Does Frankfurt offer lessons to Philly in handling drug crisis?

There weren't a large variety of leisure activities in the small village in which I grew up, in the rural west of Germany in the 1990s. One way of escape was going to the biggest city in the region, Frankfurt, which was only about an hour away by train.

I was filled with excitement every time I went there. My parents, however? Not so much. They worried. During the 1980s and early '90s, Frankfurt was notorious for its open drug scene. It was the drug capital of Germany and a drug hot spot in Europe.

The epicenter of this activity, where addicts were taking their illegal substances — mostly heroin — was a park in the financial district, halfway between Central Station and the main shopping street. As many as a thousand junkies were living in this little park. Regina Ernst, head of the city's local drug department, called the park a "ghetto" recently when she recalled Frankfurt's most inglorious years.

Luckily, Frankfurt's situation has changed for the better. Massively.

In 1991, Frankfurt saw 147 overdose deaths. Thanks to "harm reduction" measures adopted by the city, those numbers have dropped in two decades — never higher than 44 10 years ago, close to 30 and even 20 in recent years.

The park today is an enjoyable place for a walk, and the once-shabby neighborhood around Central Station is one of the city's hippest districts. Junkies, gambling halls, and brothels have mostly vanished; burger and organic food places have appeared. Then, no one wanted to live in this area; today, apartments sell for high prices.

Today, Frankfurt is a role model for other cities, in Germany and beyond. How did it manage this turnaround? And is there anything Philadelphia might learn from the experience in its sister city?

In the late '80s, politicians, prosecutors, police officers, social workers, and representatives of the city's health services came together, trying to find a solution for the horrible situation. Before, the major goals had been to eliminate the drug scene and stop the addicted from taking drugs. This time, the focus would be on "harm reduction," a mixture of helpful and repressing measures. In some cases, it would mean adopting tactics that had been taboo before.

The recognition that not every addict is willing or able to stop his addiction was vital for the steps that were to come. Frankfurt wanted to offer help to these victims, focusing on survival — reducing the number of overdose deaths.

In 1989, Frankfurt introduced a needle-exchange program, something that was inconceivable before, when police were tasked with confiscating them.

Five years later, the city opened Germany's first safe injection site. Addicts could take their own drugs in a stress-free and, most importantly, hygienic environment. The fear among Germans that the safe injection sites would encourage drug use was hotly debated, and the discussion continues. But the reduction in overdose deaths has proved the sites' value.

Without the sites, people would still use drugs, but under nonhygienic conditions. With the sites, there has been a reduction in the spread of diseases such as HIV and hepatitis. In addition, the sites take addicts off the street, reducing conflicts with other citizens in the neighborhoods. They also allow outreach workers to directly offer assistance to people suffering from addiction.

Another measure, started in 2009, is a controlled supply of diamorphine, a substitution therapy for longtime addicts covered by German health insurance. Frankfurt also offers plenty of counseling services and points of contact, run by authorities, health care services, religious communities, self-help groups, and other organizations.

A crucial change was the role played by police. Before, addicts were targeted. Today, police are fighting drug trafficking and distribution, not addicts.

The model continues to evolve, depending on the issues that arise. At the moment, the city is looking at an increasing abuse of crack around Central Station. Any measures taken will draw on lessons already learned, and the understanding that drug abuse is a problem for which there are no quick and simple solutions.

Oliver Bilger is a writer for Berlin's Der Tagesspiegel newspaper who is working with the Inquirer as part of the Arthur F. Burns Fellowship Program. obilger@philly.com