The free provision of heroin to addicts won the overwhelming support of Swiss voters yesterday.

Projections based on early results indicated that 69 per cent of voters approved the programme, believed to be the first of its kind in the world, in a poll called under the country's system of direct democracy.

Crime by heroin addicts has fallen 60 per cent since the initiative to allow health clinics to administer controlled doses of the drug began 14 years ago, according to the Swiss Federal Office of Public Health.

The support for the plan came in a referendum called by opponents of a government policy that treats hardened drug users as patients rather than criminals. Critics, including conservatives who called for the referendum, object to the annual cost of 26 million Swiss francs (£14 million), covered by the health insurance that all citizens pay and the Government covers for those who cannot afford it.

While the Swiss have a more tolerant attitute towards drugs than most European countries, a parallel referendum to legalise small-scale cannabis growing and use was soundly rejected by a margin of about two to one.

The heroin scheme was introduced in response to a public outcry over the sight of addicts openly injecting the drug in public parks, as well as a rise in HIV and hepatitis infection. About 1,300 addicts are currently on the programme of carefully supervised doses, measured to satisfy their cravings yet avoid the risks of overdose and catching infections from dirty needles.

The addicts attend one of the country's 23 heroin centres and, in groups of four, inject themselves under the watchful eye of a nurse. They leave after a few minutes — those with jobs going back to work.

Daniele Zullino, of the Geneva University Hospitals, one of the heroin centres, said: “The aim is that the patients learn how to function in society. Heroin prescription is not an end in itself.”

Dr Zullino added that after two to three years in the scheme, a third of the patients started abstinence programmes and another third changed to methadone treatment, a much cheaper option, and the preferred approach in Britain. The majority of users have tried and failed to use the heroin substitute to wean themselves off the drug. Methadone remains the more common treatment in Switzerland, with more than 16,000 patients.

Christoph Buerki, a doctor at the clinic in Berne, which has 210 patients, said: “Their average age is 40 now and they have an average of 13 years of heroin addiction before they enter this programme. Basically we are aiming at a group of people where everything else has failed. We have medicalised heroin in Switzerland. It has the image of an ugly illness, and that is why, I think, numbers of new addicts are falling.”

Andreas Kaesermann, a spokesman for the Social Democrat Party, part of the coalition Government, said: “Thanks to this policy we do not have open drug scenes anymore.”

Parliament approved the heroin measure in a revision of Switzerland's drugs law in March, but conservatives challenged the decision and forced a national referendum.

Alain Hauert, spokesman for the right-wing Swiss People's Party, said: “I don't believe that health insurance should pay for this.” He said that he wanted the State to invest more money in prevention work and law enforcement.

Sabine Geissbuhler, of the Parents against Drugs association, said that giving patients heroin was not helping them to give up the drug. “It is an outrage that the State should give addicts heroin — it is poison. You do not give people poison to make them better.”

The US, and the UN narcotics board are also critical, but other governments have followed with experimental programmes modelled on the system. The Danish parliament approved state funding for 500 addicts earlier this year. There is limited legal heroin prescribing in Britain for a small number of long-term addicts.

While the Swiss Government backed the heroin initiative, it opposed the call for marijuana legalisation because it feared that it could cause drugs tourism to Switzerland of the kind that is causing public disorder problems in border towns in the Netherlands. Oswald Sigg, a government spokesman, said: “This could lead to a situation where you have some sort of cannabis tourism in Switzerland because something that is illegal in the EU would be legal in Switzerland.”

Swiss MPs voted 106-70 against legalising cannabis for personal use last year. Switzerland has recorded the highest level of cannabis use in Europe, according to a study last July. The use of hard drugs was also increasing among 15-year-olds, according to a report by the Swiss Institute for the Prevention of Alcoholism and Drug Addiction.

The cost

— Drug-related crime costs England and Wales more than £13 billion a year

— Of the people who had HIV diagnosed in 2005, 56.8 per cent of Swiss nationals had contracted it through injecting narcotics

— A survey in 2005 showed that 88.4 per cent of addicts not using clinics occasionally or frequently shared needles

— A report in Scotland showed that 97 per cent of those treated with methadone went back to drugs, compared with 71 per cent who simply went cold turkey

— Regular heroin users have a 20 to 30 times higher risk of death than non-drug users

Sources: US Drug Enforcement Administration; UN, WHO

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