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Harm reduction overview for Netherlands

Map of Netherlands

1. National context

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.

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2. Responses to prevent and reduce drug-related infectious diseases

Needle and syringe programmes Country  data
Availability of  NSP programmes  Extensive
% NSP availability at NUTS3  :
Drug use equipment distributed at specialised drug agencies (standard prevention material)
availability of alcohol pads  Yes
availability of dry wipes  Yes
availability of containers  Yes
availability of water  Yes
availability of condoms  Yes
availability of foil  No

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
For an explanation of terms used, see the definitions of terms.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.
Testing, vaccination and treatment of infections Country  data
Availability of Hepatitis C testing in the community  Extensive
Availability of universal hepatitis B immunization programme  Yes
Hepatitis B vaccination programme specific for high risk groups  No
ARV treatment of HIV infection Full

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.
Health promotion responses Country  data
Availability of individual counselling programmes  Extensive
Availability of programmes for practical advice and training on 'safer use/safer injecting'  Extensive
Involvement of peer educators in the response to infectious diseases prevention  Yes

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.

Drug Treatment

See the country specific treatment profile.

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3. Responses to prevent and reduce drug-related deaths

Availability of drug-related death responses in the community Country  data
Availability of overdose information materials  Extensive
Availability of individual overdose risk assessment (provided by trained drugs or health workers)  Extensive
Availability of overdose response training  Limited

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.
Availability expert rating scale:

  • Full – nearly all persons in need would obtain it.
  • Extensive – a majority but not nearly all of them would obtain it.
  • Limited – more than a few but not a majority of them would obtain it.
  • Rare – just a few of them would obtain it.
Availability of drug consumption rooms Country  data
Number of facilities 31
Number of cities 25
Number of consumptions per year  :

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2014.

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4. Responses to prevent and reduce drug-related harms in recreational settings

Provision of specific responses implemented in night clubs and festivals Free, accessible, cold water Immediate First Aid ‘Chill out’ rooms Information material Outreach work Amnesty bins
Night clubs  : : : : : :
Festivals  : : : : : :

Sources:

Structured questionnaire 'Prevention and reduction of health-related harm associated with drug use' (SQ23/29), submitted in 2011.
Provision expert rating scale:

  • Full – in nearly all night clubs/festivals.
  • Extensive – a majority of night clubs/festivals provide the intervention (but not nearly all of them).
  • Limited – more than a few night clubs/festivals provide the intervention (but not a majority of them).
  • Rare – just a few night clubs/festivals provide the intervention.

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5. References and links

Related EMCDDA resources

 

About the EMCDDA

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is the reference point on drugs and drug addiction information in Europe. Inaugurated in Lisbon in 1995, it is one of the EU's decentralised agencies. Read more >>

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Page last updated: Wednesday, 03 June 2015