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The Netherlands Drug Situation 2002

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The Netherlands Drug Situation 2002 REPORT TO THE EMCDDA by the Reitox National Focal Point THE NETHERLANDS DRUG SITUATION 2002 FINAL VERSION REITOX This file at the Trimbos Institute: <F:\NationaleDrugMonitor\Focal_Point\National Report 2002\Last versions\National_report_2002_V3.doc> Written by Part I (T. Ketelaars) Part II (M.W. van Laar) Part III (A. van Gageldonk) Part IV (A.A.N. Cruts, A. van Gageldonk) November 2002 © NDM/Netherlands Focal Point 2002 Trimbos Institute NDM/Netherlands Focal Point PO Box 725 3500 AS Utrecht The Netherlands phone: +31-30-2971100 fax: +31-30-2971111 Members of the Epidemiology Working Group Epidemiology of the National Drug Monitor Members of the Study Group Epidemiology of the NDM Mr. A.A.N. Cruts, Trimbos Institute Mr. H.F.L. Garretsen, Tilburg University Mrs. C.A.M. van Gorp, M.A., Ministry of Health, Welfare and Sport (Observer) Mr. R.A. Knibbe, Universiteit Maastricht Mr. M.W.J. Koeter, Amsterdam Institute for Addiction Research (AIAR) Mr. D.J. Korf, Criminological Institute Bonger, University of Amsterdam Mrs. M.W. van Laar, Trimbos Institute Mr. R.F. Meijer, Research and Documentation Centre (WODC), Ministry of Justice Mrs. H. van de Mheen, Addiction Research Institute Foundation (IVO) Mr. A. Mol, Care Information Systems Foundation (IVZ) Mr. J.A.M. van Oers, National Institute for Health Promotion and Illness Prevention (RIVM) Mrs. E.L.M. Op de Coul, National Institute for Health Promotion and Illness Prevention (RIVM) Mr. A.W. Ouwehand, Care Information Systems Foundation (IVZ) Mr. H.G.M. Rigter, Trimbos Institute Mr. Th.A. Sluijs, Municipal Health Service Amsterdam (GG&GD Amsterdam) Mrs. J.E.E. Verdurmen, Trimbos Institute Mr. G.C.G. Verweij, Statistics Netherlands (CBS) Mr. P.P. de Vrijer, Ministry of Justice (Observer) Mrs. W.M. de Zwart, Ministry of Health Welfare and Sport (Observer) Additional consultants Mr. M.C.A. Buster, Municipal Health Service Amsterdam (GG&GD Amsterdam) Mr. A.W.M. van der Heijden, National Police Agency (KLPD) Mrs. E.H.B.M.A. Hoekstra, Ministry of Justice, Directorate of Sanctions, Rehabilitation and Victim Care (DGPJS) Mrs. A.J.J. Slotboom, National Office of the Public Prosecution Service Mr. M.C. Willemsen, DEFACTO, voor een rookvrije toekomst (Institute for Public Health and Smoking) INDEX SUMMARY MAIN TRENDS AND DEVELOPMENTS 7 PART 1 NATIONAL STRATEGIES: INSTITUTIONAL & LEGAL FRAMEWORK 11 1. Developments in drug policy and responses 13 1.1 Political framework in the drug field 13 1.2 Legal framework 16 1.3 Laws implementation 20 1.4 Developments in public attitudes and debates 21 1.5 Budget and funding arrangements 24 ________________________________________________________________ PART 2 EPIDEMIOLOGICAL SITUATION 25 2. Prevalence, patterns and developments in drug use 27 2.1 Main developments and emerging trends 27 2.2 Drug use in the population 28 2.3 Problem drug use 36 3. Health consequences 42 3.1 Drug treatment demand 42 3.2 Drug-related mortality 49 3.3 Drug-related infectious diseases 53 3.4 Other drug-related morbidity 56 4. Social and legal correlates and consequences 59 4.1 Social problems 59 4.2 Drug offences and drug-related crime 61 4.3 Social and economic costs of drug consumption 66 5. Drug markets 66 5.1 Availability and supply 66 5.2 Sources of supply and drug seizures 67 5.3 Price/purity 68 6. Main facts and trends per drug 70 7. Discussion 72 7.1 Consistency between indicators 72 7.2 Methodological limitations and data quality 72 ________________________________________________________________ PART 3 DEMAND REDUCTION INTERVENTIONS 76 8. Strategies in Demand Reduction at National Level 78 8.1 Major strategies and activities 78 8.2 Approaches and new developments 78 9. Prevention 81 9.1 School programmes 81 9.2 Youth programmes outside school 83 9.3 Family and childhood 83 9.4 Other programmes 85 10. Reduction of drug related harm 87 10.1 Description of interventions 93 10.2 Standards and evaluation 98 11. Treatment 100 11.1 “Drug-free” treatment and health care at national level 102 11.2 Substitution and maintenance programmes 103 11.3 After-care and re-integration 105 12 Interventions in the Criminal Justice System 106 12.1 Assistance to drug users in prisons 106 12.2 Alternatives to prison for drug dependent offenders 108 12.3 Evaluation and training 108 13.Quality Assurance 111 ________________________________________________________________ PART 4 KEY ISSUES 114 14. Demand reduction expenditures on drugs in 1999 116 14.1 Concepts and definitions 116 14.2 Financial mechanisms, responsibilities and accountability 116 14.3 Expenditures at national level 118 14.4 Expenditures of specialised drug treatment centres 120 14.5 Conclusions 121 14.6 Methodological information 121 15. Drug and alcohol use among young people aged 12-18 123 15.1 Prevalence, trends and patterns of use 123 15.2 Health and social consequences 128 15.3 Demand and harm reduction responses 129 15.4 Methodological information 132 16. Social exclusion and reintegration 134 16.1 Definitions and concepts 134 16.2 Drug use patterns and consequences observed among socially excluded population 135 16.3 Relationship between social exclusion and drug use 137 16.4 Political issues and reintegration programmes 138 16.5 Methodological information 140 REFERENCES 145 ÿ Bibliography 145 ÿ Data Bases/Software/Internet addresses 174 ANNEXES 178 ÿ Annex 1: Drug monitoring systems and data sources 178 ÿ Annex 2: Additional tables 180 ÿ Annex 3: List of abbreviations 185 ÿ Annex 4: List of tables 187 ÿ Annex 5: List of graphs 189 ÿ Annex 6: Map of the Netherlands, provinces and cities 190 SUMMARY: MAIN TRENDS AND DEVELOPMENTS Annual reports of the drug situation in the Netherlands are commissioned by the European Monitoring Centre for Drugs and Drug Addiction and the Ministry of Health, Welfare and Sport. The reports concentrate on illegal drugs and give an overview of developments on the following subjects: drug policy, drug use, and drug demand reduction. Each year, three special issues are dealt with. In 2002, these issues were expenditures on demand reduction, drug and alcohol use among youngsters and social exclusion and re-integration. Developments in legal, political and organisational framework Drug policy in the Netherlands has four major objectives: (1) prevention of drug use and treatment and rehabilitation of addicts; (2) reduction of harm to drug users; (3) diminishing public nuisance caused by drug users (i.e. disturbance of public order and safety in the neighbourhood); and combating the production and trafficking of drugs. The Ministry of Health, Welfare and Sport (VWS) co-ordinates overall drug policy and treatment and prevention policy. The Ministry of Justice is charged with law enforcement related to the judicial aspects of drugs. Drug-related matters concerning the local level and the police fall under the jurisdiction of the Ministry of the Interior and Kingdom Relations. Actually, policy in the Netherlands is highly decentralised. Within the limits of the law, the local authorities have extensive responsibilities in addressing the drug problem. A bill has been accepted in 2002 to amend the Opium Act to allow the cultivation and use of cannabis for medical and scientific purposes. A governmental agency can grant permission to grow cannabis after checking the integrity of potential growers. The agency also sees to the quality control and standardisation of medicines produced from cannabis. In October 2002, the Dutch government decided that physicians may prescribe cannabis to patients and that pharmacies are allowed to supply the drug for medical reasons. Approved cannabis will not be available before Summer 2003. Legal arrangements to meet the EU directive on money laundering render it more difficult for criminal organisations to retain the proceeds of their illegal activities. New is the Act for the Promotion of Integrity Assessments by the Public Administration. A new agency investigates the background of organisations that apply for subsidies and permits. Aim is to counter attempts of criminal organisations to take advantage of public money. The number of drug couriers who swallow small packages of drugs increased to unprecedented levels in 2002. This caused stagnation in the criminal law chain. A special Act went into effect on 6 March 2002 enabling to place a number of detainees together in one cell in special emergency detention facilities. On the request of Parliament the Minister of Health, Welfare and Sport decided to forbid the testing of XTC-pills at most (house) parties. She ordered to examine other methods of monitoring drug markets. Intensifying legal measures against the production, sale and use of ecstasy are meant to counterweight the increase of trade of synthetic drugs and its precursors via Dutch harbours and airports. The judiciary and the police gear up joint efforts for an annual € 18.6 million (2003-2006). The Synthetic Drugs Unit (USD) has a pivotal role in the implementation of these efforts and international contacts with countries that are important in the trafficking of ecstasy are intensified. In July 2002, the new government of the Netherlands did not formulate a new drug policy. In stead a few intentions were formulated: to combat more firmly the production and trafficking of drugs, to force recidivist criminal addicts to submit to detoxification and to after care for two years, to close 'coffee shops' near schools and the Dutch frontiers, and to stop pill testing at parties. Because the cabinet stepped down in October 2002 and new elections will be held in January 2003, it is uncertain what will happen in the near future. Developments in the drug situation in the Netherlands 7 Drug use in the general population of the Netherlands has increased from 1997 onwards, but remained stable among young people. The level of cannabis consumption in the Netherlands is an average one, compared to other European Union countries, and above average when we look at cocaine and ecstasy use.
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