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Open drug scenes 1

Helge Waal 2004 1

Comparative overview of public nuisance features with regard to open drug

scenes and different approaches taken by European Countries to address

them

Paper prepared to Pompidou group meeting

Strasbourg November 18

-19

2004

Helge Waal, Unit of Addiction Medicine, University of Oslo

Content

Introduction ................................................................................................................................ 2

Switzerland – the Zurich experience.......................................................................................... 3

Developement......................................................................................................................... 3

Austria - Wien ............................................................................................................................ 5

Germany - Frankfurt am Main ................................................................................................... 8

The development.................................................................................................................... 8

Reactions to the Taunusanlage............................................................................................... 8

The development.................................................................................................................... 9

Harm reduction as a systematic policy................................................................................. 10

Prevention of open drug scenes............................................................................................ 10

Norway – Oslo ......................................................................................................................... 11

The development.................................................................................................................. 11

“Expensive Oslo is cheap fix capital”.................................................................................. 11

The crisis .............................................................................................................................. 12

Typical development................................................................................................................ 12

Typical measures...................................................................................................................... 13

The “chasing around”............................................................................................................... 14

“Kindness is not enough”......................................................................................................... 14

Some preconditions for a positive development ...................................................................... 15

Consensus and cooperation .................................................................................................. 15

Acceptance of the drug user as a citizen .............................................................................. 15

Some concluding remarks ........................................................................................................ 18

References ................................................................................................................................ 18

Open drug scenes 1

Helge Waal 2004 2

Introduction

Seen in a historical perspective, the open drug scenes are a new form of an old phenomenon.

A larger or smaller fraction of most populations drift from the local communities towards the

city centres. Some seek new opportunities, others and escape from the control and scrutiny of

tighter neighbourhoods. Some want to unfold personal preferences of various sorts, others to

escape the stigmatization from societies negative to their behaviour or appearance.

A rich sociological literature deals with these aspects of modern society, partly with focus of

society’s incarceration and suppression of the mad, the wild and the misfits (1) and partly

with focus on consequences of and solutions to processes arising from industrialization and

modernisation of western societies (2). For this purpose, suffice it to point to some typical

societal responses. On the one extreme we find the zero tolerance approach with heavy

emphasis on criminalisation and incarceration, in particular consequently practised in

authoritarian societies. On the other extreme we find the humanistic helping and sharing

responses originating in particular from aspects of Christian traditions. In between we find

the Nordic welfare state built on the idiom “do thy duty, demand thy right”. Society has the

duty to solve problems and furnish solutions, but the deviant citizen should fall in line or

accept treatment and restrictions (3). We do also find societies where the families, the church

and welfare organisations furnish a network disciplining and accommodating the deviants

engulfed in informal, sometimes quite strict, rules and caring institutions. In the middle on

might describe a sort of “red light district” approach where society accepts deviant forms of

behaviour as long as this do not cause significant public nuisance. In formal and informal

zones of tolerance deviancy is let alone. These societal responses are deeply ingrained in the

thinking and problem solving behaviour, not only of the politicians and administrators, but

also of the public, the police and treatment professionals. New problems are therefore met

with responses typical for the respective society (4).

The open drug scenes are both a new and an old phenomenon. The city centres has long seen

aggregations of individuals with alcohol problems, different types of deviancy and poor

compliance with societies rules and often with problematic family histories. Most cities have

found ways to meet the situations with a mixture of measures from society’s traditions.

The aggregations of users of illegal psychoactive substances that have appeared in the large

European cities the last decades obviously represent new aspects of this old phenomenon.

Several phenomena lie behind. One is the cultural and political opposition from discontented

youths in a particular historic period. The second is ambivalence and split response from

society. The third is the oppression of use of new drugs caused by both realistic and

unrealistic fears. The fourth is increasing numbers of individuals seeking refuge from

increasing demands in production and education. The fifth is increasing numbers of

immigrants and asylum seekers from countries with availability of drugs and high levels of

misery. The sixth is the problems of illegal drugs; varying availability, high profits, attraction

of hard-core criminal groups, alienation of drug users from health care, variable scenery of

possibilities for profit and drugs mixed with defiance and desperation.

On this background several European cities have experienced an unparalleled growth in

aggregation of drug users in the city centres during the years from the end of 1970’s and the

early 1980’s. The phenomenon has often initiated in hippie type of adolescents characterised

by opposition to societal norms, by guitars and cannabis. In others the pattern was more

dominated by poverty, unemployment and bitterness. In both cases, the development grew in

Open drug scenes 1

Helge Waal 2004 3

seriousness with attraction of problematic personalities and persons with criminal behaviours

and patterns.

The concept of open drug scene (5) covers differing elements. The term is used for meeting

points where drugs are sold and for places where users aggregate and meet each other. It is

also used in describing the problems of nuisance and public reactions to the scenes and the

development of subcultures that might be experienced offensive. According to Bless et al (5),

there is no generally accepted definition of a drug scene as locations, types of drugs and types

of users might vary. The core concept is of course that several users meet and that drug are

sold and used. The open drug scene is defined by Bless as “all situations where citizens are

publicly confronted with drug use and drug dealing”. This definition will be used in this

paper.

I do not profess any particular authority in the understanding or solving of these complex

problems. My background is solely one of a psychiatrist in the field of substance abuse

treatment in Norway, living thorough and partaking in the different attempts to lessen the

problems. This paper is prepared on the background of participation in the COST A 6 project:

Evaluation of Drugs in Europe (6), in particular in a working group on “Evaluation of

Policies, Policy changes and Societal Responses to Politics”. This project, headed by

Professor Ambrose Uchtenhagen brought several seminars and working groups with sharing

of thoughts and experiences together with visits to some of the European scenes and

discussions of some of the measures undertaken. Further, I have visited Frankfurt,

Amsterdam, Zurich, Vienna and Copenhagen on several occasions, partly observing the

scenes and partly discussing the development and the measures. I have also supervised a EU

project evaluating the measures taken to meet the problem of overdoses in Amsterdam,

Frankfurt, Copenhagen and Oslo (7). In the preparation this paper, I have made a database

search of Medlin, PubMed, Psychlit and Sociological Abstracts with the search words “open

drug scene”.

In the following I will describe five city cases with emphasis on developmental traits and

societal measures and attempt to point out share and non-shared approaches. The aim is to

elucidate fruitful and not so fruitful patterns.

Switzerland – the Zurich experience

The description is based on papers by Klingemann (8) Falcato et al (9) Fuchs (10), Huber (11)

and Uchtenhagen (12) and repeated visits.

Developement

During the late 1970’es the Zurich drug problem was minor and largely contained by

increasing police repression. However, there was a steady rise in notified drug users and a

growing illicit marked. Therapeutic Communities, first Methadone maintenance programmes,

specialised outpatient drop-in centres and a specialised mobile emergency service were set up

to reach out to those in need for treatment. Social psychiatry coordinated these efforts and

established links to self-help groups and parents associations. During the 1980’ies the

situation changed with political and cultural controversies expressed through campaigns for

autonomous youth centres, solidarity with marginal groups such as drug users. The users

gathered in the city centre, finally settling in particular in a park in the city centre, the

Platzspitz from 1986. This scenery became well known and attracted drug users, not only

from different cantons in Switzerland but also from surrounding countries. According to

Open drug scenes 1

Helge Waal 2004 4

Klingemann (8) the scene was also infiltrated by international “drug mafia”. More than 3000

addicts visited the scene that rapidly grew out of supervision and control.

In parallel the city experienced rising problems. Drug related crimes increased in particular in

the neighbourhood of the drug scene. Deteriorating conditions for the drug users on the scene

caused serious concern. The drug related mortality tripled within 5 years. This development

caused polarised debates and several policy shifts. Initially the predominant reaction was one

of tolerance and increase of helping and therapeutic measures. The traditional approach with

emphasis on motivation, selection from outpatient to in patient service with follow-up

services aimed at abstinence was experienced as inadequate. The result was a growth in “aid

for survival” approaches, low threshold programmes with out reach teams including shelters,

primary medical care, meals, work – offers and needle-exchange. Special approaches such as

no – preconditions methadone programmes, services for special needs such as “female sex

workers” and “street rooms” – fixer cafeterias. The programs included drop-in centres with

cheap meals, showers, toilets and Laundromats combined with medical services and needle

exchange. The methadone programmes included a facility that offered computerized

distribution of methadone where the users autonomously decided on the dosage preferred

within a permitted range by use of a personal magnetic card (8). Three leading political

parties formulated a joint drug policy platform, and in 1991 the Federal Government

proclamed the “4-pillar-drug-policy” (Prevention, Treatment, Harm Reduction and Law

enforcement).

According Huber (11) the result were problematic. The vicinity of the drug scene experienced

ever increasing pressures of petty crimes and social nuisance, and the “pull-effect” of the drug

scene was a destructive element. According to Uchtenhagen (12) the “drug scene became a

subcultural world of its own, attractive for all kinds of people who were not only looking for

drugs but also for e.g. contact, suspense or easy sex. The social problems increased and the

political pressures rose until the police closed the Zurich Platzspitze in the spring of 1992.

In the continuance the police activities increased – with an increase in recorded offences from

23 000 in 1991 to 40378 in 1994. Uchtenhagen (12) judges the result to be a disaster as the

addicts and the pushers moved to neighbouring residential quarters and made backyards and

playgrounds unsafe. A new, less open open drug scene established itself in the Letten station,

a closed down railway station where a core group of 250 – 300 heavy users became a core

group and 2500 “passing clients” belonged. The problems of increasing violence, gang wars

caused public protests and reaction. A “citizen action group” called for tough and immediate

actions and posed an ultimatum in October 1994; unless the authorities closed the drug scene

within a time limit, concerted actions by “doctors, dogs and private detectives” would take

action (8).

Then followed the adoption of a joint strategy in a “Letten plan” by the federal, cantonal and

municipal authorities, replacing a long controversy between cantonal and city administrations.

According to a “three step plan” the raiding of dealers were sharply increased.

Decentralization” was systematized. The non-Zürich citizens were to receive their treatment

in their home districts, if necessary by arrest and medical check-up in a detention centre

followed by assignment to appropriate treatment and eventually out-transportation. The

communes had funding for their helping and caring facilities from the Cantonal Government

and “aid-for–survival” measures were increased. The harm reduction approach became a core

aspect with increase in heroin dispensing.

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Opendrugscenes1HelgeWaal20041ComparativeoverviewofpublicnuisancefeatureswithregardtoopendrugscenesanddifferentapproachestakenbyEuropeanCountriestoaddressthemPaperpreparedtoPompidougroupmeetingStrasbourgNovember18th-19th2004HelgeWaal,UnitofAddictionMedicine,UniversityofOsloContentIntroduction...........

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