How to beat the Drug cartels

What? South Africa should immediately legalise pharmaceutical heroin (diacetylmorphine) for registered severe addicts and supply it free of charge, with clean needles – but only on the strict condition that every single dose is taken on-site inside supervised government clinics (the proven Swiss/Dutch/Canadian heroin-assisted treatment (HAT) model).

Why?

1. South Africa is in the middle of one of the world’s fastest-growing heroin epidemics – 150 000–250 000 daily users, most smoking or injecting deadly nyaope/whoonga cocktails cut with rat poison, pool cleaner, ARVs and fentanyl analogues.

   
   

2. Since the 1970s the entire world (including us) has tried the same strategy – harsher laws, more police, more prisons, “war on drugs”. Fifty years later every single metric is worse. It makes no sense to keep doing the same thing and pray for a different result.

   
   

3. Street gangs in Cape Flats, Gauteng townships, Durban flats and PE now make most of their money from heroin. Addicts steal and prostitute themselves daily for the R300–R800 they need. Give those addicts safe, free, pharmaceutical heroin in a clinic and on day one they stop buying from the gangs. Gang income collapses wherever the clinics open.

   
   

4. This is not theory – it is 30 years of hard evidence: • Switzerland (1994–today, nationwide) – overdose deaths in the programme ≈ 0, HIV/hepatitis down 70–90 %, participant crime down 60–90 %, street dealers vanished from clinic neighbourhoods (Swiss Federal Office of Public Health, 2022). • Netherlands (25 years) – illicit heroin use fell 68 %, retention 80 %+ (Trimbos Institute). • Germany (large RCTs 2002–2008) – 67 % stayed in treatment vs 40 % on methadone; criminal offences down 62 % (Haasen et al., NEJM 2007). • Denmark & Canada (supervised programmes) – same dramatic drops in overdoses, infections and crime. Meta-analyses of all trials confirm heroin-assisted treatment beats every other option for the most damaged, long-term addicts.

   
   

5. Crime falls immediately – faster than any policing operation we have ever mounted.

   
   

6. The clinics become the ideal doorway into real treatment, social work, skills training and eventual tapering to methadone or abstinence.

   
   

7. Cost per patient is far less than the current annual societal cost of one chronic addict in police, courts, prisons, hospitals and stolen goods. Switzerland calculated a net saving of roughly 2:1. Heroin is cheap to make when not illegal.

   
   

8. Public opinion swings from hostile to strongly supportive within 12–24 months once people see quieter, cleaner, safer streets (exactly the Swiss and Danish experience).

   
   

9.     Combine It With the No-Cash Idea (see Blog #1 of this series) If we do this plan at the same time as phasing out cash as legal tender (Blog #1), the effect is not additive – it is explosive (estimates by GROK AI):

Crime Type	Free Heroin Clinics alone	Cashless society	Both initiatives together
House Burglary and robbery	Decrease 60 to 90% amongst patients	Harder to fence goods and pay cash	Decrease by 85 to 95 % in areas serviced by clinics
Street Mugging	Addicts no longer need cash daily	No Cash to Hand over	Almost disappears
Cash in Transit Heists	No Effect	Decrease to zero	Eliminated
Street Level drug sales	Gangs lose their best customers	Remaining deals leave digital trail	Heroin Market collapses twice over
Gang Income overall	Heroin revenue will decrease to near zero	All cash crimes become traceable/risky	Most street gangs financially broken within 36 months

Switzerland and the Netherlands already run heroin clinics and are almost cashless societies – their street crime rates are a fraction of ours. South Africa would be the first country to deliberately launch both policies together. The gangs lose both their daily customers and their anonymous payment method in one coordinated blow.

The evidence for the success of these heroin assisted treatment plans is strong. Once evidence for the safety and efficacy of dexamphetamine is available (for TIK and cocaine addicts) we can add this to the programme (pilots in Australia, Canada and the US already show 50–70 % reductions in street stimulant use),

How?

1. Start with five pilot clinics in the worst hotspots: Mitchells Plain/Manenbergs, Hillbrow–Joubert Park, Chatsworth, KwaMashu/Inanda and Nelson Mandela Bay.

   
   

2. Only chronic opioid-dependent adults (≥2–3 years daily use, multiple failed treatments) may register after medical screening.

   
   

3. Maximum 2–3 supervised doses per day inside the clinic – nothing leaves the building.

   
   

4. Clinics open 07:00–21:00, 365 days/year, staffed with nurses, doctors, social workers and visible security.

   
   

5. Import pharmaceutical heroin at first (Switzerland and the UK already export it for exactly these programmes); license local production later.

   
   

6. Fund by redirecting a small part of the existing multi-billion-rand drug-war budget (SAPS drug units, prisons, health). Long-term the programme pays for itself many times over.

   
   

7. Run it under the Department of Health as healthcare, not under Justice as crime.

   
   

Why not? (FAQs)

1. “It will pull drug tourists from all over Africa.” → 30 years of European data show the opposite. Strict medical criteria and the boring, bureaucratic clinic routine do not attract new or casual users. Initiation rates stayed flat or fell.

   
   

2. “Giving free drugs is immoral.” → We already give free needles, methadone and ARVs. The real choice is: safe pharmaceutical heroin in a clinic, or deadly street poison that funds gangs and kills people.

   
   

3. “Dealers will just switch to something else.” → They try, but nothing matches heroin’s daily-profit-per-customer. Every country that introduced HAT saw the heroin market shrink dramatically in the serviced areas.

   
   

4. “Gangs will attack the clinics.” → Happened in Switzerland 1994–1996. Solved with visible police protection and private security for the first 18 months.

   
   

5. “Some will still buy on the street.” → Many do at first. Within months most stop because the clinic dose is reliable, pure and free. Those who continue get higher supervised doses until the street product becomes pointless.

   
   

Referendum

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