Addiction services put individual needs ahead of abstinence

Addiction support increasingly focuses on what helps each person, rather than making abstinence the only goal, SRF reports. Heinz, a 59-year-old who has lived with addiction for 40 years, says he has reduced his drug use but cannot imagine giving it up completely.

Heinz lives at a facility run by the Pfarrer Sieber Foundation in Zurich Affoltern. “The problem is not getting clean. The problem is staying clean,” he says. He adds that life has become calmer since his consumption fell sharply about 10 years ago.

For 35 years, the foundation’s Sunnedörfli facility in Sihlbrugg emphasised distance from the drug scene and abstinence. The building has been empty for more than a year and is due to be sold.

Kuvinda Kossinna, co-chief physician at the foundation’s specialist hospital, says experience and research have shown that abstinence is not realistic for everyone, especially people with severe addiction. Support often begins with stabilising a person’s situation. For people dependent on heroin, opioid agonist therapy can replace opioids in a controlled way, save lives and help them address their health, housing and daily routines.

The aim is to reduce health and social harms, not necessarily to stop all drug use immediately. Support can include medical and psychiatric treatment, secure housing, daily structure and social contact. Some people later become abstinent; others need opioid agonist therapy for years. The priority, Kossinna says, is the best possible quality of life with as little harm as possible.

Heinz says success for him means living as steadily as possible, rather than becoming completely drug-free. Kossinna says that for people who want to live abstinently, distance from the drug scene can still help, alongside community and daily structure.