Neuropsychedelia. Nicolas Langlitz
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to heroin. The artificial scarcity of heroin produced by police operations made the drug significantly more expensive and, consequently, the crime rate skyrocketed. Soon political pressure began to mount as an increasing number of citizens were affected by thefts, robbery, and the public display of abject misery in the neat streets of Zurich and Berne.
The United States responded to the failure of its counternarcotics policy by stepping up its interdiction efforts. The country imprisoned ever more drug users at home and reinforced its police and military operations in drug-producing countries abroad. The Swiss, however, decided on an almost antithetical response to the problem. In 1994, the Swiss Federal Office of Public Health (SFOPH) began to distribute heroin to addicts under medical supervision—a decision not without controversy, especially in the French- and Italian-speaking cantons, but overall it was supported by the Swiss citizenry (Fahrenkurg 1995).
In the late 1980 and early 1990s, the civil servants of the SFOPH were also grappling with a very different drug-related problem. The Swiss Medical Association for Psycholytic Therapy (SAPT) had asked for permission to use LSD, psilocybin, and MDMA for psychotherapeutic purposes. In 1988, the group received a special permit to administer these controlled substances to patients (Styk 1992/93; Saunders 1993). But this exemption remained problematic. In 1989, a new government official took over the Department of Pharmacy at SFOPH, where he would be in charge of both the logistics of the heroin program and the scientific and medical applications of hallucinogenic drugs. After initial skepticism, Paul J. Dietschy approved both uses. Neither America, trying to form a united front in its War on Drugs, nor the United Nations that was advocating a similarly repressive stance were pleased about the Swiss pullout from the internationally established hard line on the use of controlled substances. Representing Switzerland on the International Narcotics Control Board, the Commission of Narcotic Drugs, and the Commission Pompidou of the Council of Europe, Dietschy had to bear the brunt of international criticism. However, when Claudio Vannini and Maurizio Venturini interviewed him for their history of Swiss psychedelic science, Dietschy stressed the importance of drug research for Switzerland:
In the international research community, our experiments with heroin or hallucinogens have aroused much interest. In the past, the Americans were at the forefront of this area. But then their government did not approve of such research anymore for political reasons. (This attitude has recently begun to change again.) Switzerland is one of the few countries in which such experiments are possible at all. Politically, our experiments provoke much skepticism [on the international level]. This is not voiced publicly but has been articulated repeatedly in discussions with us. . . . Apart from that, the international treaties leave a lot of freedom to the member states as to the conduct in one’s own country as long as the interests of other countries are not affected. This freedom must be used for the benefit of Switzerland. (Quoted in Vannini and Venturini 1999: 269)
Here, the very technocracy that the counterculture had rebelled against by using psychedelic drugs endorsed their scientific investigation. This government support contributed significantly to the competitive advantage of Swiss hallucinogen research and helped to make Franz Vollenweider such an interesting collaborator in the eyes of his American colleagues.
When, during my fieldwork in 2005, I first came across Dietschy’s advocacy of the Swiss drug and drug policy experiments, I began to wonder about the relationship between the Swiss government’s backing of psychedelic science and its heroin program. Was there an underlying policy, a comprehensive plan, a broader cultural matrix constituting the regulatory conditions of the work I was about to observe in the lab? To find out, I arranged a meeting with Dietschy who, it turned out, was no longer working for the Swiss Federal Office of Public Health but had moved to Swissmedic, a new federal agency comparable to the American FDA that had just taken over the regulation of medicines (but not of controlled substances) from the Swiss cantons to establish a nationally uniform regulatory regime.
Paul Dietschy was an authoritative man in his fifties with a long moustache. He wore a dark gray suit, white shirt, and a paisley silk tie. We met in one of the conference halls of the new Swissmedic building. Glass walls separating the room from the foyer gave the institution an appearance of transparency. Dietschy had invited a second person to our conversation: a tall bearded man of about the same age, but more casually dressed in a gray shirt and a sweater. Rudolf Brenneisen was a professor of pharmaceutical science at the University of Berne. The careers of Dietschy and Brenneisen had been closely entwined. During the turbulent years of Swiss drug policy reform, Brenneisen had become Dietschy’s closest scientific ally. He conducted most of the basic science research, which Dietschy needed to back up his often difficult administrative decisions. Together they had shaped one of the most adventurous episodes in the history of twentieth-century drug policy. Reminiscing about the 1990s, they looked back on a time when the current regulatory regime governing the scientific and medical uses of controlled substances in Switzerland was still in the making. Dietschy began:
When I started my job in 1989, there was a medical association for psycholytic therapy, which wanted to do research on patients with LSD, ecstasy, and psilocybin. As these substances are prohibited, the Swiss Medical Association for Psycholytic Therapy had to get a federal license according to Article 8, paragraph 5 of the Narcotics Law. Hence, they asked the SFOPH for permission. My predecessor Dr. Jean-Pierre Bertschinger and the then director kept putting this off. It wasn’t quite clear how to deal with it. Nobody had any experience in Europe. What did one have to take into account? Thus there was a vacuum and the response was continuously postponed. But then this medical association complained to the minister in charge. He gave brief directions to the federal office: No matter what, but come to a decision! In 1987 or 1988, the SAPT was given authorization without further requirements. When a renewal was due in ’89, my then chief of staff came up to me and told me where to sign. I glanced over the document and asked, “Where is the approval of the ethics commission?” And he said, “The ethics what?” At this point in time, ethics commissions were only just being introduced into human trials in Switzerland. This was pushed by the Swiss Academy of Medical Sciences. The state didn’t care yet. Shortly after I began my job, I had a meeting with this group of physicians and I told them, “Hey, the ethics commission is missing and I can’t see a neat study design. I want to see more.”
Considering that, in the United States, institutional review boards had been introduced in 1966 (Rothman 1991), it is striking that, on the federal level, Switzerland only came to police pharmaceutical research activities in the 1990s. In 1989, Dietschy was among the first to make the approval of an ethics commission a requirement. At the time, drug regulation was organized by the cantons, that is, the states of the Swiss confederation—some strict, some more permissive. To homogenize the Swiss regulatory landscape, an intercantonal control agency coordinating cantonal regulations issued guidelines for clinical trials in the mid-1990s. Only in 2002, when Swissmedic was established, did the Swiss state put an end to the cantonization of its regulatory regime. “We were in a field that was just emerging,” Dietschy remembered. In the late 1980s, the Narcotics Law only stated that the SFOPH could grant special permits for scientific research and limit medical applications of prohibited substances. “A completely open wording,” Dietschy said. “This provided us with latitude, which we don’t have anymore today.”
But this regulatory freedom was accompanied by much uncertainty, especially when internationally prohibited drugs like heroin or hallucinogens were involved. “We had zero experience with this,” Dietschy recalled. “Apart from England, there was no research on illicit drugs in Europe, which could have served as a foundation. I was a civil servant who actually had nothing to do with research. My task was a different one. But I always got applications for research projects. I was in the situation that I constantly had to face problems for which I couldn’t find an answer anywhere.”
This was how Rudolf Brenneisen became involved. The administrative decisions Dietschy had to make were politically and medically risky. As the prohibition had also choked off pharmacological research on heroin and the hallucinogens, a lot of information he would have needed was missing in the medical literature. Consequently, the SFOPH invited Brenneisen to conduct the studies necessary to fill in the blanks. Brenneisen scientifically supported Dietschy, who was in charge of the logistics of the Swiss heroin program. But he also helped him assess applications from the renascent field of hallucinogen research.