fairly stable, with a slight increase.
Something that the graph does not show is that while we have been successful in bringing a large number of users to
treatment, the type of treatment provided has changed since our harm reduction policy does mean taking a different
approach to people's treatment. We are now far more accepting of the fact that people may be using a hard drug in
spite of the fact that they are in methadone treatment. This hardly ever now constitutes a reason to interrupt treatment,
contrary to the practice ten years ago.
We allow some maintenance, with both heroin and methadone, while waiting for the patient's state of mind to
improve and for the patient to feel ready to consider withdrawal. So we no longer have the same view of methadone
treatment in the past which started with a certain dose and decreased quickly.
On the contrary, in recent years, we have been more inclined to give patients rather high doses and to maintain those
doses until we are sure that they have stabilized. That is when we start to aggressively reduce the doses. Risk reduction
is part of the treatment, in that we now authorize treatment involving maintenance for people whose drug use is not
perfectly stabilized. While waiting to undergo treatment, they face fewer health-related risks.
As for whether or not the Federal Office of Public Health uses the data, I can assure you that it does. It has even
taken steps that are part of our contracts to ensure that good use is made of the evaluation data and research in
What types of steps has the OFSP taken? First of all, there are contract provisions. In our evaluation contract, we
have a requirement for added value. We must produce reports with summaries that can be understood by the general
public. At the invitation of the Federal Office of Public Health, we are also expected to speak at public conferences and
in some cases to hold press conferences to report the results of our investigations. When a report is ready, the Federal
Office of Public Health systematically considers how the value of the report could be enhanced, by identifying who
may be interested in the report and to whom it could be distributed. That is in the contracts but is not working very
well. But a real effort is being made for that to be part of our contractual obligations. Steps are also being taken
internally to try and enhance the evaluation results.
For example, at the start of each evaluation period, which lasts three or four years, there is a discussion period with
officials from the Federal Office of Public Health who are responsible for program implementation. We select some of
the evaluation questions to determine what they should cover in the next period. There are discussions and
negotiations on the topic.
That also means that if people ask us questions, it is because they are interested and particularly eager for answers.
So they will monitor us to obtain these answers and to ensure that they obtain them in a timely fashion.
The evaluation service of the Federal Office of Public Health follows up on the evaluation. This is the service that
commissions external evaluations. There is a formal structure for returning the intermediary results to the teams and
for disseminating the information.
To ensure good use is made of the evaluations, the Federal Office of Public Health also widely distributes its
findings. This is not always perfect. It was mainly the case during the first evaluation periods, when it was in the best
interest of the policy to quickly make the findings of these evaluations public. The OFSP also uses what we call
windows of opportunity. That means that when there are debates in the chamber or when new steps are taken, we seize
the opportunity to publicize some of our evaluation findings.
You are undoubtedly wondering if these evaluations are useful. What are the evaluations used for? First of all, there
is a policy aspect to using the evaluations. They make it possible to identify what already exists, to determine where we
are at, and also to identify problems that remain unresolved. They also make it possible to validate and legitimize the
policy. And that is important in a political environment like ours, where the Narcotics Act enables the Federal Office
of Public Health to get involved in a number of areas. The cantons are, nonetheless, sovereign, namely as regards
health care. So it is very useful to validate and legitimize the policy when it is successful. In Switzerland, we have seen
that this approach reinforces stability, distribution and acceptance of the policy.
Having the evaluation findings to consider also makes it possible to evaluate the scope of the data that is helpful in
orienting the decisions and amending policies. I will give you a couple of examples of that. At the start of the
evaluation, we surveyed the general public to see how drug problems were perceived and how the general population
perceived, among other things, drug users themselves. We can see that in 1991, the majority of the population agreed
that abstinence was possible even after several failed attempts to quit, but there was still 30 per cent of the population
that had no idea whether abstinence was possible, or that truly thought that a person could not recover.
This type of data on public knowledge was used, for example, in the national awareness campaign in 1997. One of
the messages was to tell people that drug addicts can overcome their problems if we help them. It may take some time,
but they can overcome their problems. The evaluation findings justified these campaigns, which aimed to improve
general awareness in this area.
In 1991, with the initial evaluations, we sought to determine what the general public was prepared to accept in terms
of solutions to drug addiction. What is striking is that we can already see in 1991, more than ten years ago, that the vast
majority of the people agreed that it was useful to sell or distribute clean needles to drug users. There was broad-based
acceptance for this approach.
However, at the time there was a very small minority of the people who were prepared to accept over-the-counter
sales of hashish and marijuana. The majority of the people agreed that it was possible to provide drug users with
injection sites, and at that time, people agreed that it was possible to consider distributing heroin to drug users in a
This type of data was very useful for politicians to determine where they were at in comparison to their constituents
and to determine what it was possible to do politically, what was more difficult and what required further explanation.
In our opinion, the evaluation is also helpful in that it contributes to the development of shared expertise. If the
findings of the evaluation are widely distributed, the issues are well known and that makes it possible to resolve
controversy by ensuring that policies are evidence-based.
I will give you an example. Here, you can see the evolution of the number of needles distributed in low-threshold
centres between 1993 and 2000. We can see that a lot of needles were distributed in the 1994-1995 period. That was at
the time of the open drug scenes. When the scenes were closed, or broken up, many drug users entered treatment and
many others probably went underground. There was a major drop in the number of needles being distributed in these
low-threshold centres. After that, however, there was an increase in distribution and then distribution completely
It was very interesting to be able to provide politicians with information on risk reduction. Making injection
paraphernalia available was well accepted, and moreover, it did not encourage injection. If that had been the case, we
should have seen a constant increase in the number of needles being handed out to drug users, which was not the case.
Numbers have been stabilized for several years. We were also able to show that under these policies, the sharing of
needles had decreased and stabilized at a low level. We were also able to show that drug users had been able to adopt
prevention behaviour to the same extent as people in the general population with respect to condom use.
We were also able to show something that was not at all the case several years ago: when we gave them the means to
protect themselves, they did. There was a sharp decrease in the number of new cases of HIV among drug users. We also
saw that the harm reduction policy did not discourage all users from entering treatment, on the contrary, since there
was an increase in the number of people entering treatment. These are just some examples of what an evaluation can
contribute to public debate.
Now I will move on to cannabis. Before telling you about some of the experiences of the commission on which I sit,
I would like to show you a little political cartoon that will perhaps give you a sense of the extent to which the debate on
cannabis in Switzerland is taking place in a spirit of open-mindedness. This is a cartoon showing our Minister of
Health watering cannabis plants outside his office and smoking a joint. This cartoon appeared in a well-read
newspaper the day that the federal council announced the decriminalization of cannabis. These are matters that we can
talk about and even laugh about in our country.
When the federal commission on which I sit started to study cannabis, it did so on its own initiative. It was not a
mandate of the Federal Office of Public Health, even if the Federal Office was happy that we were looking into the
The Schilte report, which presented various drug policy scenarios, had always considered all illegal drugs at the
same time. The idea of the commission at that time was not to attach too much importance to the substances. It was
the person who counted and the person's risk of becoming addicted. In subsequent years, some of the members of the
commission changed. These members noted an increase in cannabis use. They had to deal with the fact that the
substance was different from the others and that the matter needed to be examined.
The first step the commission took was to look at what the objective of the cannabis policy should be. The
commission felt it was necessary to create general conditions conducive to preventing adverse consequences of
cannabis use for both users and society in general. The commission wanted a harm reduction policy.
The commission also felt that a cannabis policy should have other objectives, including protecting young people and
users. It had to promote health, prevent use, reduce problematic use, especially when it was dangerous, and avoid
criminalizing users and stigmatizing young people. The situation was already unbearable, given the number of users we
have in Switzerland.
It seemed to us that one of the objectives was to relieve the police and the justice system of having to take legal
action for minor offences, so that they could focus on more serious ones. One of the most important objectives was
uniform enforcement of current laws. At present, action taken against cannabis users varies from one canton to the
next. There is de facto inequality before the law. A cannabis policy required coming up with common guidelines for all
drugs. We felt it was important to protect other segments of the population, to suppress the illegal cannabis markets
and to obtain a better cost-benefit relationship than under the current policy.
As a result, the commission heard from a number of experts. It commissioned studies from experts. Its final position
was retained by the Federal Council. The commission decided not to take the legal environment in Switzerland into
account. It decided to freely examine the constraints and to focus essentially on public or social health.
After having examined various options, the committee unanimously proposed a model to decriminalize possession
and use of cannabis and to legalize the acquisition of it. It considered a scenario to legalize but not liberalize cannabis.
The idea was to clearly regulate it.
We knew full well that this model was incompatible with the 1961 Convention. Nevertheless, we wanted to send a
political signal to the Federal Council by saying that the commission was proposing this scenario. The regulations we
felt were necessary under this legalization scenario required the development of requirements for qualifying authorized
vendors, in other words clear directives for selling the product, an advertising ban, the possibility of imposing prices, a
ban on sales to people under the age of 18 — there was a discussion as to whether we should propose 18 or 16 years of
age, which is the age required to drink alcohol — and a residence certificate, for purchases, to avoid problems with
We thought that it was possible to set the number of cannabis plants authorized for personal use and to regulate
commercial production. We felt it was extremely important to develop very strong additional measures, such as
strengthening prevention and access to the council for at-risk and problem users.
That was the commission's main recommendation. We knew that it ran counter to the 1961 Convention. So we had
to admit that there was a second choice, involving partial decriminalization, in the event that the legalization option
turned out to be too politically sensitive, which was the case — it was unrealistic politically. Our proposal involved
material decriminalization of use and preparatory acts, and the application of the opportunity principle for trafficking,
in other words the possibility for the Federal Council to regulate legal action, the possibility to take action for
trafficking or not, which would be adopted this time by the Confederation and result in the same rules for all cantons.
This is not currently the case.
The Chairman: At the start of your presentation, you talked about an external evaluation. Am I to conclude that it
was an independent evaluation?
Ms Dubois-Arber: Yes. However, I say ``but.'' It has always been the subject of discussions with the Federal Office of
Public Health. In principle, it is. Our reports are initially discussed by the Federal Office of Public Health. To date they
have never been held back. They have always been published afterwards. The Federal Office of Public Health cannot in
principle ask us to change the substance. They could ask us to change the wording of a sentence. It is up to us to decide
whether or not we accept the proposed change in wording. In principle, it is independent. We have, for example, the
opportunity to draft scientific publications on the basis of our reports. There again, we are not expected to submit our
articles prior to publication. We send a copy of the article at the same time as we submit it for publication. The only
thing we have to do in some cases is to wait several months before sending the article to publication. Fundamentally,
there are no obstacles.
The Chairman: You do not face any budgetary obstacles either?
Ms Dubois-Arber: We have a budget.
The Chairman: Budget negotiations do not affect the quality of the evaluations?
Ms Dubois-Arber: I do not know. The budget is renewed every four years. The policy evaluation is not entrenched in
the Constitution. The Federal Office of Public Health has the choice to not be evaluated or to decrease its budgets.
The Chairman: It is not a monitoring centre like the ones found in other European Union countries, which are
relatively independent, both in terms of their budgets and their ability to publish or share information with the general
public, among others, and whose duty it is to do so. After having been so involved with the Swiss system, would you be
in favour of the model that is found in other European countries that have independent monitoring centres?
Ms Dubois-Arber: A monitoring centre does not do evaluations. The two roles are different. We are standardizing
our statistics so that they are closer to what exists in Europe. The wealth of our data is equivalent to what can be found
in other European countries. A monitoring centre does not reach conclusions or make recommendations. In general, it
monitors the results of policies and drug use trends. It does not take a critical look at how policies evolve. That is not
its role, and generally speaking, it does not have the tools to do so. With an evaluation mandate, we take a specific look
at a specific policy and analyze it. That is not the case with the monitoring centre. The monitoring centre observes, it
does not do critical analyses or evaluations. We can use data from a monitoring centre in an evaluation. What
monitoring centres do not observe, generally speaking, are processes. They rarely monitor specific measures in detail.
The processes are the most difficult to evaluate, to get a precise idea as to how program implementation is unfolding,
the number of programs implemented, their quality, etc. Most European monitoring centres are not necessarily
authorized to do that.
The Chairman: In your opinion, does Switzerland have a well-structured drug strategy because it is a federated state?
Powers are divided between at least two major jurisdictions, and then there is the role of the municipalities.
Ms Dubois-Arber: Yes, we feel that the policy was put in place in a very intelligent way. The Federal Office of Public
Health has a rather tenuous legal basis for intervening in drugs, the Narcotics Act, but all implementation is done at
the canton level. Essentially, its role with respect to policy implementation involves incitement and coordination. The
OFSP showed innovation with, among other things, heroin prescriptions, et cetera, but for the most part, it has aligned
itself with the cantons that had the most advanced approaches. The OFSP has adopted an intelligent approach, taking
advantage of subsidies, programs, opportunities to invest public funds, and innovation to gradually win over the
cantons that were the most reluctant to adopt its policy. I live in a canton where, 10 years ago, harm reduction was out
of the question. It was not possible to distribute needles to drug users, they could only be sold in drugstores. Gradually,
faced with this successful OFSP policy, the canton came on board, and it is now a canton where injection sites are
talked about, and perhaps in a few years we will even be talking about heroin substitution treatment. Given the limited
opportunities for intervention at the federal level, the approach to innovation and encouragement, with the cantons
remaining sovereign, was an intelligent one.
The Chairman: The exercising of confederal jurisdiction is perhaps more integrated with the cantons than it is here in
Canada. In Canada, we have a federal system, but two jurisdictions, the federal and provincial governments, exercise
power. Health is primarily a provincial responsibility, at least in terms of public health research implementation, but
the federal government also has a role under the Canada Health Act. That is why I asked your colleague about this
earlier on and it is also why I am asking you how this cooperation works.
Ms Dubois-Arber: That is where the difficulty lies. In our opinion, in Switzerland, cantons are truly sovereign in
terms of health care. The only exception is the Epidemics Act. That is why the Confederation, in the case of AIDS, was
able to intervene and to make proposals, but in principle, the canton is sovereign, and the organization of hospitals is
also a canton responsibility. The Confederation has a limited ability to intervene; the possibilities for direct
intervention are quite small. Everything is done indirectly. Ms Steber Büchli talked about areas where the jurisdictions
could work together to try and gradually win the cantons over to the policy. In Switzerland, it is not possible to have
policy directives in the area of health care. Medicare is dealt with on the federal level, but the organization of care, the
organization of social policies, the concrete aspects of this and the policy implementation are truly canton
responsibilities. There is very little leeway.
The Chairman: Does the national strategy involve a policy to persuade the cantons to coordinate criminal authority
for enactment of the law with a federal body?
Ms Dubois-Arber: Yes. Absolutely.
The Chairman: Implementation is at the canton level. It is the same in Canada. That is why I am focusing on these
questions of integration.
Switzerland has introduced heroin maintenance treatment programs. Why have they not done the same for cocaine?
Ms Dubois-Arber: We do not have the same problem with cocaine as you do. There are two types of cocaine users in
Switzerland. There are well-integrated, rich people who use cocaine on a very recreational basis. We know virtually
nothing about these people. Generally speaking, they do not show up at all in our statistics.
The Chairman: Do they show up in your statistics in terms of levels of users?
Ms Dubois-Arber: We have very little data on levels of use. We have data on the population in general. One out of
every thousand people use hard drugs. A few years ago, we did not separate heroin and cocaine. Small percentages of
people use these drugs. We do not have people injecting pure cocaine. We have heroin. As for people who are injecting
drugs, to date and without exception, to the best of my knowledge, the bulk of all injections are heroin. That is the type
of drug use we face. For these reasons, we did not need cocaine maintenance treatment programs, because we do not
have cocaine addict in our treatment centres. They are not part of our drug-use habits. Now, most users who are
seriously addicted to heroin also inject cocaine. But that use is secondary.
The Chairman: You mentioned in your presentation that the user cohort was getting older. You offered to address
that in a more specific question. How do you determine that? Is it a good sign with respect to young drug users who try
drugs but do not remain users?
Ms Dubois-Arber: There are some grey areas. For several years now, about every three years, we have seen surveys
from the low-threshold centres, centres where needles are distributed and where sometimes injection is allowed.
These centres are supposed to receive the most addicted users, the ones who inject the most. Each year, these surveys
show that the average age is higher. So we have the impression that we are dealing with a user cohort that is getting
older. Of course, there are always new drug users. But every time we do a survey, we see not only the average age of
users is higher, but we also see that the average injection time, the percentage of users who have been using for less than
two years, is also getting smaller. So we are under the impression that there are users who continue to inject heroin, but
fewer than in the past.
As my colleague already mentioned, we are seeing people use a host of products together; people are using heroin,
cocaine, ecstasy, medication and some are injecting sedatives and everything else imaginable. What this type of drug
use could become remains a grey area.
New ecstasy users are also another grey area. This is a rather new trend. We do not know to what extent this use will
remain separate for these people, in other words, we will have ecstasy and cocaine users who will or will not start
injecting heroin. Not enough time has passed for us to have clear answers on that. But let us say that our population of
heroin addicts is getting a bit older.
The Chairman: At the end of your presentation you mentioned some proposals and recommendations made by the
commission. Can you explain the difference between decriminalization and legalization? We make a distinction
between the two and we would like to compare ours to yours.
Ms Dubois-Arber: The Commission was not supposed to delve too deeply into that. It is the difference between the
police and the courts.
The Chairman: So far, we make the same distinction.
Ms Dubois-Arber: But I get it mixed-up every time. What legalization actually means is that...
The Chairman: There will not be court proceedings.
Ms Dubois-Arber: At any rate, what the commission was proposing was that it no longer be subjected to any
prosecution, that consumption be totally free of all criminal prosecution; that it no longer be a crime.
Decriminalization, unless I am mistaken, is the absence of prosecution, meaning no criminal proceedings are brought.
I do not believe there is any fundamental difference in our interpretations of the term. Perhaps we are the ones
The Chairman: When I read your slide on the first option and even the second option, they are fairly comparable. I
compare it roughly to making and drinking wine. You can make your own wine.
Ms Dubois-Arber: No.
The Chairman: You cannot make wine for personal consumption?
Ms Dubois-Arber: Not at all. I do not know whether you would ever actually be prosecuted, but there is a Federal
Alcohol Board. In the opinion of the commission, cannabis was not such a dangerous drug as to warrant different
treatment from legal drugs that, compared to tobacco, were much more dangerous. The Commission wanted to
propose a policy more like our alcohol policy. A cannabis board, for example, could have been created. That is not
liberalization. Unfettered access to everything was not being advocated, just as there are restrictions on how alcohol is
produced and sold. The idea, in fact, was to come up with a law and a system more like what we have for alcohol, with
places where it can be legally sold, a licensing system, a consumption monitoring system, including monitoring of the
THC content of the products sold, and everything else that is basically similar to what we have with an alcohol board.
The Chairman: Your commission wanted to dispense with the international legal environment in making its
preferred recommendation. You knew your recommendation was incompatible with the Single Convention of 1961.
Do you have any studies, and are they the same studies your colleague before you mentioned, about the flexibility of
Ms Dubois Arber: We knew it was incompatible.
The Chairman: Did you get that from an external opinion or from members of the Commission who had in-depth
Ms Dubois-Arber: I am not a lawyer, but it was clear to the commission — we knew from the outset — that under
the Single Convention of 1961, it was totally incompatible to even think of legalization and decriminalization. Our
thinking was more public- health oriented. We wanted to be able to treat this substance as we would any substance,
taking into account how it is currently consumed, how it is currently prosecuted and what harm it does relative to other
The Chairman: I am aware that you are not a lawyer, but I am going to ask you questions as a public health expert.
You will see, in my view, that there is a connection between values and constitutional rights, at least according to my
interpretation of the right to health. If I were to show you that the right to health may be jeopardized by legislation or
an international convention, and this commission tells you there is a convention, but that this convention must not be
construed as running counter to one of the constitutional values held by a country or party to the convention, would it
not be more promising to ensure that your recommendation was not contrary to the conventions? The convention is
not supposed to run counter to your constitutional values. If the right to health is a sufficiently important value for you
to have included it in your national constitution, the international convention cannot stand in the way of that.
Ms Dubois-Arber: We in fact asked ourselves whether it made sense to apply the convention in the interest of public
health or whether we should not instead denounce it.
The Chairman: Exactly. Should an international convention prevent a country from providing public health
programs which it deems helpful?
Ms Dubois-Arber: That is what the commission felt. It would be extremely difficult to denounce a convention on the
international stage, but it could be done. We felt that our cannabis laws did not make sense from a public health point
of view compared to the way the law dealt with, for instance, tobacco or alcohol. The commission felt that one thing
stood in the way of sending out a credible prevention message to young people. On the one hand, we could not say that
smoking pot was illegal while knowing full well that 30 per cent of the population smoked up, and on the other hand
that smoking cigarettes was much more dangerous than smoking pot, but that it was not illegal. From a prevention
point of view that seemed counterproductive. We decided to make public health our first priority and put aside the
legal environment at a certain point.
The Chairman: I am just checking with Mr. Sansfaçon to see whether what you are telling us is included in the
commission's brief. That is very important. I think you see what I am getting at. It does not make sense that a
government should stop studying a subject just because it has signed a convention, especially if the study concludes
that public health policy is lacking. That is certainly the conclusion you reached.
Ms Dubois-Arber: Yes. In the report, we state that we wish to free ourselves from the situation in order to pursue our
work freely and without any second thoughts to any possible constraints imposed by international law.
The Chairman: At the end of your presentation, you questioned the objectives of the policy. I presume that the Swiss
are not so different from Canadians, at least they were not ten years ago. The public feel that the aim of public policy
should be to reduce use, but according to your recommendations, it is not a fundamental objective. Could you explain?
Ms Dubois-Arber: When the first measures were introduced in 1991, one of the main objectives was to reduce the
problematic use of illegal drugs, and harm reduction. This is clearly stated in the message of the Swiss Federal Office of
There were figures at the time. The very first proposal was to reduce by 20 per cent the number of hard core addicts.
There was no exact figure in that regard at the next stage, because people realized that the objective had not been met
and that it was difficult to quantify, but that it was possible to reduce the level of use.
The Chairman: Is that objective still as important today?
Ms Dubois-Arber: Yes, for hard core addicts. That is the objective for the use of all illegal drugs, but especially
heroin and cocaine.
The Chairman: What are your figures on pot smoking among Swiss youth?
Ms Dubois-Arber: We have the figures for 1998.
The Chairman: I mean the ones your colleague was referring to.
Ms Dubois-Arber: They are also included in the report on marijuana. According to a regular WHO investigation
carried out in 1998 and which surveyed 15-year-old students, over 30 per cent of respondents said they had smoked up
and one third of those people said they did so on a regular basis. That is a lot.
The Chairman: Your statistics seem to indicate that there has been no reduction in the use of heroin. However, it
seems that the quality of life of heroin addicts has improved. Is this not your real objective?
Ms Dubois-Arber: In the last few years, the proportion of addicts who inject themselves has fallen in relation to the
people who visit low-threshold centres. The AIDS epidemic is partly responsible for their decreasing numbers.
However, it is not a big decrease. But on the other hand, when cocaine became accessible to a certain segment of the
population, injected drug use of cocaine increased. If you look at this population as a whole, you will find that the
proportion of people injecting themselves and the average number of injections has decreased, but you cannot forget
that there are subgroups which evolve differently.
Senator Rossiter: Why is the residential treatment not used as frequently as methadone and heroin treatments over
that designated period of time? Does it require a referral? Is it less effective?
Ms Dubois-Arber: Offering treatment which involves harm reduction, such as methadone, and that is less restricted
than in the past allows a person to be treated as an outpatient and continue to have a family, professional and social
life. So this treatment is more attractive for drug users in the most difficult phase of their drug use in comparison to
treatment where they are institutionalized for several months and weaned off their habits, etc. This has perhaps made
other types of treatment less popular. We have very little data on the effectiveness of residential treatment that started
by withdrawing the drugs. There was probably a lot of relapses with this type of treatment. We hope, without having
sufficient data, that there is a better selection of people who enter residential therapy, so that the people are more
prepared to receive that type of treatment. This treatment is more difficult and daunting from the outset, and it is not
necessarily limited to users in their most active drug use phase.
Senator Rossiter: Is the residential treatment much more expensive per person per use?
Ms Dubois-Arber: Yes.
Senator Rossiter: Are there different locales in each canton, or in the country as a whole, where these treatments take
Ms Dubois-Arber: Residential treatment involves a broad range of very different possibilities, including methadone
treatment. There is no codification for residential treatment. It can be offered by various institutions, including public
or religious ones. The current quality of residential treatment is not being monitored, which means that there is no
codification as to what treatment of this type must involve.
There is one statistic for residential treatment. People conducting the research — Mr. Uchtenhagen could
undoubtedly tell you about this this afternoon — and who compare their research data are trying to have greater
consistency and more opportunities to compare the various approaches. At present, there are different ways of treating
people undergoing residential treatment.
The Chairman: I will consult the committee researchers and I will decide perhaps to write to you, hoping that I will
receive a reply.
Before suspending the committee's proceedings, I want to remind all of those who are interested in the work of this
committee, that they can find more information on illegal drugs by consulting our Web site at the following address:
www.parl.gc.ca. There you will find the briefs submitted by all of our witnesses, as well as their biographical data and
any supplementary documentation submitted by the witnesses. There are also more than 150 links related to illegal
drugs. E-mail messages may also be sent to us through this Web site.