For many years drug users in Bem were not allowed to use public facilities such as restaurants and cafés and, therefore, had nowhere to rest and meet friends. This led to an open 'street drug scene' developing, which drew many complaints froin local people. Consequently, in 1983, a group of employees of the Contact Foundation in Bern decided to establish a project for drug users, where they could rest, get a hot meal and a drink. Apart from simply providing a meeting place, the workers' aim was to also establish a cultural centre to provide alternative activities and stimulate other interests in drug users. It was planned to have video-projects, guided theatre visits, promote self-help initiatives, and so on.
A suitable venue was found near the drug scene, but there was no money for the necessary constructional alterations. However, after long negotiations, the construction work began in 1985. For this work the group engaged unemployed junkies. This experience proved so encouraging that the project still exists today, as an independent progranune. The café finally opened the surruner of 1986 but, by this time, the drug scene had moved because their meeting place had been closed temporarily due to the construction work.
Looking back, we have learnt a lot from the experience of establishing such a revolutionary concept and we can also learn that in the development of such an idea there are crucial points. Responsibility for developing the concept on a day-to-day basis was an unexpected event which, although perceived as an occasionally unthinkable demand from the clients at the time, was not stopped. So, the concept of the centre was developed to provide:
— a room for junkies where they can meet without being forced to buy or consume anything, as is expected in a regular restaurant;
— a café bar which has sandwiches, cookies, yoghurts, fruits and hot and cold drinks available, but no alcohol;
— clean needles, syringes and condoms, free of charge, for everybody. Information on safer drug use, safer sex and proper use of condoms is also on display.
— A café, run by social workers who are willing to talk and to counsel the clients.
— A second room where the consumption of intravenous drugs is allowed. One of the main aims is that the consumption of drugs should be possible in a hygienic and stress-free manner, which means that there should be enough time for everyone to test the drug through injecting a small amount first. Clients are encouraged to exchange information about the purity of the drugs.
— Safer drug use techniques, like 'chasing the dragon', should be promoted and unsafe methods like sharing injecting equipment eradicated.
Later we added to this a health service operated by nurses, who provide counselling, deal with physical problems such as abcesses, charige dressings and so on.
The news about this place quickly spread through the drug scene. The uptake of this project was tremendous; despite the fact that most drug users gathered at another location, they moved during the opening hours to our place.
However, from the beginning we encountered a lot of difficulties — drug-related, environmental and legal. For example, we had to deal with overdose cases, so all the workers are trained in First Aid and resuscitation, but we use Ambubags to avoid direct contact. Respiratory failure was most common on days when the quality of the drugs was high. We do not use Naloxone as we believe this is only manageable in a hospital and overdosing on opiates alone is rare. We have to take into account that people are using a variety of drugs — heroin, cocaine, Flunitrazepam (Rohypnol), alcohol and other substances — in an unknown mixture.
We also had problems with the neighbourhood. The shopkeeper next door claimed to be losing sales, so we changed the opening hours of the café to between 7 and 10 p.m. on Monday to Wednesday and Friday.
On top of these problems the legal situation was still unclear. Two employees who talked about the project in public were accused of letting people know where they could consume illicit drugs, and were charged with 'assisting others to commit an offence' which is forbidden by drug law. The charges were later dropped, because consumption of illicit drugs is not a major offence and for minor offences the accusation of 'assisting others' does not stand in Swiss law in general.
However, Swiss law worlcs on the principle of legality and not of opportunity. This means that if the police know where illicit drugs are regularly being used they have to react, i.e. to chase the drug users until they no longer know where to go to take drugs. At this crucial point, we got help from the legal system. From personal contacts the authorities had always been informed about our work and, even though they did not totally agree with our concepts, they had some respect for it. A working group of judges and prosecutors met to find a way for the project to operate that was still consistent with the law. They found an article in the drug law which states that if someone is receiving medical treatment it is possible to drop criminal proceedings for consumption of illicit drugs. So they agreed that we were running this project under the basic premise of providing medical treatment. We agreed to ensure that no dealing took place on the premises and that minors were sent away. Under these conditions the police were advised to drop any further action against the centre and its clients, which they have respected so far.
Our local authorities came under pressure from the administrations of other cantons, mainly Zurich, but they stood finn. One of the most famous professors of penal law came to the same conclusions, so it is generally no longer considered as unlawful. This has encouraged several other Swiss cities to establish 'Fixerstueblis' (Basle, Lucerne, St Gallen).
Meanwhile, news about the project had spread all over the world. We were soon inundated with TV teams, journalists and professionals wanting to study the project and interview the clients. We had to be very unfriendly to many of them to protect our clients and to prevent them from beconung exhibits in a human zoo. Also, it was not desirable to have too much publicity as we had enough problems to deal with.
As the project became more successful in attracting clients, it also attracted the dealers, who hung round outside the agency during opening hours. This made the project even more attractive for drug users as they knew that they could score near our agency during opening hours. The place slowly became overcrowded. More people meant more problems with the neighbours. We told the authorities that in order to disperse the problem we badly needed a second similar place, but there was no money and there were no other suitable premises.
Meanwhile, our landlord had had enough and terminated the contract of tenancy. The only thing we could do was stall until we could open another place. The project that had opened in summer 1986 finally closed on 12 January 1990.
A NEW BEGINNING
After some time we found a suitable location — a cellar (Nageligassel that belonged to the city. However, we were unable to begin operating from the new location straight away because of long negotiations with the authorities, and also because there was an election during which no one wanted to make a decision. During these discussions, it was mainly the director of police who opposed the project.
It was obvious that, with only one room, we would soon encounter all the same problems that we had with the first premises. So we deCided to set up temporary premises near the open drug scene, on a place called 'Kleine Schanze' or 'Schanzli'. This opened on 15 January 1990 as the successor to the first project, but had to close a few days later because of operational difficulties: it was much smaller than we had wanted, there was no room for counselling, there was enormous stress on both cliehts and workers and, to top it all, the police photographed everyone coming in and out. So we covered the entry with a tent, broke through a wall to enlarge the space and demanded an additional unit. This addition was prornised for the end of April and the place reopened. The second location, the cellar, was supposed to open in June 1990.
On 2 April the authorities closed the public toilet where the open drug scene was centred and the scene moved to our temporary premises at Schanzli. The place quickly became overcrowded each night and it was almost impossible to pass or enter our building. Inside, you could not go one step without colliding with someone. Providing care, which is what we set out to do, was virtually impossible. We were just about able to give out clean needles, syringes and condoms and were ready for emergencies, like resuscitation. Consequently, we need to re-think our aims to adapt to the circumstances.
EFFECTS OF THE PROJECT
In setting up a street-level drugs agency with shooting room, the Contact Foundation of Bern established a service for drug users that was, from the very beginning, at the heart of the drug scene. With this project it was possible to reach drug users who had had no previous contact with any helping agency. The close proximity and easy access to the project meant that workers were much closer to the daily reality of their clients and, consequently, relationships became more genuine. With this growth of trust came many examples of the positive impact the project has had on clients' lifestyles. By providing information, advice and education, the project has enhanced the self-awareness of the drug user. Therefore, the drug scene is more visible today and the junkies do not hide which, in our opinion, is very important for the political process. More importantly, since the project started there have been no deaths due to overdose in the neighbourhood of the agency.
A recent Swiss study of former alcoholics and drug addicts demonstrated that giving up the habit of taking alcohol or drugs was typically related to situations where negatively experienced stress was lowered. We are convinced that our service helps the user to plan new steps towards an improvement in their lives. But, as all our energy has been,devoted to establishing the service during the past four years, there has been no time (or money) for scientific evaluation. However, as we are frequently asked for results, mainly from politicians, we have established a research programme, which is about to start. At last, the project may serve as a model for other cities.