This working paper examines the present situation regarding Heroin-assisted treatment (HAT), in addition to the early history (in the 1990s and early 2000s) of HAT as a contemporary drug treatment intervention. It explores domestic policy contexts in several countries making use of the intervention, with particular reference to those states that pioneered it, such as Switzerland and the Netherlands. It deploys a special focus on the relationships obtaining between these countries and the institutions of the United Nations-administered international drug control regime, relationships which have been long-contested and provided the context for disputes surrounding both HAT and other innovative forms of drug policies and practices. 

The paper conducts a brief global survey of HAT trials, which have provided the evidence base for the intervention, and facilities where it is practiced.  It considers the key policy debates within which the intervention sits, drawing on evidence gathered from both documentary sources and interviews with former officials from countries which, in the context of HAT, dealt with the International Narcotics Control Board (INCB or Board) and the international drug control regime more broadly. The author sets out with a working hypothesis regarding the INCB, namely that it was a prominent force in blocking the progress of HAT in UN member states.

[See also, online article on Heroin-assisted treatment by Transform Drug Policy Foundation]