Diacetylmorphine (pharmaceutical heroin) substitution treatment is intended for individuals with a severe heroin addiction. It is administered in specialist centres.
Diacetylmorphine-assisted treatment (treatment involving the prescription of heroin, also referred to as “HAT” treatment in Switzerland) consists of the strictly regulated and controlled administration of diacetylmorphine, accompanied by medical and psychosocial care. It was first tested in Switzerland in 1994 as part of a cohort study. In the light of the positive results obtained, it was adopted as a therapeutic measure and included in the Narcotics Act in its revised version of 2011. In 2019, some 1700 addicted persons received this treatment in 22 specialist outpatient centres and one penal institution. Around 8% of addicted persons in Switzerland thus benefit from diacetylmorphine-substitution treatment.
The FOPH is responsible for issuing licences for this treatment, for its monitoring and controlling, and for providing information pertaining to it.
The goals of diacetylmorphine-assisted treatment are similar to those of other substitution-based treatments:
- to build a long-term therapeutic alliance
- to improve the physical and mental health of those affected and promote their social integration
- to facilitate low-risk use and create the conditions for permanent abstinence
- to distance those affected from the illegal drug scene and prevent crime associated with the supply of drugs.
Diacetylmorphine-assisted treatment has been scientifically monitored and evaluated since 1994. The results show clearly that a constant improvement results in the addicted individuals’ mental and physical health as well as in their social situation. Crime levels have been clearly reduced.
The criteria for admission to diacetylmorphine-assisted treatment are as follows:
- minimum age 18 years
- severe heroin dependency for at least two years
- at least two unsuccessful treatment attempts (unsatisfactory results or treatment discontinued)
- physical, mental or social consequences of drug use.
The FOPH has the following tasks in respect of diacetylmorphine-assisted treatment:
- issuing licences to institutions, physicians and patients
- monitoring the institutions and carrying out related controls in cooperation with the relevant cantonal authorities
- coordination of the “HAT” network for diacetylmorphine-assisted treatment in order to promote the pooling of experience and knowledge
- compilation of the annual report on diacetylmorphine-assisted treatment
Heroin-assisted treatment in Switzerland: Results of the 2019 survey (in French) (PDF, 2 MB, 21.07.2021)Résultats de l’enquête 2019
Heroin-assisted treatment in Switzerland: Results of the 2018 survey (PDF, 6 MB, 26.02.2020)Gerhard Gmel, Florian Labhart, Etienne Maffli
Heroin-assisted treatment in Switzerland: Results of the 2016 survey (in French) (PDF, 765 kB, 15.08.2017)Résultats de l’enquête 2016
Heroin-assisted treatment in Switzerland: Results of the 2015 survey (in French) (PDF, 195 kB, 11.02.2021)Résultats de l’enquête 2015
Diacetylmorphine-assisted treatment is strictly regulated. The legal basis is as follows:
Last modification 06.08.2021