We moved to the Netherlands in 2016, a country that has historically had a heroin problem by being a small country with the largest port in Europe.
Here, consumption of any abuse drug is decriminalized. (Strangely, the sale of cannabis has never been legal, but it's "tolerated".)
The state provides needles and facilities for people to shoot up, and support for them.
One big difference is that support. Addicts get proper medical care, and know that at any time, they could get medical support if they decided to kick the habit.
If someone ODs, his or her friends will call emergency services, because they know that emergency service will arrive promptly, without police officers, and not try to fuck with them at all.
Another difference is that while Dutch people also find junkies pretty disgusting, they consider it a medical issue, and the junkies victims, not criminals. So no one's going to set anyone on fire.