The decision in the Netherlands to treat heroin addiction as a medical condition rather than a criminal offence will intensify pressure on other countries to reconsider their drugs policy.
When the Dutch government last week came out in favour of medical prescription of heroin, it also vowed to push for the substance to be registered as a medication, and for addicts to be treated like other patients. The government said it would work towards altering national legislation to make heroin legal and submit a proposal to the World Health Organisation (WHO), asking for it to be registered as a medicine.
Bas Kuijk, a spokesman for the Dutch Ministry of Health, explained: "We have a small group of addicts that are beyond help. By treating them as patients rather than criminals, we improve their life quality and their chances of survival. Also, as these people disturb society by committing crime to finance their habit, we reduce crime by giving them the heroin on prescription."
The Netherlands is following in the footsteps of Switzerland where heroin has been available to a limited group of addicts since 1998. It will also send a strong signal to Germany, which launched nationwide heroin trials last month, and other European countries struggling to find effective ways of dealing with escalating drug deaths.
It is ironic that the model for the European heroin programmes is the old British prescription-based system, which was close to being abandoned after some doctors were found to be prescribing too liberally in the mid-60s. Today about 310 patients in the UK are prescribed heroin although the total number of heroin addicts is estimated to be 270,000.
In an attempt to tackle spiralling drug deaths and drug related crime Switzerland decided to test a similar system by running heroin trials from 1994 to 1996. In the Netherlands, where drug-fuelled property theft is a big problem, the pilot project on heroin saw an 85.7% reduction in time spent on illegal activities among the participants.
However, some groups in the Netherlands are not convinced the change in heroin policy will work.
A spokesman for the Christian Democratic party (CDA), the main political opponent of the Netherlands' heroin programme, said: "We are not convinced about the success of the small pilot project they conducted here, as it only involved the upper layer of addicts and didn't reach those in really bad situations."
The Dutch results echo those of the Swiss heroin trials where the number of criminal offences decreased by about 60% during the first six months of treatment. But the Swiss results have also been criticised. It has been argued that the reduction could be due to heavy investments in social services for addicts rather than prescribing the drug.
However, recent statistics from Switzerland show that overall drug related deaths, mostly from heroin overdoses, have fallen from 419 in 1992 to 181 by 1999.
Susanne Fluckinger, the manager of Lifeline, a heroin substitution clinic in Zurich, said: "Here we help people to survive. It's for people who have tried other ways but failed. People who come here are very ill. The average age is 33, they usually have been addicted for more than 10 years, and many have tried six or more therapies."
Switzerland has about 30,000 addicts, of which around 15,000 are in methadone substitution programmes and less than 2,000 in heroin schemes. The country spends around £42m per year to implement its four-track drugs policy: prevention, therapy, harm reduction and law enforcement. The Dutch government plans to spend £28.6m on heroin prescriptions in 2002 and 2003.
As for the public attitude to these new policies, in Switzerland the outcome of referendums in 1997 and 1998 is taken as evidence that the policy has huge public support. But there is also opposition. The Swiss people's party (SVP) has been critical of the policy, and in neighbouring Germany public opinion is less supportive.
Jurgen Weimer at the Drugs Authority in Frankfurt, said: "People like to have simple solutions for complicated problems. A typical promoter of this is BildZeitung [a best selling tabloid]. People would like to put the addicts in prison, lock them up and have them treated."
With 270,000 estimated regular users, Britain has one of the worst heroin problems in the Western world. The home secretary, David Blunkett, has signalled that he is ready to promote wider use of heroin prescriptions, but this will be a difficult budget priority to argue for in a situation where schools and hospitals are crying for more resources.