The national focal point in the Netherlands is integrated within the National Drug Monitor, established in 1999 by the Minister of Health, Welfare and Sport in order to evaluate and review registration and survey research data at the national level, and to report these data to the Lower Chamber of Parliament, concerned ministries and other stakeholders inside and outside the country. The national focal point is part of the Drug Monitoring and Policy Department of the Trimbos Institute, the national research institute for mental health care, addiction care and social work, which is tasked with informing policymakers and politicians about the mental health issues that concern the Dutch population. There is close collaboration with the Research and Documentation Centre of the Ministry of Security and Justice.
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Last updated: Friday, May 20, 2016
General population surveys on drug use prevalence were carried out in the Netherlands in 1997, 2001, 2005, 2009 and 2014 among adults aged 15–64. In 2014 the sample size consisted of 5 867 respondents who completed the questionnaire through the internet or were interviewed face-to-face. Some 24.1 % of respondents reported lifetime prevalence of cannabis use. The gender gap regarding cannabis use remains wide — last year prevalence of cannabis use was about twice as high among males than females (10.2 % and 5.3 % respectively). Lifetime prevalence of ecstasy use was 7.4 %, and last year prevalence was 2.4 %. Cocaine was the third most popular ‘ever used’ drug, with lifetime prevalence of 5.1 %. More than a third of those aged 15–34 (35.4 %) reported ever having used cannabis, followed by ecstasy at 12.3 % and cocaine at 7.3 %. Last year prevalence of cannabis use among young adults was 15.6 %, while 8.3 % reported using cannabis in the last 30 days. Prevalence data from 2009 and 2014 are not comparable to those of previous years due to methodological changes in the latest surveys; however, there are some indications that ecstasy use had increased in the recent years.
European School Survey Project on Alcohol and Other Drugs (ESPAD) studies among students aged 15–16 have been carried out regularly since 1999, with the most recent survey results available from 2011. The results for illicit drug use showed a fairly stable trend in this age group for cannabis use. In 2011 the lifetime prevalence rate of cannabis use was 27 %. The percentage of students using drugs such as ecstasy, amphetamines, cocaine or heroin is much lower. Inhalants were the most popular drug after cannabis, with lifetime prevalence reported at 7 %, followed by ecstasy at 4 %, cocaine and LSD at 2 % and heroin and amphetamines at 1 %. Results indicated 23 % for last year prevalence of cannabis use (25 % in 2007; 23 % in 2007), and 14 % for last month prevalence (15 % in 2007; 13 % in 2003). With regard to gender, the reported lifetime prevalence of cannabis use was 34 % among males and 21 % among females.
The Dutch National School Surveys on Substance Use among students aged 12–18 in secondary education has been carried out every three or four years since 1988, and the Health Behaviour in School-aged Children (HBSC) study of students aged 11–16 has been carried out every four years since 2001. The results of these surveys point towards an increasing trend in cannabis use among secondary school students from1988 to 1996 that stabilised between 2001 and 2007 and then decreased slightly up to 2013.
The results of the most recent HBSC 2013 survey indicate that the lifetime prevalence of cannabis use was 17 % among 15-year-old boys and 15 % among girls of the same age group, which is a further decline compared to 2009/10 survey results (23 % and 18 % respectively). Although heavy use of cannabis remained significantly more prevalent among boys than girls (1.5 % and 0.1 % respectively) in 2013, comparison with the previous study also indicates a decline in heavy cannabis use among 15-years-olds (2.9 % among boys and 0.4 % among girls in 2009/10).
In 2013 an online survey among a convenience sample of 3 335 people aged 15–35 who had frequently visited parties, festivals and clubs in the past 12 months found that last year prevalence of cannabis use was about three times higher among this group of (frequent) visitors to different nightlife settings than among the general population, while for cocaine it was about ten times higher and for ecstasy 20 times higher, with older age and higher education having a protective effect on the use of illicit drugs in a nightlife settings. The survey also measured the prevalence of gamma-hydroxybutyrate (GHB)/gamma-butyrolactone (GBL) use and the use of new psychoactive substances (e.g. 4 fluoramphetamine). The findings from the survey cannot be generalised to everyone who attends parties, festivals and clubs. The Antenna study, using mixed methods, has been implemented since 1993 in Amsterdam, and targets adolescents and young adults in nightlife settings and particular neighbourhoods. The 2013 survey showed that levels of ecstasy use had increased appreciably between 2008 and 2013. Moreover, there seemed to be a revival of the use of laughing gas (N2O).
In 2010 pilot projects were carried out to measure metabolites of illicit substances in wastewater in four major Dutch cities. The findings indicated that cocaine metabolites dominated in all cities, while the highest level of amphetamine was detected in Eindhoven (however, it may be difficult to distinguish between illicit dumping of amphetamine in the environment and human consumption). It is not clear yet what the findings from the wastewater analyses indicate about the use of substances by the population of these cities. Look for an in-depth review of more recent studies in our Perspectives on Drugs.
The recent trend in Dutch drug policy is a shift towards stricter legal measures against cannabis-related criminality and a stricter policy against nuisance associated with coffee shops, although the focus on health promotion remains an important aspect of drug policy and a national prevention programme for 2014–16 was launched in 2014. The programme implies that an individual is ultimately responsible for his or her own health behaviour, while the national government should provide professionals and citizens with reliable and accessible information. Priority is given to high-risk groups and young people, and activities in recreational settings, especially those tackling the use of illicit and licit substances, predominate. A new development in the area of prevention is a clear focus on implementation rather than researching new interventions. Prevention activities are funded mainly by the Ministry of Health, Welfare and Sport. However, local municipalities are responsible for carrying out the prevention programmes in close cooperation with the schools, municipal care services, neighbourhood centres, other entities involved in substance-use prevention and national health promoting institutes. In order to support municipalities and promote evidence-based prevention interventions, a national database of evaluated prevention projects is hosted by the Centre for Healthy Living of the National Institute of Public Health and the Environment.
Universal prevention is carried out in schools through the Healthy School and Drugs programme, which is the oldest school-based prevention programme in the Netherlands. The programme comprises several lectures in secondary schools on alcohol, tobacco and cannabis. There are several e-learning modules for lower vocational education and on driving under the influence, and the programme includes basic and expanded courses for teachers on the early identification of drug use among students. Following a recent evaluation (2014) that indicated the ineffectiveness of the programme in preventing the onset of alcohol, tobacco and cannabis use, it was discontinued for primary schools and revised for the secondary schools to increase the skill-focused components, and to provide more intensive interventions on social norms, self-regulation and impulse control, and professional training for educational staff. A Swedish programme, Preventing Heavy Alcohol Use in Adolescents (the Örebro programme), has been effectively implemented in the Netherlands under the name PAS. Outside school, the project Alcohol and Drug Prevention at Clubs and Pubs tries to create a healthy and safe nightlife environment using a healthy settings approach. The focus is on reducing the high-risk use of substances among young people and its related problems. Electronic media and new applications are increasingly used to provide information and counselling on drug-related issues, for example the Drugs Information Line.
More attention has been given in recent years to a shift towards selective prevention interventions. These interventions, carried out by non-governmental organisations in cooperation with government services, are mostly targeted at children of addicted parents, and youths on the streets, from socio-economically deprived neighbourhoods, in special institutional settings (such as child residential care or custodial institutions), and in recreational settings. The Ministry of Health, Welfare and Sport finances a number of projects in recreational settings, which focus on the implementation of safe clubbing regulations, person-to-person interventions, and the testing of substances (often ‘club’ drugs) at addiction care organisations. These projects are linked to other nationwide monitoring systems and are particularly important for the rapid sharing of information about new or dangerous psychoactive substances and their hazardous health effects in recreational settings, and for issuing local warnings. An increasing role in selective prevention interventions is played by social neighbourhood teams, developed as part of an ongoing reorganisation of general healthcare. Recently, prevention programmes have been piloted for young people with a slight intellectual disability and those who hang around on the streets. In 2011 a new initiative, based on the Australian Adolescence Cannabis Check-Up, was launched in 19 locations and also online to target young cannabis users with a low motivation for abstinence. The programme uses a non-offending motivational enhancement technique to encourage the participants to re-evaluate their cannabis use practices.
In the indicated prevention area, activities focusing on early identification of substance use or dependence are on the increase. In 2014 the Ministry of Health, Welfare and Sports implemented an additional screening of 15- to 16-year-olds in schools. A special guide for professionals working with young people was published in 2010. In addition to information, the guide also provides several tools, such as a step-by-step identification process, a screening card and motivational enhancement. In 2012 new interventions targeting GHB users and young people from immigrant communities (e.g. Turkish or Moroccan) were launched.
Up to 2012 the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) defined problem drug use as injecting drug use or long duration/regular use of opiates, cocaine and/or amphetamines. However, in 2012 a new definition of ‘high-risk drug use’ was adopted. The new definition includes ‘problem drug use’, but is broader (mainly in its inclusion of high-risk use of more substances). Details are available here.
The most recent estimate of the high-risk opioid user population was calculated in 2012 using the treatment multiplier, and it suggested that there were about14 000 high-risk opioid users (range: 12 700–16 300). This corresponds to a rate of 0.84 per 1 000 inhabitants aged 15–64 (range: 0.76–0.97). Available data indicate a decline in the estimated number of opioid users since the beginning of the century. The ageing of the opioid user population and the low popularity of opiates among younger drug users are suggested as reasons for the trend. It is also noted that many high-risk drug users, including opiate users, use crack cocaine.
In 2014 a general population survey estimated that 1.3 % of 15- to 64-year-olds in the Netherlands had used cannabis daily or almost daily within the last 30 days.
The National Alcohol and Drugs Information System (LADIS) is the most comprehensive information system on treatment demand clients in the Netherlands. LADIS contains data from the regular drug treatment services, and provides nationwide coverage. However, some private clinics and some addiction units from the mental healthcare sector do not participate in the system yet, and in 2011 probation services discontinued their participation in LADIS. It is estimated that only about 5 % of addiction care is not included in LADIS. Another source of information is the register of hospital admissions, the National Hospital Care Basic Registration (LBZ), which records the number of admissions due to drug-related problems during the year; however, the register is not in line with the EMCDDA treatment demand indicator guidelines and therefore it is not reported to the EMCDDA.
In 2014 a total of 190 outpatient and 15 inpatient units submitted treatment demand data to LADIS.
Data showed that in 2014 a total of 10 631 clients entered treatment, of which 6 101 were new clients entering treatment for the first time. Almost half of all clients (5 061 clients or 48 %) reported cannabis as their primary drug, followed by 2 791 clients (26 %) who entered treatment for cocaine and 1 113 (10 %) for opioids. A slightly different distribution was identified among new treatment clients, with more than half requesting treatment for cannabis (3 429 clients or 56 %), followed by 1 344 (22 %) for cocaine and 435 (7 %) for stimulants. Traditionally, injecting drug use is rare among treatment clients.
A decline in treatment demands related to heroin, and recently also to cocaine, and a steady increase in cannabis-related treatment demands was noted in the Netherlands until 2010 and has stabilised since then.
The mean age of all treatment clients in 2014 was 32 years, while new treatment clients were slightly younger – on average 30 years old. The majority (79 %) of all treatment clients were male, while 77 % of new treatment clients were male.
The National HIV/AIDS Registration of the HIV Monitoring Foundation monitors people living with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) who attend HIV treatment centres.
The Amsterdam Cohort Study, initiated in 1985, had recruited 1 661 (injecting) drug users by the end of 2012. On entering the study, 322 (19 %) drug users tested positive for HIV, while 19 people became HIV positive during the observation time. The data from the cohort indicated a sharp reduction in HIV transmission among people who inject drugs (PWID) between 1986 and 2000, with sporadic new HIV cases detected in 2005 and 2008. This is linked to a decline in drug injecting and sharing of injecting equipment.
According to the European Centre for Disease Prevention and Control, in 2014 no newly detected HIV cases was linked to injecting drug use.
Hepatitis B virus (HBV) infection and hepatitis C virus (HCV) infection notification data are reported by the municipal health services to the National Institute of Public Health and the Environment (RIVM). The Netherlands is considered a low prevalence country for HBV and HCV among the general population, while estimated HCV prevalence among ever-injectors range from 30 % to 80 % depending on the geographic location.
According to the European Centre for Disease Prevention and Control, in 2014 there were no notifications of acute HBV infection among PWID out of 66 reported cases. In 2014 four of 403 chronic HBV infections were linked to injecting drug use. About 52 acute HCV infection cases were reported in 2014, and 39 had a known transmission route. Injecting drug use was reported as the likely transmission route for two cases. The Amsterdam Cohort data also indicates a decline in HCV incidence among those who had ever injected, while the prevalence of HCV remains substantial in this cohort.
In general, available information suggests that the incidence of HIV, HBV and HCV has remained at low levels for many years in the Netherlands, which is attributed to the widely available harm reduction services. However, men who have sex with men injecting crystal methamphetamine (slamming) are increasingly recognised as a potential source of a new HCV epidemic wave.
The main source of official Dutch statistics on drug-induced deaths is the General Mortality Register or Causes of Deaths Statistics managed by Statistics Netherlands (CBS). The register has national coverage and only includes residents of the Netherlands. Cases are classified according to ICD-10 and refer mainly to direct or acute deaths (drug overdoses). Data extraction and reporting is in line with the EMCDDA definitions and recommendations. Data on drug-induced deaths among non-residents are available from a separate database.
In 2014 a total of 123 drug-induced deaths were registered, all of which had been toxicologically confirmed. Opiates were present in 40 of these cases. The majority of cases were male (96). The mean age of the victims was 44 years.
From 1996 to 2013 the total number of recorded drug-induced deaths varied between a minimum of 94 cases in 2010 and a maximum of 144 cases in 2001 and 2013. Despite some fluctuations over the years, the total number of drug-induced deaths in the Netherlands has remained relatively low. This might be explained by the low number of socially marginalised high-risk drug users, widely available prevention and treatment measures targeting high-risk drug users and a low rate of injecting drug use.
The drug-induced mortality rate among adults (aged 15–64) was 10.8 deaths per million in 2014, lower than the most recent European average of 19.2 deaths per million.
Responsibility for the organisation, implementation and coordination of addiction care in the Netherlands is delegated to regional and local authorities, and is part of the broader mental healthcare agenda. Addiction care is provided by 14 regular addiction care and treatment institutes, of which seven have merged with a mental health institute and one with an institute for social support. Municipal public health services, general psychiatric hospitals, several religious organisations and some private clinics also offer care for people with addiction problems. Addiction care is also available in the criminal justice sector, and within the probation services.
In the past decade, however, the number of addiction service providers has reduced considerably due to the many mergers that took place for economic reasons in the Dutch mental healthcare and addiction care services. Further agreements were reached in 2012 among main stakeholders and funding institutions in mental health to gradually reduce the number of beds in long-term residential mental healthcare settings, including addiction services, and to expand outpatient services, services through general practitioners and e-health interventions (e.g. Drugsondercontrole). This shift supports an overall vision that puts addiction clients in charge of their own addiction treatment, by shifting the care towards empowerment, reintegration and self-regulation by the clients. Since the start of 2014 addiction care has been provided in a three-stepped approach, with frontline support from a general practitioner or a general practice mental health worker, followed by the primary mental healthcare and secondary mental healthcare.
In general, funding for drug treatment is mainly provided by health insurance, while the public budget for social support at the national and local levels is mainly provided for special projects, such as heroin-assisted therapy.
The options for drug treatment interventions in the Netherlands are diverse, with predominantly outpatient treatment options. Opioid substitution treatment (OST) is dominant for opiate dependence. Psychosocial interventions are frequently provided to complement OST in order to achieve longer-term effectiveness, reduce relapses and promote social reintegration. In recent years, however, new treatment options have been introduced for young cannabis users, people with multiple (addiction and mental health) problems, and crack and GHB users. In addition, new treatment settings for homeless drug users in several municipalities have been opened.
The psychosocial treatments that are frequently used in drug treatment centres include motivational interviewing, relapse prevention techniques, cognitive behavioural therapies, and family, community and home-based treatment therapies.
Methadone has been the most commonly prescribed substitution substance since 1968. Heroin-assisted treatment (HAT, introduced in 1998) and high-dosage buprenorphine treatment (introduced in 1999) are also available. HAT is provided at 18 outpatient treatment units and is used with a restricted and controlled group of treatment-resistant opiate users. Methadone, on the other hand, is available via various outpatient treatment providers, including office-based practitioners and mobile units.
According to the latest available data (2014), a total of 7 569 clients were in methadone maintenance treatment, while 697 persons received HAT. The number of people receiving buprenorphine-based maintenance is not available.
In the Netherlands there is a lot of overlap between outreach work, low-threshold services, harm reduction activities and ‘social addiction care’. The first goal is to make and maintain contact with difficult-to-reach drug users (hidden populations). All four services attempt to motivate difficult-to-reach drug users to participate in some kind of treatment to prevent their individual and/or social situation from worsening. If this is not feasible, support is given to these drug users to help them reduce drug-related harm.
Most outreach work is carried out by low-threshold services in outpatient care facilities. These services are active in ‘street corner work’, offering daytime shelter in drop-in centres for street-based problem drug users, ‘living room’ projects for drug-using prostitutes and drug consumption rooms for chronic hard drug users. Other target groups are injecting drug users, extremely high-risk drug users and drug users from foreign countries. Outreach activities also feature in programmes for reducing drug-related public nuisance, which are often a collaborative venture between treatment and care facilities, police and civil groups. Outreach work is often ‘on the spot’ education (i.e. at places where young people meet), applying peer support techniques. Another approach is targeting drug users who have been imprisoned, for example by offering pre-release counselling.
Needle and syringe programmes have been established for more than 20 years in the Netherlands and are available in all major Dutch cities. These programmes are mainly implemented by street drugs workers, addiction care providers and, to a much lesser extent, by pharmacists. There are around 150 specialist agencies for needle and syringe programmes in the Netherlands. In some cities pharmacies also provide needle and syringe programmes, and in Rotterdam needle and syringe exchange is supported at several police stations. There are no national registration data on the number of syringes and needles exchanged. However, data from Amsterdam show that from 1990 to 1993 approximately one million needles were exchanged. Since 1993 there has been a sharp decline, to 92 400 syringes in 2014. In Rotterdam the number of syringes given out in the same year decreased to around 48 800 (including some police stations), from 422 400 in 2000. The decline in the number of needles and syringes exchanged can be explained by several factors, such as the reduction of heroin injecting in general, the reduction of the injecting drug use population and the reduced popularity of injecting as such, and also the increasing inhalative use of drugs, such as crack cocaine. Therefore, it is assumed that existing programmes meet the needs of the majority of people who inject drugs and are in need of clean injecting equipment. There are also 31 drug consumption rooms in 25 cities targeting people who inject drugs and those who smoke or inhale drugs.
A national HBV vaccination campaign targeting behavioural risk groups has been implemented since 2002. This campaign offers screening for HBV infection and vaccination for vulnerable people. Approximately 18 600 PWID have benefited from the programme since its inception until 2012, when drug users were removed as a target group of this campaign as it was thought that the HBV risk rate had been substantially reduced among this group. HBV vaccination is now part of individual care and the responsibility of addiction care institutes. In 2015 HCV treatment availability was expanded and has become reimbursable.
The Netherlands has domestic production of cannabis and synthetic drugs and is an exporter of these drugs; however, it is also a transit country for heroin and cocaine. Cannabis cultivation occurs mainly indoors, with only a small fraction of its cultivation sites discovered outside. The main destinations for cannabis produced in the Netherlands are the United Kingdom, Germany, Italy and Scandinavian countries. In 2014 some 6 006 cannabis plantations were dismantled, which indicates an increasing trend since 2011.
In 2013 and 2014 the National Squad for Support at Dismantlements destroyed more than 50 synthetic drugs production locations, while 42 similar facilities were seized in 2012 and 30 in 2011, indicating an increase in recent years. Most of those laboratories were involved in amphetamine and MDMA production and/or the conversion of pre-precursors for its production. The United Kingdom and Scandinavian countries are the primary destinations for amphetamines produced in the Netherlands, while MDMA is also trafficked to Australia.
Heroin originates mainly from Afghanistan and from there is trafficked to the Netherlands via Iran, Turkey and the Balkan countries, although it is noted that the northern route along the Black Sea is an alternative. Cocaine is supplied from Peru, Bolivia and Colombia via African countries, from where it is delivered by boat to Rotterdam; however, a part of it is smuggled into the country by air.
Data on drug seizures in the Netherlands are collected centrally by the National Police Agency. The register includes data from the regional police departments, customs, the Royal Military Police and the Synthetic Drugs Unit (now part of the National Police Force). Not all departments report each year; this, and the lack of a uniform registration system, hampers the quality of the data collected and thus data are not fully complete and trends cannot be reported. The most complete reporting dates back to 2012, while more recent data are only available for cannabis plants. In 2012 some 2 200 kg of cannabis resin, 12 600 kg of herbal cannabis, 1.4 million cannabis plants (1.2 million in 2013 and 1.6 million in 2014), 750 kg of heroin, 10 tons of cocaine, more than 2.4 million ecstasy tablets, 680 kg of amphetamine and 0.5 kg of methamphetamine were seized in the Netherlands.
In 2014 a total of 21 387 offences against the Opium Act were registered by the Public Prosecutor, which is the highest number registered since 2007. Slightly more than half of all reports have been linked to ‘soft drugs’. The majority of offences related to ‘hard drugs’ are linked to their possession.
The Netherlands Opium Act, which came into force in 1928 and was fundamentally amended in 1976, is the basis for the present drug legislation. It defines drug trafficking, cultivation and production, dealing in and possession of drugs as criminal acts. The Act and its amendments confirm the distinction between List I drugs (e.g. heroin, cocaine, ecstasy, amphetamines) and List II drugs (e.g. cannabis or hallucinogenic mushrooms). In 2012 it was proposed that cannabis with over 15 % tetrahydrocannabinol (THC) should be placed in List I, but this has not yet been implemented. Furthermore, criteria defining the ‘professional cultivation of cannabis’ for prosecution purposes were also revised in the Opium Act Directive. New psychoactive substances are regulated through amendments to relevant Schedules of the Opium Act.
Drug use as such does not constitute a crime in legal terms. However, there are situations when the use of drugs is prohibited at the local level for reasons of public order or to protect the health of youngsters, such as at schools and on public transport. It is up to the responsible authorities — which is not the national government — to regulate this.
The possession of small quantities of drugs for personal use is not subject to targeted investigation by the police. Anyone found in possession of less than 0.5 g of List I drugs will generally not be prosecuted, though the police will confiscate the drugs and refer the individual to a care agency. The threshold amount for cannabis is set at 5 g. However, a new formulation was introduced in the Opium Act Directive in 2012. In place of the wording ‘a police dismissal should follow if a cannabis user is caught with less than 5 grams of cannabis’, it now states that ‘in principle a police dismissal will follow if a person is carrying less than 5 grams of cannabis’, which opens the way to the arrest and prosecution of people in possession of less than 5 g of cannabis in certain circumstances.
Drug users are convicted when they have committed a crime such as selling drugs, theft, robbery or burglary. A special law — the Placement in an Institution for Prolific Offenders (ISD) — was introduced in 2004 for the treatment of prolific offenders, of which problematic drug users are a major percentage. The measure consists of a combination of imprisonment and behavioural interventions and treatment, which is mostly carried out in care institutions outside prison.
Supplying drugs is punishable according to the Opium Act (possession, cultivation or manufacture, import or export), according to the quantity and type of drug being supplied, with penalties reaching up to 12 years’ imprisonment.
The 1995 White Paper ‘Drug policy: continuity and change’ set out some of the basic principles of the Dutch drug policy on illicit drugs. These included a continuation of the distinction between ‘soft’ (List II) and ‘hard’ (List I) drugs, and the White Paper took a balanced and integrated approach. It also outlined four major objectives: (i) to prevent drug use and to treat and rehabilitate drug users; (ii) to reduce harm to users; (iii) to diminish public nuisance caused by drug users; and (iv) to combat the production and trafficking of drugs.
Following the publication of the 1995 White Paper, other aspects of Dutch drug policy have been elaborated in different strategies and policy notes or letters to Parliament focused on specific drugs and issues.
In 2001 the White Paper ‘A combined effort to combat ecstasy’ discussed the intensification of law enforcement efforts to tackle the production and trafficking of ecstasy. This policy was put on a continuing basis in 2007. Cocaine was addressed in 2002 through the ‘Plan to combat drug trafficking at Schiphol airport’, which was also given a continuous footing in subsequent years. In 2004 the ‘Cannabis policy document’ adopted a more restrictive approach to cannabis and especially to professional cannabis production. The medical prescription of heroin to treat chronic and treatment-resistant opiate addicts was established as a regular part of the treatment system in 2009. Organised crime in relation to synthetic drugs, heroin, cocaine and the large-scale cultivation of cannabis were targeted as priority areas in the Police and the Public Prosecution Office policy letter for 2008–12 and again for 2012–16. In 2009 a policy letter to the Parliament, ‘Letter outlining the new Dutch policy’, placed an increased emphasis on prevention and the reduction of drug use. It also adjusted the ‘coffee shop’ policy to make the establishments small, and principally for local users, and with the number of shops restricted to reflect the local situation, and established an integrated approach for fighting organised crime.
In the current Opium Act Directive the objective of the drug policy is described as follows: ‘The [new] Dutch drugs policy aims to discourage and reduce drug use, certainly in so far as it causes damage to health and to society, and to prevent and reduce the damage associated with drug use, drug production and the drugs trade’ (Stc 2011–11134).
Dutch cannabis policy has been elaborated in a series of policy letters. As in some other countries, the expediency principle is applied to Dutch policy on investigations and prosecutions. This principle implies that the Public Prosecutor has the discretionary power to refrain from the prosecution of criminal offences if this is judged to be in the public interest. The expediency principle also provides the basis for the coffee shop policy. Users can buy cannabis in a coffee shop, preventing them from coming into contact with hard drugs. Though still a criminal offence, the sale of small quantities is condoned if a coffee shop adheres to the following strictly controlled ‘AHOJGI’ criteria: A — no Advertising; H — no sale of hard drugs; O — no public nuisance (overlast) in and around the COFFEE SHOP; J — no admittance or sale to minors (jong) (younger than 18 years); G — no sale of large (groot) quantities per transaction (maximum 5 g), with a maximum stock for selling of 500 gram; I — admittance and sales are limited to residents (ingezetenen) of the Netherlands. This was introduced in 2013, and enforcement rests with the powers of the Mayor and may be implemented in phases.
In November 2015 the Government formulated a new policy view on drug prevention, intending among other things to change the entrenched opinion among young adults that the use of drugs in nightlife settings is normal. The following measures were announced: supporting parents in talking to their adolescent children about drugs; informing young people about the risks of drug use by modernising education at schools; supporting municipalities in their drug prevention policies.
The responsibility for Dutch drug policy is shared between several ministries. The Ministry of Health, Welfare and Sport is tasked with coordination, while the Ministry of Security and Justice is responsible for law enforcement and matters relating to local government and the police. The Ministry of Foreign Affairs is in charge of certain issues, including matters relating to HIV/AIDS and injecting drug use, on behalf of the Government at the international level. Regular coordination takes place through meetings between drug policy managers at the relevant ministries.
In the Netherlands there is no budget earmarked beforehand in the drug policy documents and there is no review of executed expenditures. The number of overall estimations of drug-related public expenditure is also limited, with only one study in this area (1). The methods used are not fully explained and information is sometimes fragmented or forms a part of broader budgets. The study’s results were questioned by later research (2, 3, 4).
The available study of total drug-related public expenditure (5) estimated that for 2003 this represented 0.5 % of gross domestic product (1). Most of the expenditure was attributed to law enforcement (75 %), followed by treatment (13 %), harm reduction (10 %) and prevention (2 %).
The available information does not allow the total size and trends in drug-related public expenditure in the Netherlands in recent years to be reported.
(1) H. Rigter (2006), ‘What drug policies cost: Drug policy spending in the Netherlands in 2003’, Addiction 101, pp. 323–329.
(2) D. E. G. Moolenaar (2009), ‘Modelling criminal justice system costs by offence: Lessons from the Netherlands’, European Journal on Criminal Policy and Research 15, pp. 309–326.
(3) B. Nauta, D. E. G. Moolenaar and F. P. Van Tulder (2011), ‘Kosten van criminaliteit’, in S. N. Kalidien and N. E. De Heer-De Lange (eds), Criminaliteit en rechtshandhaving 2010: Ontwikkelingen en samenhangen, Raad voor de Rechtspraak/WODC/CBS, Den Haag, pp. 241–270.
(4) M. Van Ooyen-Houben and E. Kleemans (2015), ‘Drug policy: The “Dutch Model”,’ Crime and Justice 44(1), pp. 165–226, doi:10.1086/681551.
(5) Some of the funds allocated by governments for expenditure on tasks related to drugs are identified as such in the budget (‘labelled’). Often, however, the bulk of drug-related expenditure is not identified (‘unlabelled’) and must be estimated by modelling approaches. The total budget is the sum of labelled and unlabelled drug-related expenditure.
Drug research in the Netherlands is extensive and covers many domains. Public funding of drug-related research is to a large extent delegated to intermediary agencies, although ministries and municipalities also directly fund a considerable number of research projects. Many academic institutions are involved in drug research, sometimes together with researchers from institutes for addiction care. A national meeting is organised annually for drug researchers to stay informed about recent developments (Forum Alcohol and Drugs research, FADO). In March 2016 a two-day alcohol and drug conference was held, with a focus on informing local organisations and municipalities on the latest developments in research and prevention of alcohol and drug use. The number of publications in national and international scientific journals is extensive. The development and implementation of multidisciplinary evidence-based guidelines, protocols and training materials are the most important channels for disseminating drug-related research findings from the scientific community to practitioners and decision-makers. The Netherlands national focal point maintains part of the website of the Trimbos Institute to disseminate reports on research findings. Research on nuisance and crime is funded by municipalities and nationally. The Ministry of Security and Justice, and especially the Research and Documentation Centre of the ministry (WODC), is an important player in funding research that is carried out by diverse research institutes and universities. It also conducts its own research (for example, monitoring organised crime and criminal recidivism of offenders). Reports carried out by WODC or funded by WODC are public and contain a summary in English, available on www.wodc.nl. Moreover, the Netherlands Organization for Health Research and Development initiated the European Area Network on Illicit Drugs (ERANID), consisting of nine organisations in six different European Union Member States.
Recent drug-related studies have mainly focused on aspects related to the consequences of drug use, responses to the drug situation, and prevalence, incidence and patterns of drug use. Studies on the mechanisms of drug use and effects, methodology issues and supply and markets were also mentioned.
|Problem opioid use (rate/1 000)||2012||1.26||0.2||10.7|
|All clients entering treatment (%)||2014||10.5%||4%||90%|
|New clients entering treatment (%)||2014||5.7%||2%||89%|
|Purity — heroin brown (%)||2014||1||44.9%||7%||52%|
|Price per gram — heroin brown (EUR)||2014||EUR 34||EUR 23||EUR 140|
|Prevalence of drug use — schools (%)||2011||2.0%||1%||5%|
|Prevalence of drug use — young adults (%)||2014||3.0%||0%||4%|
|Prevalence of drug use — all adults (%)||2014||1.5%||0%||2%|
|All clients entering treatment (%)||2014||26.3%||0%||38%|
|New clients entering treatment (%)||2014||22.0%||0%||40%|
|Price per gram (EUR)||2014||EUR 52||EUR 47||EUR 107|
|Prevalence of drug use — schools (%)||2011||1.0%||1%||7%|
|Prevalence of drug use — young adults (%)||2014||2.9%||0%||3%|
|Prevalence of drug use — all adults (%)||2014||1.3%||0%||1%|
|All clients entering treatment (%)||2014||6.6%||0%||70%|
|New clients entering treatment (%)||2014||6.2%||0%||75%|
|Price per gram (EUR)||2014||EUR 7||EUR 3||EUR 63|
|Prevalence of drug use — schools (%)||2011||4.0%||1%||4%|
|Prevalence of drug use — young adults (%)||2014||5.5%||0%||6%|
|Prevalence of drug use — all adults (%)||2014||2.4%||0%||2%|
|All clients entering treatment (%)||2014||0.4%||0%||2%|
|New clients entering treatment (%)||2014||0.7%||0%||2%|
|Purity (mg of MDMA base per unit)||2014||118 mg||27 mg||131 mg|
|Price per tablet (EUR)||2014||EUR 4||EUR 4||EUR 16|
|Prevalence of drug use — schools (%)||2011||27.0%||5%||42%|
|Prevalence of drug use — young adults (%)||2014||15.6%||0%||24%|
|Prevalence of drug use — all adults (%)||2014||7.7%||0%||11%|
|All clients entering treatment (%)||2014||47.6%||3%||63%|
|New clients entering treatment (%)||2014||56.2%||7%||77%|
|Potency — herbal (%)||:||:||3%||15%|
|Potency — resin (%)||2014||17.8%||3%||29%|
|Price per gram — herbal (EUR)||:||:||EUR 3||EUR 23|
|Price per gram — resin (EUR)||2014||EUR 9||EUR 3||EUR 22|
|Prevalence of problem drug use|
|Problem drug use (rate/1 000)||:||:||2.7||10.0|
|Injecting drug use (rate/1 000)||2008||0.2||0.2||9.2|
|Drug-related infectious diseases/deaths|
|HIV infections newly diagnosed (cases / million)||2014||0.0||0.0||50.9|
|HIV prevalence (%)||:||:||0%||31%|
|HCV prevalence (%)||:||:||15%||84%|
|Drug-related deaths (rate/million)||2014||10.8||2.4||113.2|
|Health and social responses|
|Syringes distributed||2012||237 400||382||7 199 660|
|Clients in substitution treatment||2014||7 569||178||161 388|
|All clients||2014||10 631||271||100 456|
|New clients||2014||6 101||28||35 007|
|All clients with known primary drug||2014||10 631||271||97 068|
|New clients with known primary drug||2014||6 101||28||34 088|
|Drug law offences|
|Number of reports of offences||2014||21 387||537||282 177|
|Offences for use/possession||2008||7 390||13||398 422|
b Break in time series.
p Eurostat provisional value.
: Not available.
1 Gross domestic product (GDP) is a measure of economic activity. It is defined as the value of all goods and services produced less the value of any goods or services used in their creation. The volume index of GDP per capita in Purchasing Power Standards (PPS) is expressed in relation to the European Union (EU-27) average set to equal 100. If the index of a country is higher than 100, this country's level of GDP per head is higher than the EU average and vice versa.
2 Expenditure on social protection contains: benefits, which consist of transfers in cash or in kind to households and individuals to relieve them of the burden of a defined set of risks or needs.
3 Unemployment rates represent unemployed persons as a percentage of the labour force. Unemployed persons comprise persons aged 15 to 74 who were: (a) without work during the reference week; (b) currently available for work; (c) actively seeking work.
4 Situation of penal institutions on 1 September, 2014.
5 Share of persons aged 0+ with an equivalent disposable income below the at-risk-of-poverty threshold, which is set at 60 % of the national median equivalised disposable income (after social transfers).
|Year||The Netherlands||EU (28 countries)||Source|
|Population||2014||16 829 289||506 944 075 bep||Eurostat|
|Population by age classes||15–24||2014||12.2 %||11.3 % bep||Eurostat|
|25–49||33.1 %||34.7 % bep|
|50–64||20.4 %||19.9 % bep|
|GDP per capita in PPS (Purchasing Power Standards) 1||2014||131||100||Eurostat|
|Total expenditure on social protection (% of GDP) 2||2013||31.3 % bp||:||Eurostat|
|Unemployment rate 3||2015||6.9 %||9.4 %||Eurostat|
|Unemployment rate of population aged under 25 years||2015||11.3 %||20.3 %||Eurostat|
|Prison population rate (per 100 000 of national population) 4||2014||58.6||:||Council of Europe, SPACE I-2014.1|
|At risk of poverty rate 5||2014||11.6 %||17.2 %||SILC|
Da Costakade 45
PO Box 725
NL-3500 AS Utrecht
Tel. +31 302971186
Fax +31 302971187
Head of national focal point: Mrs Margriet van Laar
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