Today, November 30^th 2008, the Swiss were asked in a national referendum to approve or not a proposal to make heroin available on prescription in their health service. As expected they approved.

Nobody would suggest, I hope, that heroin addiction is a desirable state to be in. It exists, however, largely as a by product of criminal activity.

The advantages of the Swiss proposal are obvious. At a stroke the market of the drug trafficker and the street vendor disappears. There will be no further need for addicts to engage in low grade criminality in order to fund their expensive habit. There will be less or no incentive for the criminal fraternity to lead the curious, the unintelligent, the inadequate and the hopeless into drug taking in the knowledge that it will lead to addiction and provide them with a captive market. Addicts will become known to doctors and might be led to see their addiction as a health problem. They can be helped to control and kick the habit. Some may just accept less harmful substitutes. Over time the number of addicts is likely to decrease significantly.

They will not be given access to supplies which they might sell but a safe and hygienic environment in which they can inject the drug supplied.

Of course there will be a cost. I suggest that through legitimate channels the cost of the drug itself will be nothing like the cost of illicit supplies. If such a policy were to be widely accepted it could have an effect on the situation in Afghanistan where much of the heroin originates. To set against the cost would be a reduction in crime and the possibility that the problem could be reduced to insignificant proportions.

At the same time the Swiss were asked to vote on a proposal to decriminalize cannabis which in their wisdom they rejected. There would seem to be a contradiction here. However, having consulted a friend who lives in Switzerland, I got a reply which I half expected. It is apparently the case that the Swiss do not share the recently acquired abhorrence of smoking which exists in England. According to him the Swiss ‘smoke like trains' from an early age. He reports that cannabis dealers are not arrested because the police and even judges smoke the stuff. Decriminalisation is an irrelevance and as he puts it 'the Swiss do not do what does not work'.

What the implications of this heroin policy might be are difficult to see. I cannot imagine that alcohol or tobacco could ever be available on prescription nor can I see a case for so called recreational drugs like ecstasy. Relative addictiveness cannot be a test because both tobacco and alcohol would come into that category. There remains the question of cocaine often seen as an upmarket problem. After all Dr Watson's friend Sherlock Holmes was a partaker. Maybe for reasons like this it does not feature so much in discussion of drugs. It could be a candidate for a parallel programme. Perhaps we should just wait to see what happens to heroin in Switzerland.