In the 1990s Switzerland, facing Europe’s highest HIV infection rate from injection drug use, initiated a trial of either heroin maintenance or of methadone treatment supplemented with heroin. The findings were: fitness for work improved considerably: permanent employment more than doubled; patients’ housing situations rapidly improved and stabilized (in particular, there was no homelessness); no fatal overdose due to prescribed substances; no notable disturbances in local neighbourhoods; significant economic benefits in terms of savings per patient-day, owing to marked reductions in legal and
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