Zurich's Crack Crisis: No Quick Fix in Sight, Specialist Warns

Zurich is deploying measures at four key locations to combat a growing crack cocaine problem, a situation that intensifies each summer. Dr. Philip Bruggmann, an internal medicine specialist at the Arud addiction medicine center, observes that while the overall number of new patients seeking treatment for crack addiction hasn't drastically increased, existing long-term patients are falling into a downward spiral due to renewed crack use and increased street presence.

Bruggmann attributes the limited number of new patients to a lack of awareness about available services, particularly among younger individuals, and the absence of a specific, stabilizing medication comparable to methadone for opioid addiction. He notes that crack's intense, immediate craving mechanism differs fundamentally from opioids, making it exceptionally difficult to manage.

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No, in summer there are more people consuming in public spaces. Some come to the city specifically for this, it's also easier to sleep outside. And I estimate that there are more consumers now.

While specific therapies for crack addiction are limited, Bruggmann mentions that stimulant treatments like amphetamines show moderate effectiveness in some individuals. Addressing co-occurring mental health issues such as ADHD, anxiety, or panic disorders is also a crucial part of the treatment approach. However, he emphasizes that no single medication can stabilize crack users as effectively as opioid substitutes do for opioid-dependent individuals, highlighting the unique challenges posed by crack's potent psychoactive effects and the persistent urge for the next high.

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You will never find a medication that stabilizes the situation for a crack-addicted person as much as methadone, heroin, or morphine does for opioid addiction. These are two completely different substance classes with completely different mechanisms of action: with opioids, a saturation is reached at a certain dose, with crack cocaine, usually not. The mechanisms of action in the brain and the causes of repeated use differ fundamentally. The constant craving for the next kick is incomparably strong with the stimulant crack.