March 26, 2024 – ZURICH — The lobby of this addiction clinic is unremarkable, except for the network of metal chutes and tubes that hug the walls as they snake downward from a pharmacy on the upper floors. Every few minutes, a new prescription comes clattering down, delivering a bottle full of powerful and effective pills used to treat opioid addiction … But at Arud Centre for Addiction Medicine, a leading Swiss clinic, all patients in need of addiction care are given instant access to weeks’ worth of medication. They are not required to participate in counseling, or subjected to drug tests, or punished if they relapse and use illicit substances. It is a strategy that many American methadone clinics warn would result in disaster — but that European experts say is the continent’s key to success.

“We have access to a very broad population because it’s so easy to access our treatment center,” Philip Bruggmann, a Swiss doctor and Arud’s head of internal medicine, told STAT during a recent visit to the clinic’s headquarters in central Zurich. “This wouldn’t be possible in a system which is very restrictive, where people are getting kicked out of the program or disappearing because they can’t comply with the regulations and rules. I think we would lose a lot of patients. They would die.”

Instead, the opioid death rate here is roughly one-twentieth the rate in the United States. The country has become a model for a highly effective, evidence-based policy response to a drug epidemic. And in roughly a dozen wealthy, developed nations where methadone is far more accessible than in the U.S., public health outcomes are far better.