ZURICH A group of people who look like they have seen the dark side of life are sitting at metal tables in a large tent.
Hookahs rustle as the crowd draws smoke into their lungs. Others load the pipes with a light substance. They use freebase or crack, strong combustible forms of cocaine.
Cocaine-related mental images of partying surface glues seem far away in the reality of the room. The staff monitors events from behind a glass wall.
It’s an ordinary autumn afternoon in Zurich’s largest drug use room, Kaserne. Here, addicts can use illegal drugs without fear of police intervention.
The specialty of Zurich is that customers are also allowed to sell hard drugs to each other on a small scale. It’s called microdilution here. The police are also aware of the trading and do not intervene.
Brigitte von Flüe’s face suffered wounds after burning the drug Levamisol, which is used to repel parasitic worms. The drug is used to continue cocaine.
Substitol capsules are used in the substitution treatment of opioid addiction. However, by breaking the capsule, the medicine can be used by sniffing or pricking.
“Take a picture of my teeth,” says 64-year-old Keong, who has used heroin for almost 50 years. “That’s what drugs do.”
Manager responsible for Zurich operating rooms Florian Meyer stresses that the drug trade is not free, but that there are defined rules for it.
Sellers must be seriously addicted themselves. Microdilation must take place in a designated part of the operating room, such as a smoking area, and it must be inconspicuous.
– We don’t want to see a drug kiosk, scales on the table or money changing hands. They know the rules, Meyer describes.
He justifies the permissive line with practicality. The city does not want the drug trade to nest in the surroundings of the utility rooms. By tolerating microdealing inside the premises, the authorities are able to control who has access to shopping and who does not.
Only adults registered in Zurich can enter.
Drug dealers making large sums of money are not accepted on the premises. In addition, there is zero tolerance for drug dealing and the use of substances in the vicinity of the operating rooms. The police and social workers patrolling on foot monitor the situation.
Violation of the rules results in a ban on access to the utility rooms. According to Meyer, even a short ban is a tangible punishment for addicts, because at the same time they lose access to drugs.
There are utility rooms in several other cities in Switzerland. The line is not everywhere as liberal as in Zurich. For example, in the operating rooms of Geneva, microdilution is prohibited.
According to Meyer, in cities that prohibit microdilution, disorder related to the street drug trade occurs around the operating rooms.
“Freebase was my downfall”
The long-haired man, gesturing briskly, introduces himself and agrees to an interview.
The man says his name Keongbut he is called To Tiger. He says that he is 64 years old, from Southeast Asia, and that he has been using heroin since he was 15-16 years old.
Tiger is one of Kaserne’s regular customers. He receives opioid medication for his heroin addiction through a substitution treatment program. But that’s not enough, so he comes to the utility room almost every day.
– I’m an addict. I miss the mix of heroin and cocaine. I’m crazy about it. We call it a cocktail. It cannot be replaced because there is something missing in replacement therapy. I’ll get those cookies. Freebase was my downfall, Tiger describes.
He considers allowing microdilution in the premises of the operating rooms to be a good practice, because addicts buy substances anyway. Tiger himself admits that he sells drugs sometimes.
– We don’t make a lot of money with it. It goes to finance own use and maybe food and other things like that. Sometimes we are so penniless that we have to beg, says Tiger.
The man starts talking about his life at length. He worked as a mechanic at a factory for 25 years. At that time, drug use was still somewhat under control. He had a wife and three children, but the marriage ended in divorce. There were scrimmages and punishments.
Tiger states that addiction is horrible. He says that he tried to get off drugs several times. Nowadays, simply controlling the usage would be enough. The problem, he says, is that you can never have enough freebase.
In Tiger’s opinion, recovery rooms are an important service for addicts, because the social workers who work in them advise and try to help clients with various problems. At the same time, drugs stay out of the street scene.
– I do not care. But it is not nice if children and tourists see when drugs are inhaled, smoked or injected into a vein. It will be a bad image, says Tiger.
interviewed Tiger before filming his drug use.
From the needle park to utility rooms
In the 1980s and 1990s, the drug situation in Zurich was one of the darkest in Europe. For example, Platzspitzpark, located next to the main train station, was known as Neulapuisto because heroin was openly sold and spiked there.
Every day, up to 2,000 people came to the park to buy drugs, and there were many overdoses.
– At that time, AIDS was a new problem. We found that many people contracted HIV through use. We had to do something, recalls the retired doctor André Seidenberg.
He was involved in solving Zurich’s drug problem, and during his career ran clinics that distributed heroin and methadone to addicts.
Platzspitzpark, located between the Sihl and Limmat rivers, was once one of the worst drug dens in Europe. It’s cool in the park these days.
At its worst, there were about 25 overdoses in the park every day.
In the early 1990s, a needle exchange point operated in this building. Up to 10,000 dirty needles were exchanged for clean ones a day.
The authorities decided to set up operating rooms to combat drug abuse. The first of them was opened in Zurich already in the early 1990s.
Currently, there are three operating rooms in the city. Two are located in the center and one further away. The premises are open at different times during the day, so that there are no significant disturbances in the environment of a single place. They are closed at night.
Utility rooms could be characterized as havens for addicts. The average age of customers is currently 51 years. Many were already involved in Platzspitzpark’s drug scene in the 80s and 90s. People under thirty are the smallest customer group, says Florian Meyer, Zurich’s manager responsible for operating rooms.
According to Meyer, drugs are used a total of about 28,000 times a month in the city’s three drug rooms. He considers the number significant. So every day, drugs are used several hundred times in each operating room.
– It serves as a good justification for politicians and neighbors when we say that these 28,000 uses take place in our premises and not in public places or private apartments, says Meyer.
Along with heroin, the most common drug in Zurich’s operating rooms is freebase cocaine. It causes a strong but short-lived euphoria, so it must be smoked at regular intervals to maintain intoxication. The substance is highly addictive and can cause a fatal overdose.
– These are seriously addicted people. They use it all day, says Meyer.
He states that, according to wastewater studies, Zurich is one of Europe’s most significant cocaine concentrations. At the moment, however, the use of freebase is not increasing. The future situation can only be guessed.
About 65 percent of the clients of Zurich’s operating rooms fall under the scope of heroin-assisted treatment due to opioid addiction, says Meyer.
Replacement treatment can be accessed quickly
An effective substitution treatment program is one of the foundations of Switzerland’s drug harm reduction policy. Replacement therapy patients can also receive heroin from a pharmaceutical company.
Located in Zurich, the Arud Center for Addiction Medicine runs Switzerland’s largest addiction treatment clinic. The center has approximately 1,500 patients in opioid replacement therapy.
The rule is that opioid addicts without previous treatment can get treatment immediately without an appointment, says Arud’s psychiatric manager Thilo Beck.
– We know that every day in opioid replacement therapy is a safer day. “When our patients are using illegal opioids out there, they are at a much higher risk of dying or having complications,” Beck says.
A 20-year-old working in the IT field Leon is one of Arud’s patients receiving heroin treatment. He appears in this story under a pseudonym because the employer does not know about his opioid addiction.
Leon says that he started using opioids at the age of 15 with oxycodone. It is a very powerful pain reliever that caused the large opioid epidemic in the United States.
– I was able to spend 1-2 years without getting physically hooked. Then I slowly became addicted to oxycodone. At the age of 17, I sought treatment at Arudi. I have been in replacement therapy for three years now, says Leon.
According to Leon, there are many advantages to accessing replacement care. First of all, he doesn’t have to do illegal things like buying substances off the street and spending large amounts of money on them. Second, medical heroin is pure, so he does not have to fear the health risks of impure street drugs.
– I can say that I live a normal life. I work as a software engineer and study computer science. The treatment does not mess up my work and school life.
Leon says that he has never been to a drug room. He thinks they are suitable for people who don’t have a clean place to use substances.
The drug problem went out of sight, not solved
Customers of utility rooms are allowed to stay in the premises even during the entire opening hours. For example, there is food and the opportunity to take a shower and rest.
In addition, the staff gives addicts counseling related to drug use, health and social problems.
Director Florian Meyer says that operating rooms are a very effective and inexpensive way to reduce drug harm. In 30 years, no one has died from an overdose in the facilities in Zurich.
Overdoses do happen, of course, but the staff handles milder cases. A total of around 17 potentially fatal overdoses occur in operating rooms each year. Then an ambulance is called, says Meyer.
According to him, the use rooms have removed visible drug use from Zurich’s streetscape so effectively that people sometimes think the problem has disappeared.
– It is important for us to show the people that the drug problem still exists. It has not been resolved, but users are in these places. We still need support to develop our services for the future, says Meyer.
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