Once again, drug scenes in Zurich, Geneva, Lausanne, Lucerne and other cities in Switzerland are disturbing parents of children and the whole neighbourhood. The affected public  does not want to continue to accept the terrible situation. Fears of a major crisis arise again. Crack users are merely the tip of the miserable iceberg that has become visible again.

The drug crisis of the 80s and 90s was one of the biggest disasters in Switzerland. At that time, more than 10,000 people died an avoidable, miserable death. In 1994 alone, 400 lives ended due to overdose; another 600 died from AIDS and other infectious diseases. School buildings, commercial enterprises, entire neighborhoods reached the limits of their functionality.

In 1986, 360 practicing doctors responded to an appeal by their association. They resisted the authorities‘ ban on syringes with their signatures. Most of them cared for opioid addicts with methadone in their practices in the following years. From this circle, the association for risk reduction in using drugs Arud was founded at the end of 1991, which introduced the nationwide low-threshold methadone dispensing. That was the game-changer of the drug crisis.

General medical expertise became crucial in the help system. Today, this know-how is almost completely lacking. Addiction problems are attributed to psychiatry, social work, police and the judiciary. Fundamental improvements are not to be expected from this system.

More than 30 years ago, we carried out experiments with heroin-containing sugarettes and cocaine-containing cocquerettesin Zurich on behalf of the Federal Office of Public Health. The inhalation trials were poorly prepared. Due to dangerous medical problems, they had to be ended prematurely.

Instead of solving the technical problems, temporary emergency measures were continued permanently in an improvised way. That is why heroin-based treatments still play no role in the care of 97 percent of the addicts.

Even today, there are not only problems with cocaine in the form of crack. Again, almost 200 opioid addicts die from overdoses every year. Again, there are almost half as many as 30 years ago; almost twice as many as died in the flames of Crans-Montana, which still oppress Switzerland so much. Junkies do not enjoy human sympathy.

It is not health and lives of those affected that are the goal of those officially responsible, but socio-political concerns and ideology, then as now. Our trials with inhalable heroin and cocaine in the 1990s showed that inhalable offers for addicts were highly attractive even under unpleasant conditions. In principle, they could bring many more addicted people out of the dependence of the dangerous, illegal market.

Cocaine trials and experiments with inhalable opioids such as heroin or fentanyl have actually been urgent for over thirty years. The successful results of the scientific experiments were ignored. The public pressure of the problem had eased to such an extent that further developments since the end of the 1990s no longer seemed necessary.

Those responsible basked in the successes of Swiss drug policy until they now wake up frightened. With the old emergency measures, they can no longer control the problems. Why? What is really effective?

The repressive forces of the police and the judiciary are undoubtedly necessary and effective in maintaining security and order. But the fight against drugs detracts from this goal more than it promotes it. From 1968 until peak times in the needle park Platzspitz, the police forces against drugs in Zurich were increased a hundredfold. The scene grew as well.

Psychotherapy and prevention can only prove short-term improvements in the small percentage range, if at all, but no lasting effects on drug addiction. Withdrawal treatments are usually a malpractice for opioid addicts. They increase the susceptibility to diseases and mortality of heroin addicts by 200 to 400 percent.

The medically controlled delivery of substances with the addictive desired effect is inexpensive, attractive and highly effective in the long term. The introduction of low-threshold methadone delivery was the game changer at the time. It allowed most opioid addicts to stop their unwanted and dangerous actions and behaviors almost immediately: four times fewer illnesses, deaths, and socially disruptive behaviors.

Today, two-thirds of opioid addicts in Switzerland are in safe treatment with methadone, morphine, diaphine or buprenorphine. With suitable inhalation tools, we could also get the remaining third out of the illegal markets. This would also be possible with cocaine, but safe drug delivery tools must first be developed for this.

It is not only crack users who have problems with cocaine. More than 1 percent of the Swiss population consumes it more often. This is a huge health and social problem and it is much bigger worldwide. Sustainable solutions are required, not emergency measures.

It is an unscientific rumor that admixtures and cutting agents are causing diseases and death of cocaine users. Inhalation of hot, naked cocaine gases impairs blood circulation and kills mucosal tissue in the airways. Putrid suppuration, chronic inflammation of the lungs and heart valves can be fatal in the long term. Uncontrolled cocaine doses are life-threatening due to heart attacks and strokes.

In Geneva, the psychiatric university hospital is planning trials with cocaine inhalations. Extremely problematic crack users are to be allowed to inhale heated cocaine gas during limited opening hours in Professor Daniele Zullino’s drug outpatient clinic. Consumption can exclusively take place under supervision on site.

The experiments expressly have only socio-political goals. The Swiss Human Research Act is to be circumvented in this way. These arguments come from the Federal Addiction Commission EKSN. The EKSN and those responsible for the experiment have not submitted an analysis of the possible damage.

But every drug dispensing is and remains a punishable, life-threatening bodily injury, a criminal offence against life and limb, if no benefit for the health of the person concerned can be proven. It is not intended to prove any individual medical benefit: unethical human experiments with naked hot cocaine gases.

I have filed a criminal complaint. Neither the Geneva public prosecutor’s office nor the court wanted to confirm to me that they wanted to investigate the official offences. The Swiss Academy of Medical Sciences refuses to answer my questions about ethical admissibility.

Professor Zullino argues only with the opinion of the authorities, the reputation and the community of professionals. He has no evidence to support his claims that the planned levies are less dangerous than the consumption of crack cocaine. And he does not plan to provide such proof.

It is to be feared that the planned cocaine trials will lead to the fact that a medically correct testing of cocaine distribution will never again be possible. Today, there is only an attempt to establish a new emergency measure that does not tackle the fundamental problems of the illegal market. It can only be carried out in special facilities that are financially and staff-intensive. Beyond the most extreme crack scene, such premacies will never be able to be effective, even in the best case scenario.

Cocaine addiction affects not only a few hundred crack addicts in Switzerland, but more than 1 percent of the population. Internationally, there are millions. Only if we succeed in freeing a large part of these people from the illegal market and thus from the greatest burden of their addictive existence, can we hope for a sustainable improvement, for them and the hole of society

Triales to inhale cocaine and opioids are urgently necessary, but only effective if they are carried out in a medically correct manner. In order to protect the respiratory tract, cocaine would have to be packaged in microscopically tiny, fatty liposome beads for inhalation. Through fingerprint security and suitable programming, both cocaine and opioids could be safely dosed in a spray and dispensed under medical supervision.

The proposal is 30 years old. With a detailed scientific experimental plan, safety and efficacy would have to be proven according to all the rules of the medical art. This requires extensive preparatory work and physical medical and pharmaceutical expertise. Presumably, this is not to be expected from the state. The development of an inhalation tool is legal an feasible in the private sector. Who cares? who will do it?