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REPORT to the EMCDDA by the Reitox National Focal Point the NETHERLANDS DRUG SITUATION 2010

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REPORT to the EMCDDA by the Reitox National Focal Point the NETHERLANDS DRUG SITUATION 2010 REPORT TO THE EMCDDA by the Reitox National Focal Point THE NETHERLANDS DRUG SITUATION 2010 FINAL VERSION As approved by the Scientific Committee of the Netherlands National Drug Monitor (NDM) on the 22nd of December 2010 1 This National Report was supported by grants from the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), the Ministry of Health, Welfare and Sport (VWS), and the Ministry of Security and Justice. This report was written by Margriet van Laar1 Guus Cruts1 André van Gageldonk1 Marianne van Ooyen-Houben2 Esther Croes1 Ronald Meijer2 Toine Ketelaars1 1Trimbos Institute (Netherlands Institute of Mental Health and Addiction). 2Scientific Research and Documentation Centre (WODC), Ministry of Security and Justice. 2 Members of the Scientific Committee of the Netherlands National Drug Monitor (NDM) Mr. prof. dr. H.G. van de Bunt, Erasmus University Rotterdam Mr. prof. dr. H.F.L. Garretsen, Tilburg University (chair) Mr. dr. P.G.J. Greeven, Novadic-Kentron Mr. prof. dr. R.A. Knibbe, Maastricht University Mr. dr. M.W.J. Koeter, Amsterdam Institute for Addiction Research (AIAR) Mr. prof. dr. D.J. Korf, Bonger Institute of Criminology, University of Amsterdam Ms. prof. dr. H. van de Mheen, Addiction Research Institute Rotterdam (IVO) Mr. dr. C.G. Schoemaker, National Institute of Public Health and the Environment (RIVM) Mr. A.W. Ouwehand, Organization Care Information Systems (IVZ) Mr. mr. A.W.M van der Heijden, MA, Public Prosecution Service (OM) Observers Mrs. mr. R. Muradin, Ministry of Security and Justice Mrs. drs. W.M. de Zwart, Ministry of Health, Welfare and Sport Additional consultant Mr. dr. M.C.A. Buster, Municipal Health Service Amsterdam (GGD Amsterdam) 3 PREFACE The Report on the Drug Situation in the Netherlands 2010 has been written for the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). Each year, national centres of expertise on drug-related issues in the member states of the European Union („Focal Points‟) draw up a report on their respective national drugs situation, according to guidelines provided by the EMCDDA. These reports form the basis of the “Annual Report on the State of the Drug Problem in the European Union” compiled by the EMCDDA. In keeping with the guidelines, the report focuses on new developments in the reporting year. In order to avoid too much overlap, the reader is repeatedly referred to previous National Reports. This 2010 national report was written by the staff of the Bureau of the Netherlands National Drug Monitor (NDM) at the Trimbos Institute and staff of the Scientific Research and Documentation Centre (WODC) of the Ministry of Justice. The NDM was established in 1999 on the initiative of the Ministry of Health, Welfare and Sport. The Ministry of Security and Justice also participates in the NDM. The NDM carries out the functions of the Netherlands Focal Point. The NDM relies on the contribution of a multitude of experts and input from registration systems and monitors in the Netherlands. In particular, the authors would like to thank the members of the Scientific Committee of the NDM and other expert reviewers for their valuable comments on the draft version of the report. 5 Table of contents Preface 5 Summary 9 Part A: New developments and trends 14 1 Drug policy: legislation, strategies and economic analysis 15 1.1 Legal framework 15 1.2 National action plan, strategy, evaluation and coordination 21 1.3 Economic analysis 25 2 Drug use in the population 28 2.1 Drug use in the general population 28 2.2 Drug use in the school and youth populations 31 2.3 Drug use among targeted groups 35 3 Prevention 42 3.1 Universal prevention 43 3.2 Selective prevention and indicated prevention 44 3.3 Mass media campaigns 46 3.4 Research 46 4 Problem drug use 49 4.1 Prevalence estimates of problem drug use 49 4.2 Data on problem drug users from non-treatment sources 51 4.3 Intensive, frequent, long-term and other problematic forms of use 55 5 Drug-related treatment: treatment demand and availability 57 5.1 Strategy/policy 57 5.2 Treatment systems 57 5.3 Clients in treatment 66 6 Health correlates and consequences 72 6.1 Drug-related infectious diseases 72 6.2 Other drug-related morbidity 83 6.3 Drug-related deaths and mortality among drug users 89 7 Responses to health correlates and consequences 92 7.1 Prevention of drug-related emergencies and drug-related deaths 92 7.2 Prevention and treatment of drug-related infectious diseases 92 7.3 Responses to other health correlates among drug users 98 6 8 Social correlates and consequences 100 8.1 Social exclusion 100 8.2 Social reintegration 103 9 Drug related crime, prevention of drug related crime and prison 109 9.1 Drug related crime 109 9.2 Prevention of drug related crime 121 9.3 Interventions in the criminal justice system 123 9.4 Drug use and problem drug use in prison 131 9.5 Responses to drug related health issues 132 9.6 New developments 133 10 Drug markets 134 10.1 Availability and supply 134 10.2 Seizures 138 10.3 Price/purity 139 Part B: Selected issues 147 11 History, methods and implementation of national treatment guidelines 148 11.1 History and overall framework 148 11.2 Existing guidelines: framework and content per guideline 150 11.3 Experiences in the Netherlands with the implementation of guidelines 157 11.4 Comparison with the WHO guidelines on pharmacological treatment 165 of opiate dependence 12 Mortality related to drug use: a comprehensive approach and public 169 health implications 12.1 Overall mortality among problem drug users 169 12.2 Conclusions from a public health perspective 172 Part C 174 13 Bibliography 175 13.1 References 175 13.2 Alphabetic list of relevant data bases 196 13.3 List of relevant internet addresses 200 14 Annexes 203 14.1 List of tables used in the text 203 14.2 List of graphs used in the text 204 14.3 List of abbreviations used in the text 206 Map of the Netherlands: provinces and major cities 209 7 8 Summary Developments in drug law and policies (chapter 1) The intended new Dutch drug policy was delayed because the Dutch government fell in February 2010. The resigned government decided to sustain coffee shop pilot projects to combat public nuisance on the municipal level. In these projects all kind of measures will be tested for their effectiveness: to encourage small-scale coffee shops, to spread the coffee shops, innovative enforcement, to introduce a special identity card system for coffee shops, more requirements for coffee shops owners, traffic measures, tackling illegal selling points and communication with foreign drugs tourists. An amendment of the Opium Act to forbid grow shops, where materials and equipment for cannabis cultivation are sold, has been prepared. An expert committee was installed in 2010, which will work out scenarios for the ranking of drugs in the Opium Act. With regards to traffic offences, a bill will be re-introduced to the Lower House to amend the Road Traffic Act; limiting values for drugged driving offences will be defined. In certain Dutch regions a 'zero tolerance' drug policy is executed at clubs and dance events. Developments in drug use in the population and specific target groups (chapter 2) Drug use in the general population remained generally stable between 2001 and 2005. Data for 2009/2010 are not yet available. Several other (local) sources suggest no major changes in the prevalence of cannabis use. Drug use among pupils (12-18 years) from regular secondary schools generally stabilised between 2003 and 2007, although the overall trend since 1996 is decreasing. Prevalence rates of drug use are appreciably higher among subpopulations of pupils from special education (depending on school type), residential youth care, judicial institutions for youth and in general among low-educated people. A national survey in 2009/2009 showed that drug use was also relatively common among young people recruited in clubs and large-scale parties, with last year prevalence rates being about 4 to 15 times higher compared to young adolescents and adults in the general population (15-34 years). In a psychiatric epidemiological survey in the general population of 18-64 years, 0.3% of the respondents fulfilled a 12-month DSM IV diagnosis of cannabis dependence, and 0.4% fulfilled a DSM IV diagnosis of cannabis abuse. This means that about one in nine last year cannabis users had a cannabis use disorder. Various indicators strongly point at an increase in the (problem) use of GHB in some subpopulations (both in and outside the nightlife scene), but trend data are lacking so far. In 2008/2009, 7.8% of a sample of visitors of large-scale parties had used GHB in the last year. For visitors of clubs and discotheques the last year prevalence was 3.4%. For comparison, rates of recent cocaine use in these groups were 12% and 5%, respectively. Developments in prevention (chapter 3) The focus of preventive activities has been shifting towards the risk groups of young people and people with a low socio-economic status, although specific interventions for these groups are relatively scarce. Effective interventions are presented at a new website and a knowledge 9 synthesis study has been conducted for prevention of substance use (problems) among youngsters as well as adults. With regard to universal prevention, new modules have been added to the most popular prevention program the Healthy School and Drugs, the Centre Safe and Healthy Nightlife has been launched, and a Point of Support against Recreational Violence has been initiated.
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