The Swiss experience From the four pillars policy to a new Strategy on addiction

Jann Schumacher

Date:  September 6th 3:30pm Main Ballroom


In the late 1980s Switzerland faced the HIV and open drug scenes crisis rethinking his drug police practices: health professionals started innovative public health programs at local level introducing harm reduction practices like low-threshold methadone programs, needle exchanges, safe injection rooms and heroin-assisted treatment. In 1991 the goals of the Swiss drug policy became to lower negative consequences for drug users, lower negative consequences for the population and reduce the consumption of drugs. At the same time prevention, treatment and repression maintained a key role and the cooperation between the different actors was strengthened.

Evaluations helped to shape policy debates and the results (increase in public safety, decrease of drug related crime, decrease in drug related death, decrease of HIV and injected drug use, increase in access to treatment) extended the public support so that the four pillars policy was confirmed by public vote in 2008.

The well established treatment system and a stable situation regarding drug use in Switzerland has led to define a new national strategy on addiction (2017-2024) which builds on the experience of the four-pillar policy while at the same time promotes new (integrative) approaches in treatment, harm reduction and prevention. It creates the basis for effective responses to new forms of addiction, differentiates between low-risk behaviour/risk behaviour/addiction, promotes cross-sector networking and cooperation. Early support and social integration are amongst the main goals.
The major current themes are the integration of addiction prevention in the noncommunicable diseases prevention, the extension of harm reduction to alcohol and tobacco (e.g. e-cigarettes), regulation (cannabis), support health-promoting conditions and ensure that addiction affected people receive effective treatment, with particular attention to interdisciplinarity (related to the rise of medical treatment).

Learning Objectives:

History of the Swiss drug policy and key factors of the four pillars policy (integrality of the four pillars, cooperation, the importance of local level and broad public support, pragmatic approach, evidence based);
Fields, goals and actions of the new National Strategy on addiction;
The current situation on addiction and major current themes in Switzerland;
The organization of the treatment system in Switzerland (access, assessment, outpatient, residential, costs, …) and the importance of integrated care
The role of Recovery Capital in Switzerland’s approach


Psychologist, University of Zürich (1996)
Training in cognitive behavioural therapy (1997-2000)
Director Residential alcohol treatment center, Ingrado – Servizi per le dipendenze, Lugano, Switzerland (1997-now)
President Ticino Addiction (Swiss Federation of Addiction Professionals)
Vice President Federal Commission for Alcohol Issues

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