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 2021, 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.
Further information on the various licences may be found on this page.
Goals
Results
Admission criteria
Tasks of the FOPH
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:
Heroingestützte/diacetylmorphingestützte Behandlung in der Schweiz 2021 (PDF, 7 MB, 21.12.2022)in German
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
Documents
Request to reduce the time limit for the dispensing of diacetylmorphine (PDF, 179 kB, 26.04.2023)available in German and French
Request for the exceptional dispensing of up to one month's supply of doses of diacetylmorphine (PDF, 202 kB, 26.04.2023)available in German and French
Notification of delegation within the framework of prescribed diacetylmorphine-assisted treatment (PDF, 202 kB, 26.04.2023)available in German and French
2020-2021 Diacetylmorphine-assisted (heroin-assisted) treatment: situation analysis
- Traitement avec prescription d’héroïne: analyse de la situation: Prise de position de l'OFSP 2021 (PDF, 212 kB, 12.11.2021)(only in French)
- Situationsanalyse der HeGeBe: Executive Summary 2021 (PDF, 157 kB, 12.11.2021)(in German)
- Situationsanalyse der HeGeBe: Schlussbericht 2021 (PDF, 1 MB, 12.11.2021)(only in German)
- Situationsanalyse der HeGeBe: Pflichtenheft 2020 (PDF, 474 kB, 05.06.2020)(in German)
Heroin-assisted treatment in Switzerland: results of the surveys
Results of 2019, 2020 and 2021: please consult the German or French page.
Links
List of centres providing diacetylmorphine-assisted treatment (“HeGeBe” treatment)
- Anstalt Realta Cazis
- Arud Zentrum Horgen
- Arud Zentrum Zürich
- ASBO Ambulante Suchtbehandlung Bener Oberland
- Biwak Burgdorf
- Drop-in
- HeGeBe ZOPA Zug
- HeGeBe-SH, Schaffhausen
- Ikarus Winterthur
- Janus, Basel
- KODA Bern
- Medizinisch-Soziale Ambulatorien Zürich
- MSH St. Gallen
- Neumühle Chur
- PDAG Windisch
- PEPS Genève
- POLADD Lausanne
- Psychiatrische Dienste Olten
- Psychiatrische Dienste Solothurn
- PZW Wetzikon
- Réseau fribourgeois de santé mentale: addiction et centre cantonal d'addictologie
- Suprax Bienne
- Zentrum für Abhängigkeitserkrankungen (ZfA) Basel-Land
Legislation
Diacetylmorphine-assisted treatment is strictly regulated. The legal basis is as follows:
Last modification 31.03.2023
Contact
Federal Office of Public Health FOPH
Prevention Non-communicable diseases Division
Schwarzenburgstrasse 157
3003
Bern
Switzerland
Tel.
+41 58 463 88 24