A little more than a decade ago, Switzerland embarked on what is by all accounts a successful program of prescribing heroin to addicts. Now, some doctors are calling for that program to be expanded to include prescribing cocaine as well, the Swiss news agency Swiss Info reported last week. The Swiss government isn't so sure, however, especially with a controversial vote on decriminalizing cannabis set for later this month.

At a national conference on addiction in Bern last week, doctors broached the topic with government officials. "Of the 150 heroin patients I have here, perhaps a third of them could also benefit from cocaine prescription," said Dr. Daniel Meili, who heads Zurich's prescription heroin program. "They come here to get the heroin, but they are also addicted to cocaine, which they buy on the illegal market. "They can spend between [$8,000-16,000] a month to feed their habit, which means they are often involved in crime."

According to the Swiss government, there are some 90,000 cocaine users in the country, although many of them are recreational users. Drug-related crime increased 6% last year, the government reported.

A typical client for prescription cocaine would be a multi-drug addict already receiving prescription heroin, said Meili. Clients who remain strung out on cocaine do not reap the benefits enjoyed by the heroin prescription program's other clients, such as improved health, more stable lifestyle, even regular employment, he said. "The mortality risk among these patients is quite high," he said. "Without treatment, many of them will die in the next ten years."

But the Federal Health Office, which doctors look to for assistance, isn't so sure. "There's just no evidence that such a scheme would be successful," said Markus Jann, head of the drug addiction department. "We would be very hesitant about trying such a thing, and anyhow we have more important addictions to tackle, such as alcohol or tobacco," he told Swiss Info.

Still, the ultimate decision on whether to allow a prescription cocaine program lies with local authorities, and in Zurich doctors and officials are in the talking stages of a trial program that would involve around 20 patients. "If Zurich wants to try, we won't be against it," Jann told Swiss Info. "We will follow it with interest, but there's no reason for us to finance it. There are many different options for treating cocaine addiction without working with cocaine itself. We haven't tried everything yet."

The government is also reluctant to pronounce on something as potentially controversial as prescription cocaine because of nervousness over a looming vote on a government measure that would decriminalize cannabis. "The Federal Health Office -- which spent months drafting the legislation and lobbying for it ?fears that a rash move towards cocaine prescription could encourage opposition to the law," Swiss Info reported.

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