Our partner in Netherlands
Trimbos-instituut (Netherlands Institute of Public Health and Addiction)
Da Costakade 45
PO Box 725
NL-3500 AS Utrecht
Tel. +31 302971186
Fax +31 302971187
Head of focal point: Mr Margriet van Laar
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 national level, and to report these data to the Lower Chamber of Parliament, concerned ministries and other stakeholders inside and outside the country. The NFP is part of the Drug Monitoring Department of the Trimbos Institute, the national research institute for mental health care, addiction care and social work in the Netherlands, which is tasked with informing policymakers and politicians about the mental health issues that concern the Dutch population.
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Drug use among the general population and young people
General population surveys on drug use prevalence were carried out in the Netherlands in 1997, 2001, 2005 and 2009 among adults aged 15–64. In 2009 the sample size consisted of 5 769 respondents. Some 25.7 % of respondents reported lifetime prevalence of cannabis use. The gender gap regarding cannabis use remains wide — last year prevalence of cannabis use was about 2.3 times higher among males than females (9.8 % and 4.2 % respectively). Lifetime prevalence of ecstasy use was 6.2 %, and last year prevalence was 1.4 %. Cocaine was the third most popular ‘ever used’ drug, with lifetime prevalence of 5.2 %. More than a third of those aged 15–34 (36.8 %) reported ever having used cannabis, followed by ecstasy at 11.6 % and cocaine at 7.6 %. Last year prevalence of cannabis use among young adults was 13.7 %, while 7.7 % reported using cannabis in the last 30 days. However, due to methodological changes in the latest survey, prevalence data from 2009 are not comparable to those of previous years. Therefore trends in drug use cannot be determined.
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 carried out in 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 has been carried out every three or four years since 1988, and the Health Behaviour in School-aged Children (HBSC) 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 since 1988, up to 1996, which stabilised between 2001 and 2007, and then decreased up to 2013.
The results of the most recent HBSC 2013 survey indicate that the lifetime prevalence of cannabis use was 17 % among 15-years-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).
Several national and local studies, inter alia, inquiring about cannabis use were carried out between 2005 and 2009 among the general population. The results of those studies are available in the reports on the Netherlands drug situation for 2010, 2011 and 2012.
In 2013 an online survey among a convenience sample of 3 335 people aged 15–35 who had visited parties, festivals and clubs 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 twenty 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. The findings from the survey cannot be generalised to everyone who attends parties, festivals and clubs. An Antenna study, using mixed methods, has been implemented since 1993 in Amsterdam, and targets adolescents and young adults in nightlife settings and particular neighbourhoods.
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. It is not clear yet what these findings from the wastewater analyses indicate about the use of substances by the population of these cities.
Look for Prevalence of drug use in the 'Statistical bulletin' for more information
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 is being revised 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 will be played by social neighbourhood teams, which are being 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.
See the Prevention profile for Netherlands for more information.
High-risk drug use
Up to 2012 the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) defined problem drug use as injecting drug use (IDU) 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 around 14 000 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.
Look for High risk drug-use in the Statistical bulletin for more information.
The National Alcohol and Drugs Information System (LADIS) is the most comprehensive information system on treatment demand clients in the Netherlands. The 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 the LADIS. It is estimated that about 5 % of addiction care is not included in the LADIS. Another source of information is the register of the hospital admissions, the National Hospital Care Basic Registration (LBZ), which records the number of admissions due to drug-related problems during the year; however, it is not clear how the definitions in this register relate to the treatment demand indicator guidelines.
In 2013, a total of 190 outpatient and 15 inpatient units submitted treatment demand data to the LADIS.
Data showed that in 2013 a total of 11 754 clients entered treatment, of which 6 744 were new clients entering treatment for the first time. Some 48 % of all treatment clients reported cannabis as their primary drug, followed by 26 % for cocaine and 10 % for opioids. A slightly different distribution was identified among new treatment clients, with 57 % requesting treatment for cannabis, followed by 22 % for cocaine and 5.0 % for opioids. Traditionally, injecting drug use is rare among treatment clients, and the proportion of drug injectors among all treatment clients using injectable substances is below 1 %.
A decline in treatment demands related to heroin, and recently also to cocaine, and a steady increase in cannabis-related treatment demands has been noted in the Netherlands in recent years. There has also been a noticeable increase in the number of clients entering treatment for GHB as their primary drug, from 59 cases in 2007 to 769 in 2013. Although the figures are low, the analysis of data shows that these clients have high recidivism rates when compared to clients entering treatment for other drug problems.
The mean age of all treatment clients in 2013 was 32 years, while new treatment clients were slightly younger – on average 29 years old. The majority (80 %) of all treatment clients were male. The proportion of males among new treatment clients (77 %) was slightly lower than among all treatment clients.
Look for Treatment demand indicator in the Statistical bulletin for more information.
Drug-related infectious diseases
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 five cases injecting drug use was the most likely route of transmission.
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.
According to the European Centre for Disease Prevention and Control, in 2013 there were no notifications of acute HBV infection among PWID out of 143 reported cases. In 2013 three of 1 144 chronic HBV infections were linked to injecting drug use. About 65 acute HCV infection cases were reported in 2013, and 57 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.
Look for Drug-related infectious diseases in the Statistical bulletin for more information.
Drug-induced deaths and mortality among drug users
The main source providing the 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 2012, a total of 118 drug-induced deaths were registered. The majority of cases were male (95). The mean age of the victims was 42 years.
From 1996 to 2012 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. 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 10.2 deaths per million in 2012, lower than the 2013 European average of 17.2 deaths per million.
Look for Drug-related deaths in the Statistical bulletin for more information.
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 13 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 10 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. In 2012, further agreements were reached 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 of 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. However, there have been some challenges related to co-payment for the primary mental healthcare services.
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. In 2012 out-of-pocket payments for addiction treatment were increased, which reduced the number of outpatient treatment clients and created resistance from care providers. As a result, in October 2012 the measure was cancelled. Some measures are taken by the Council for Care Insurance and the National Health Care Institute to further determine reimbursement criteria for addiction care.
The options for drug treatment interventions in the Netherlands are diverse. Outpatient opioid substitution treatment (OST) is dominant for opiate dependence. Psychosocial interventions are more 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 municipality 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 (2013), a total of 8 185 clients were in methadone maintenance treatment. The number of people receiving buprenorphine-based maintenance treatment is not available.
See the Treatment profile for Netherlands for additional information.
Harm reduction responses
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, to175 000 syringes in 2013. In Rotterdam the number of syringes given out in the same year decreased to around 84 800 (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. 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. However, from 2012 drug users no longer have access to this free programme, as it was thought that the HBV risk rate had been substantially reduced among this group.
See the Harm reduction overview for Netherlands for additional information.
Drug markets and drug-law offences
The Netherlands has a pivotal position within the international drugs trade, and thus plays a major role as a transit country for heroin, cocaine and other illicit substances. The supply of heroin to Europe, including to the Netherlands, is mainly dependent on the production of opium in Afghanistan. The Netherlands is an endpoint of the Balkan route, while the northern route along the Black Sea is used as an alternative. Heroin is distributed from the Netherlands to other western European countries. Cocaine is supplied from Peru, Bolivia and Colombia via African countries, from where it is delivered by boat to Antwerp (in Belgium) or Rotterdam, to be smuggled on to other European countries. No substantial new developments were observed by the National Police Agency in the domestic production of cannabis in the Netherlands. The main destinations for cannabis produced in the Netherlands are the United Kingdom, Germany, Italy and Scandinavian countries. In 2013 some 5 962 cannabis plantations were dismantled, which might indicate an increase when compared to 2012. At the same time there has also been an improvement in the registration of these activities. Cannabis resin is smuggled to the Netherlands by sea from Morocco.
In 2013, the National Squad for Support at Dismantlements destroyed 57 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 production and/or the conversion of pre-precursors for its production.
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. 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), 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 2013, a total of 17 130 offences against the Opium Act were registered by the Public Prosecutor, which is fewer than were registered in 2012. Since 2009, slightly more than half of all reports have been linked to ‘soft drugs’, while the proportion of reports linked to ‘hard drugs’ has decreased. This shift might be attributed to an intensification in police actions directed at cannabis production.
Look for Drug law offences in the Statistical bulletin for additional data.
National drug laws
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). Since 2012, there is a proposal to place cannabis that has over 15 % tetrahydrocannabinol (THC) in List I. 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 on a 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 Directive Act 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.
Go to the European Legal Database on Drugs (ELDD) for additional information.
National drug strategy
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 the 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).
More recently, the ‘Drug policy letter’ of 27 May 2011 of the Rutte I administration set out the two pillars of Dutch drug policy: (i) the protection of public health; and (ii) combating public nuisance and organised crime. This policy letter also outlined the alterations to the accessibility of coffee shops so they would become closed clubs, only accessible to Dutch adult residents. Follow-up policy letters in October and December 2011 further elaborated the changes to be made to the coffee shop system. This included altering the Opium Act Directive to make the shops closed members-only clubs, and putting resident criteria in place. Both measures were implemented in the three southern provinces in May 2012. However, a policy letter from the Minister of Security and Justice in November 2012, under the Rutte II administration, confirmed that the additional closed club criteria would not be implemented further, while the residence criteria would remain in place (to enter into force nationally from 1 January 2013, while the decision to actually enforce it became a matter of local tailoring). In a policy letter from April 2012 the Minister of Security and Justice established that the mayors of the municipalities are primarily responsible for the enforcement of the criteria, often in close cooperation with the police. Sanctions for violating the criteria may be administrative and/or criminal.
Coordination mechanism in the field of drugs
The responsibility for the drug policy is shared between several ministries. The Ministry of Health, Welfare and Sport is tasked with the coordination, while the Ministry of Security and Justice is responsible for the 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).
The available study of total drug-related public expenditure (4) 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.
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. 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. Drug-related studies in the field of security and justice, which are conducted in commission of or by the Research and Documentation Centre (WODC) of the Ministry of Security and Justice, are all made public on the WODC website. Recent drug-related studies mentioned in the 2014 Dutch National report 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, evidence-based treatments, and supply and markets — which included studies on the coffee shops — were also mentioned.
See Drug-related research for more detailed information.
Key national figures and statistics
b Break in time series.
p Eurostat provisional value.
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, 2012.
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 ||506 824 509 ep |
|Population by age classes ||15–24 || 2014 ||12.2 % ||11.3 % bep |
|25–49 ||33.1 % ||34.7 % bep |
|50–64 ||20.4 % ||19.9 % bep |
|GDP per capita in PPS (Purchasing Power Standards) 1 || 2013 ||131 ||100 ||Eurostat |
|Total expenditure on social protection (% of GDP) 2 || 2012 ||33.3 % p ||29.5% p ||Eurostat |
|Unemployment rate 3 || 2014 ||7.4 % ||10.2 % ||Eurostat |
|Unemployment rate of population aged under 25 years || 2014 ||12.7 % ||22.2 % ||Eurostat |
|Prison population rate (per 100 000 of national population) 4 || 2013 ||62.9 || : ||Council of Europe, SPACE I-2013 |
|At risk of poverty rate 5 || 2013 ||10.4 % ||16.6 % ||SILC |
Data sheet — key statistics on the drug situation
| || || || ||EU range || || || |
| ||Year || ||Country data ||Min. ||Max. ||Average ||Rank ||Reporting Countries |
|Opioids || || || || || || || || |
|Problem opioid use (rate/1 000) ||2012 ||1 ||1.26 ||0.2 ||10.7 || ||4 ||21 |
|All clients entering treatment (%) ||2013 || ||10.2% ||6% ||93% || || || |
|New clients entering treatment (%) ||2013 || ||33.7% ||2% ||81% || || || |
|Purity — heroin brown (%) ||2013 ||2 ||35.5% ||6% ||42% || ||23 ||24 |
|Price per gram — heroin brown (EUR) ||2013 || ||EUR 35 ||EUR 25 ||EUR 158 || ||5 ||22 |
| || || || || || || || || |
|Cocaine || || || || || || || || |
|Prevalence of drug use — schools (%) ||2011 || ||2.0% ||1% ||5% || || || |
|Prevalence of drug use — young adults (%) ||2009 || ||2.4% ||0% ||4% ||2% || || |
|Prevalence of drug use — all adults (%) ||2009 ||3 ||1.2% ||0% ||2% ||1% ||23 ||26 |
|All clients entering treatment (%) ||2013 || ||26.5% ||0% ||39% || || || |
|New clients entering treatment (%) ||2013 || ||32.2% ||0% ||40% || || || |
|Purity (%) ||2013 || ||61.3% ||20% ||75% || ||25 ||27 |
|Price per gram (EUR) ||2012 || ||EUR 54 ||EUR 47 ||EUR 103 || ||6 ||24 |
| || || || || || || || || |
|Amphetamines || || || || || || || || |
|Prevalence of drug use — schools (%) ||2011 || ||1.0% ||1% ||7% || || || |
|Prevalence of drug use — young adults (%) ||: || ||: ||0% ||3% ||1% || || |
|Prevalence of drug use — all adults (%) ||2009 ||3 ||0.4% ||0% ||1% ||1% ||11 ||25 |
|All clients entering treatment (%) ||2013 || ||6.5% ||0% ||70% || || || |
|New clients entering treatment (%) ||2013 || ||: ||0% ||74% || || || |
|Purity (%) ||2013 || ||46.8% ||5% ||71% || ||24 ||25 |
|Price per gram (EUR) ||2013 || ||EUR 8 ||EUR 8 ||EUR 63 || ||2 ||21 |
| || || || || || || || || |
|Ecstasy || || || || || || || || |
|Prevalence of drug use — schools (%) ||2011 || ||4.0% ||1% ||4% || || || |
|Prevalence of drug use — young adults (%) ||2009 ||3 ||3.1% ||0% ||3% ||1% || || |
|Prevalence of drug use — all adults (%) ||2009 ||3 ||1.4% ||0% ||2% ||1% ||24 ||25 |
|All clients entering treatment (%) ||2013 || ||0.6% ||0% ||2% || || || |
|New clients entering treatment (%) ||2013 || ||3.5% ||0% ||4% || || || |
|Purity (mg of MDMA base per unit) ||2013 || ||111 mg ||26 mg ||144 mg || ||20 ||23 |
|Price per tablet (EUR) ||2013 || ||EUR 4 ||EUR 3 ||EUR 24 || ||2 ||19 |
| || || || || || || || || |
|Cannabis || || || || || || || || |
|Prevalence of drug use — schools (%) ||2011 || ||27.0% ||5% ||42% || || || |
|Prevalence of drug use — young adults (%) ||2009 ||3 ||13.7% ||0% ||22% ||12% || || |
|Prevalence of drug use — all adults (%) ||2009 ||3 ||7.0% ||0% ||9% ||6% ||24 ||27 |
|All clients entering treatment (%) ||2013 || ||47.8% ||3% ||63% || || || |
|New clients entering treatment (%) ||2013 || ||25.1% ||5% ||80% || || || |
|Potency — herbal (%) ||2013 || ||4.8% ||2% ||13% || ||3 ||22 |
|Potency — resin (%) ||2013 || ||14.9% ||3% ||22% || ||14 ||20 |
|Price per gram — herbal (EUR) ||2013 || ||EUR 5 ||EUR 4 ||EUR 25 || ||2 ||19 |
|Price per gram — resin (EUR) ||2013 || ||EUR 10 ||EUR 3 ||EUR 21 || ||11 ||21 |
| || || || || || || || || |
|Prevalence of problem drug use || || || || || || || || |
|Problem drug use (rate/1 000) ||: || ||: ||2.0 ||10.0 || || || |
|Injecting drug use (rate/1 000) ||2008 ||4 ||0.2 ||0.2 ||9.2 || || || |
| || || || || || || || || |
|Drug-related infectious diseases/deaths || || || || || || || || |
|HIV infections newly diagnosed (rate/million) ||2013 || ||0.3 ||0.0 ||54.5 || || || |
|HIV prevalence (%) ||: || ||: ||0% ||49% || || || |
|HCV prevalence (%) ||: || ||: ||14% ||84% || || || |
|Drug-related deaths (rate/million) ||2012 || ||7.0 ||1.5 ||84.1 || || || |
| || || || || || || || || |
|Health and social responses || || || || || || || || |
|Syringes distributed ||2012 || ||237 400 ||124 406 ||9 239 506 || || || |
|Clients in substitution treatment ||2013 || ||8 185 ||180 ||172 513 || || || |
| || || || || || || || || |
|Treatment demand || || || || || || || || |
|All clients ||2013 || ||11 754 ||289 ||101 753 || || || |
|New clients ||2013 || ||220 ||19 ||35 229 || || || |
|All clients with known primary drug ||2013 || ||11 754 ||287 ||99 186 || || || |
|New clients with known primary drug ||2013 || ||6 744 ||19 ||34 524 || || || |
| || || || || || || || || |
|Drug law offences || || || || || || || || |
|Number of reports of offences ||2013 || ||17 130 ||429 ||426 707 || || || |
|Offences for use/possession ||: || ||: ||58 ||397 713 || || || |
| || || || || || || || || |