From: [r--h] at [weeds.hacktic.nl] (Richard v.d. Horst) Newsgroups: alt.drugs Subject: Fact sheet- The Netherlands Date: Fri, 22 Apr 1994 17:34:00 GMT In order to bring more clearness about the Dutch drug policy, I post the latest fact sheet- February 1994. I've reformatted it to 79 chars/line to ease reading/printing. Please note that my news server is currently having problems, so I can't answer any posted replies (but email works properly). Typos are OCR's, though I double-checked all tables on their correctness... Note- I've been notified that #5 on page 7 should be "Importing/Exporting". - Richard === THE DRUG POLICY IN THE NETHERLANDS February 1994 Ministry of Welfare, Health Ministry of Justice and Cultural Affairs P.O. Box 3008 P.O. Box 20301 2280 MK Rijswijk 2500 EH 's-Gravenhage The Netherlands The Netherlands Telephone: (31) 703406937 Telephone: (31) 703706915 Telefax: (31) 703405233 Telefax: (31) 703707933 _Table_of_contents:_ page 1. Description of the situation and trends/statistics 1 1.1 Traffic 1 1.2 Drug misuse 2 1.3 Description of users and type of use 5 2. Governmental structures responsible for drugs 6 3. National legislation 6 3.1 Basic approach 6 3.2 Legislation/penalties concerning production, traffic, possession and sale 6 3.2.1 Practical enforcement prosecution policy and the expediency principle 8 3.3 Legislation/penalties eoncerning commerce of precursors and essential chemicals 9 3.4 International treaties and agreements 9 4. Practical law enforcement 9 Organisation of police services / Assessment of current effectiveness of law enforcement services/problem areas/possible proposals for new policies 9 5. Information/Education/Prevention 10 5.1 General principies 10 5.2 Organisation and policy of services responsible for prevention activities 11 5.3 Prevention of HIV infection/Aids among drug misusers 11 5.3.1 Needle exchange schemes and outreach work 12 5.3.2 Epidemiology of Aids 12 6. Treatment and rehabilitation 12 6.1 General principles of treatment and rehabilitation policy; assessment of the programmes 12 6.2 General organisation of services / Types of treatment offered 13 6.3 Assessment of treatment and rehabilitation programmes 14 7. Drug policy debate in Parliament 16 8. International cooperation 16 8.1 Cooperation within the United Nations system 16 8.2 Regional and bilateral cooperation within Europe (including money-laundering) 16 8.3 Drug liaison officers 16 8.4 Drugs-related assistance within and outside Europe 17 BASIC APPROACH OF DRUG POLICY The central objective is to restrict as much as possible the risks that drug abuse present to drug users themselves, their immediate environment and society as a whole. These risks, or the likelihood of harmful effects, are dependent not only on the psychotropic or other properties of the substance, but primarily on the type of user, the reasons for use and the circumstances in which the drugs are taken. Experience has shown that a pragmatic approach aimed at seeking solutions for concrete problems is more effective than one that is emotional and dogmatic. There is no question of a laissez-faire attitude being taken. It is part of Dutch tradition that whatever the probiem to be tackled, the effectiveness of the measures to be applied is of primary importance. Legislation is obviously considered useful in the Netherlands, but great value is likewise attached to strongly organised social control. Although the risks to society must of course be taken into account, the government tries to ensure that drug users are not caused more harm by prosecution and imprisonment than by the use of drugs themselves. Dutch policy is also continuously seeking to strike the right balance between the different types of measures. The Minister for Welfare, Health and Cultural Affairs has been made responsible for coordinating the government's drug policy to which there are two facets: the enforcement of the Opium Act and poiicy on prevention and treatment. The Minister for Justice is responsible for implementing the Opium Act as far as the illicit aspects are concerned. 1. DESCRIPTION OF THE SITUATION AND TRENDS/STATISTICS 1.1 _Traffic:_Number_and_quantity_of_seizures_by_substance_(in_kgs)_ 1989 1990 1991 1992 1993 HEROIN (total) * 492 532 406 570 916 - South East Asia 167 85 49 36 65 - South West Asia 288 413 308 478 773 - unknown 37 34 49 56 78 COCAINE 1425 4288 2492 3433 3499 AMPHETAMINES 65 47 128 267 293 - tablets 24000 2500 30705 142 - oil (in litres) 90 7 120 60 2 LSD (in dosages) 8075 5146 1630 50002 187082 LSD (in grs) 64 3 MDA (in kgs) 776 0.35 MDA (in tablets) 2500000 335 MDMA (in kgs) 0.750 0.322 0.700 300 1.5 MDMA (in tablets) 930000 48 10286 1625391 MDMA (in litres) 2 MDEA (in kgs) 6 MDEA (in tablets) 188532 52053 CANNABIS (total) 42315 109762 96292 94593 - Hashish 14071 90010 73962 75292 28173 - Hashoil (in litres) 18.6 - Marihuana 28234 19752 22330 19301 110049 - Dutch grown Marihuana plants (in number) 71945 313242 150696 Marihuana plants (in weight) 1245 * The difference between the total quantity of heroin and the sum of the SE Asia and SW Asia heroin relates to seized heroin of which the origin could not be established (unknown). [Source: Criminal Intelligence Service] -2- _-_General_assessment_of_situation_ Most of all seized heroin originates from South West Asia and was smuggled along the Balkan route. Chinese crime syndicates have been re-establishing themselves in the illicit traffic of heroin coming from South East Asia. An increasing number of Nigerian couriers are involved in illicit traffic of heroin coming from Asia. The quantity of seized cocaine in 1990 increased by 300% compared to 1989 and originates from Colombia. There is evidence that Surinam and other countries in the Caribbean region have been used as transit countries, from which cocaine is trafficked by air and sea. The Netherlands police succeeded in detecting clandestine amphetamine laboratories and in dismantling several organisations involved in this manufacture (using precursors and essential chemicals from Germany and Belgium) and exportation. The majority of seized cannabis was being shipped or transported by lorries from northern africa. The supply of cannabis is in the hands of organized groups. 1.2 DRUG MISUSE The Netherlands is one of the most densely populated countries of Europe, with 15 million inhabitants. Appr. 90% lives in urban areas. Amsterdam has 700,000 inhabitants. _-_Estimate_of_total_number_of_drug_misusers/addicts_ - Netherlands: 21,000 addicts. Sources: 1) assessments of municipalities; 2) recent research on all methadone programmes in the Netheriands (Bureau Driessen, 1990; 1993). - Amsterdam: 6,000 - 7,000 addicts. Source: capture/recapture method based on several data systems: Municipal Health Service, Municipal Police, local studies (1990)(1993). _-_Prevalence/incidence_data_ Prevalence of drug use in 1990 (population of 12 years and over in Amsterdam) ------------------------------------------------------------------------------- Ever used Used past year Used past month drug n % n % n % N ------------------------------------------------------------------------ Tobacco 3010 67.7 2066 46.5 1899 42.7 4444 Alcohol 3820 86.0 3459 77.8 3073 69.1 4444 Hypnotics 847 19.1 420 9.5 289 6.5 4442 Sedatives 912 20.5 417 9.4 272 6.1 4439 Cannabis 1111 25.0 438 9.9 268 6.0 4442 Cocaine 245 5.5 57 1.3 17 0.4 4440 Amphetamines 183 4.1 20 0.5 10 0.2 4440 Ecstasy 56 1.3 30 0.7 5 0.1 4442 Hallucinogens 182 4.1 13 0.3 3 0.1 4430 Inhalants 42 0.9 6 0.1 2 0.0 4430 Opiates 325 7.3 86 1.9 28 0.6 4425 Pharm. opiates 295 6.7 83 1.9 28 0.6 4425 Heroin 48 1.0 5 0.1 1 0.0 4425 ------------------------------------------------------------------------ -3- Source: Licit and illicit drug use in Amsterdam: report of a household survey in 1990 on the prevalence of drug use among the population of 12 years and over / J.P. Sandwijk, P.D.A. Cohen, S. Musterd. Amsterdam: Instituut voor Sociale Geografie, Faculteit der Ruimtelijke Wetenschappen, Universiteit van Amsterdam The table shows that even in Amsterdam (an urban area where drug use is always highest) cocaine use was very low in 1990. The househoid survey will be repeated in 1994. At present, the most recent data on prevalence of drug use are the following data, based on school surveys among pupils aged 12 to 18 years: _______________________________________________________________________________ Frequency of drug use in lifetime for students aged 12 to 18 in percentages (N=7,216) 12-13 yr 14-15 yr 16-17 yr 18+ yr total 12+ yr M* F* M F M F M F M F T ------------------------------------------------------------ cannabis 4.2 1.8 15.4 12.6 32.5 19.7 46.8 22.0 16.6 10.4 13.6 cocaine 0.6 0.7 1.7 1.0 3.6 1.9 2.9 1.5 1.9 1.1 1.5 XTC 1.9 0.7 4.7 2.7 6.9 3.0 6.9 1.5 4.5 2.1 3.3 amphetamines 0.8 0.6 2.6 1.4 5.1 2.8 5.2 0.8 2.8 1.4 2.1 heroin 0.7 0.2 1.2 0.5 0.3 0.8 1.7 0.0 0.9 0.5 0.7 * M = Male F = Female _______________________________________________________________________________ Frequency of drug use during previous month (= current use) for students aged 12 to 18 in percentages (N=7,216) 12-13 yr 14-15 yr 16-17 yr 18+ yr total 12+ yr M* F* M F M F M F M F T ------------------------------------------------------------ cannabis 2.1 0.7 7.4 4.6 17.9 7.8 17.0 6.1 8.8 4.1 6.5 cocaine 0.3 0.1 0.3 0.2 0.6 0.7 1.2 0.0 0.4 0.3 0.3 XTC 0.5 0.1 1.2 0.9 2.5 1.0 2.3 0.8 1.3 0.6 1.0 amphetamines 0.4 0.2 0.7 0.2 1.6 0.6 0.6 0.8 0.8 0.3 0.6 heroin 0.2 0.1 0.3 0.2 0.0 0.1 0.6 0.0 0.2 0.1 0.2 * M = Male F = Female _______________________________________________________________________________ -4- The table shows that current cannabis and cocaine use is relatively low. The average last month prevalence of cannabis use in the _entire_ (12-18 years) sample was 6.5 %; cocaine 0.3%. Source: Youth and risky behavior. Results from the third National Youth Health Care Survey on smoking, drinking, drug use and gambling by school children from the age of 10 years. Kuipers, Mensink and de Zwart, NIAD, Utrecht, 1993. The standardized methodology has been developed by the Epidemiology experts of the Pompidou group of the Council of Europe. In two earlier studies it was found that cannabis use has been rather stable (slight differences upwards and downwards) since the beginning of the seventies. Sources: Korf: "Twenty years of soft drug use in Holland: a retrospective view, based on twenty years of prevalence studies", Dutch Journal of Alcohol, Drugs and other Psychotropic Substances, 1988 (14) nr. 3, 81-89 and: Driessen and Van Dam: "The development of cannabis use in the Netherlands, some European countries and the USA since 1969", Dutch Journal of Alcohol, Drugs and other Psychotropic Substances, 1989 (15) nr 1, 2-15. The recent NIAD-study cited above indicates that the prevalence of cannabis use among school children of 12-18 years has increased in recent years. However, the dominant pattern of consumption is still incidental and recreational. As there have been no significant changes in the Dutch policy on cannabis in recent years, the higher popularity of cannabis among young people may reflect changes in Western European youth culture. Similar increases of the prevalence of cannabis use among youngsters have recently been reported for Germany, The United States, Norway, Denmark and the United Kingdom. In view of the increase in prevalence, the prevention efforts will be intensified. Ecstacy (MDMA) was first seen in the Netherlands in 1985. in 1988 Ecstacy was brought under legal controI (Schedule I, Opium Act), mainly to prevent large-scale trafficking and export. In 1993 Eve (MDEA) was brought under legal control as well (Scheduie I, Opium Act), in reaction to agressive marketing efforts of producers. At present, use ot Ecstacy can be observed especially in the circuit of so-called house parties and discotheques and is of an experimental and recreational nature. The NIAD-study cited above shows a 3.3 % life-time prevalence of use of Ecstacy among school children of 12-18 years. The last-month prevalence in this group was 1.0 %. While there is no evidence of large-scale misuse, the situation warrants careful monitoring from a preventive point of view, as the pills sold as Ecstacy sometimes in fact contain substances with a higher risk, such as amphetamines and LSD. The NIAD has developed a special project to monitor developments in this area. _-_Indirect_indicators_ _Treatment_clients_ Methadone is supplied to 7,000 people on an average day (point prevalence) in appr. 60 municipalities. (This means that the total number of addicts receiving methadone is greater than 7,000!) Source: National (State) Inspectorate for Drugs (1990); Driessen (1990, 1993). -5- In 1992 the Consultation Bureaus for Alcohol and Drug problems had 21,715 clients, which is 39% of the total case-load. _Drug_related_deaths_ Netherlands, 1991: 74 residents (primary and secondary cause of death). Source: National Bureau for Statistics, based on the WHO International Classification of Diseases (ICD-9). Amsterdam, 1992: 19 residents. Sources: annual registration Municipal Health Service, 1993; methodology validated in an analysis of the backgrounds of 'Acute death after drug misuse in Amsterdam" (in Dutch) by Cobelens, Schrader and Sluijs, 1990. 1.3 DESCRIPTION OF USERS AND TYPE OF USE _-_The_most_used_drugs_ Cannabis products are the most popular illicit drugs. Cannabis use generally does not create problems to users. Heroin is still the preferred drug among addicts, although they do not restrict their use to heroin and combine all manner of substances, including cocaine, other psychotropic substances (e.g. benzodiazepines) and alcohol. "Crack" use is almost absent in the Netherlands. _-_Average_age_of_drug_misusers_ The average age of addicts is rising and today lies between 25 and 35; people are older when they take drugs for the first time (with the exception of cannabis). _-_Socio-demographic_profile_of_drug_misusers_ Cocaine use in the general population (primary cocaine users in all social strata and income groups) seems to be mainly experimental and/or recreational. An in-depth field study in Amsterdam among experienced users (at least 5 years of use) revealed that the average age of cocaine users was 30 years and the age at which they started was 22 years. The large majority was non-deviant and 50% never use more than half a gram a week. The users do not underestimate the negative effects, which mainly occur at a level of 2.5 gram a week. 86.2% of the users reported to have stopped for more than a month, against 11.9% who never stopped since they started cocaine use. Since the use is embedded in non-marginalized social settings where confrontation with the police is rare, some kinds of informal use-control rules could be developed (Cohen, 1989), A follow-up study has been carried out (Cohen & Sas, 1993) . One of the main conclusions of this study is that almost half of the 1991 follow-up respondents had ceased cocaine consumption since they were interviewed in 1987. Over the years drug misuse increased among groups in a relatively disadvantaged social and economic position, particularly among ethnic minorities from Morocco and Turkey. -6- _-_Routes_of_administration_ A recent research report confirms that the prevalence of drug injecting has been steadily decreasing (Grund & Blanken, 1993). A growing majority of drug users, 70 - 75 %, now prefers the method of smoking heroin or "chasing the dragon" (inhaling the fume). On average, only 25 - 30 % of the hard drug users now practises injecting. According to the researchers, this development of a less harmful pattern of heroin use can be seen as a result of the pragmatic drug policy. The comparatively low repression of drug users and the enforcement emphasis on the importation level of the drug trade created the situation in which a stable and fairly relaxed consumer market could emerge, in which heroin is sold of reasonable price and at a purity level (40 %) sufficient for smoking. 2. GOVERNMENTAL STRUCTURES RESPONSIBLE FOR DRUGS _-_Basic_organisation_of_responsibilities_at_national_and_local_level_and_the _coordinating_bodies_ The larger Municipal Police Forces, for which the burgomasters carry responsibility, have special criminal investigation departments (CIDs) dealing exclusively with offences under the Opium Act. They receive support from other CIDs or from uniformed police when undertaking major operations. The National and Municipal Police work in close cooperation with the Central Narcotics agency of the National Criminal Intelligence Service (CRI) in The Hague, for which the Minister of Justice is responsible. The CRI collects information in the Netherlands and abroad and passes it on to the local police, one of its sources being specially appointed drugs liaison officers stationed in foreign countries (see also item 8.3). In larger cities, policy on actions against illegal offenders of the Opium Act is usually preceded by tripartite consultation between the burgomaster, the head of the Public Prosecutions Department and the Iocal chief of police. As to treatment policy, in 1994 23 larger municipalities (working closely together with the other relevant cities in 23 regions) receive a special budget from the (national) Ministry of the Interior and are directly responsible for treatment policy and for funding treatment. 3. NATIONAL LEGISIATION 3.1 _Basic_approach_ Responsibility for implementing the Opium Act rests with the Minister for Welfare, Health and Cultural Affairs for the licit aspects (strict supervision of the production and medical use of the drugs) and the Minister of Justice for the illicit aspects: law enforcement policy. 3.2 _Legislation/penalties_concerning_production,_traffic,_possession_and_sale_ The Opium Act of 1919 was radically amended in 1928 and again in 1976. The possession, sale, transport, trafficking, manufacture, etc., of all drugs mentioned in -7- this Act, except for medical or scientific purposes, is deemed a punishable offence. _Drug_consumption_is_not_prohibited_by_law_. The Opium Act also provides for the strict supervision of the production and medical use of the drugs referred to in the Act. Hemp (cannabis) products and other drugs are subject to different statutory penalties. Policy in the administration of criminal justice likewise maintains a clear cut distinction between drug users and traffickers, one of its aims being to avoid classifying the possession of drugs by users as serious crimes, as they would then no longer be accessible to any form of prevention or voluntary intervention. A distinction is also made between 'drugs presenting unacceptable risks' (such as heroin, cocaine, LSD, amphetamines and hash oil), classified as Schedule I drugs in the Opium Act, and 'hemp (cannabis) products', classified as Schedule II substances in the Opium Act. The possession of any of these substances for personal use is subject to less severe penalties than possession for the purpose of trafficking. The following table indicates the maximum penalty which can be imposed for offences involving various substances. Substance Offence Maximum penalty 1. Schedule I importing or exporting 12 years'imprisonment substances (opiates, (trafficking) and/or FL.100,000,- fine cocaine, etc.) 2. Schedule I selling, transporting, 8 years'imprisonment substances (opiates, manufacturing and/or FL.100,000,- fine cocaine, etc.) 3. Schedule I planning import or 6 years'imprisonment substances (opiates, export, etc. and/or FL.100,000,- fine cocaine, etc.) 4. Schedule I possession 4 years'imprisonment substances (opiates, and/or FL.100,000,- fine cocaine, etc.) 4 years' imprisonment 5. Hemp products selling manufacturing, and/or FL.100,000,- fine (hashish & marijuana) possesion - Contrary to the general rule, offences under the Qpium Act may carry both a penalty of a fine and an unconditional term of imprisonment. - If the vafue of the things with which such offences have been comrnitted or which have been obtained wholly or partially by means of such offences, exceeds a quarter of the maximum fine, a fine of one category higher may be imposed: FL.100,000,- would become FL.1,000,000,-. -8- 6. Hemp products selling, manufacturing, 2 years'imprisonment (hashish & marijuana) possession and/or FL.25,000,- fine 7. Schedule I possession for personal 1 years'imprisonment substances (opiates, use and/or FL.10,000,- fine cocaine, etc.) 8. Hemp products selling, manufacturing, 1 month's imprisonment (hashish & marijuana) possession of up to 30 and/or FL.5,000,- fine grams Explanatory notes Offences which are punishable under the Opium Act are subject to the general criminal law provision whereby the maximum penalty may be increased by one-third when the offence has been committed more than once. In that case the maximum penalty is 16 years imprisonment. - Other offences, such as advertising the sale/supply of drugs, are covered by the Opium Act. - In accordance with an amendment to the Opium Act in 1985, both trafficking and activities preparatory to trafficking in Schedule I drugs are now offences. This enables action to be taken at an earlier stage in the chain of trafficking operations and provides greater opportunities for dealing with the organisers. Furthermore, any person who attempts to import drugs into the Netherlands, regardless of their nationality. In general, 'conspiring' or planning to commit an offence is not deemed punishable in Dutch criminal law. - A Bill is currently being prepared which will greatly facilitate the detection, freezing and confiscation of the proceeds of criminal acts, thereby considerably increasing the efficiency with which national and international drugs traffic can be combated. 3.2.1 _Practical_enforcement:_prosecution_policy_and_the_expediency_principle_ One of the basic premises of Duteh criminal procedure is the expediency principle laid down in the Code of Criminal Procedure whereby the Public Prosecutions Department is empowered to refrain from instituting criminal proceedings if there are weighty public interests to be considered 'on grounds deriving from the general good'. Guidelines have therefore been established for detecting and prosecuting offences under the Opium Act. Similar guidelines also exist for other offences such as the illegal possession of firearms, pirate broadcasting and exceeding the speed limit. The guidelines contain recommendations regarding the penalties to be imposed and set out the priorities to be observed in detecting and prosecuting offences. The 'Guidelines for detection and prosecution policy for offences under the Opium Act' established in 1976 are based on the priorities already laid down in the Opium Act. International drug trafficking has the highest priority, possession of drugs the lowest. This does not, however, imply that we take no action at all with regard to possession: drugs are confiscated, but an addict is not thrown into jail if he has less than half a gramme in his possession. We try to offer assistance in these cases. An early intervention network set up by the Alcohol and Drug Clinics, provides for counsellors to visit suspects at police stations in the Netherlands. The low priority accorded the possession and sale of up to 30 grams of hemp products has resulted in dealers selling small quantities of hemp products in youth -9- centres and so-called coffee shops. The authorities keep a fixed eye on these sales points. By doing so the authorities follow the guidelines- no dealers quantities, that means > 30 gram, no sale of any other drugs (e.g. cocaine, heroin), no advertisements, no encouragement to use, no sale to minors. Policy aims to maintain a separation between the market for drugs presenting unacceptable risks and the market for hemp products. In addition, the work of the tripartite consultative body, has led in recent years to a number of preventive maesures being included in new administrative rules as f.i. in relation to the location of coffee shops; on the other hand, these rules make it possible for a mayor to close the shops in cases when a dealer has been arrested and will be prosecuted. This latter measure is very effective: if the coffee shop in question is allowed to remain open, other persons will continue the dealer's activities as soon as he has been arrested. 3.3 _Legislation/penalties_concerning_commerce_of_precursors_and_essential _chemicals_ Article 12 of the Vienna convention has been implemented within the European Union; a decision was recentiy taken to amend our on legislation on the legal traffic in precursors and chemicals. The Ministry of Economic Affairs has already changed the legislation for the import and export to third countries. A separate Act including regulations on the control of the legal traffic within the Community has been drafted and will pass Parliament soon; the Economic Surveillance Service will be responsible for supervision. 3.4 _International_treaties_and_agreements_ The Netherlands have ratified the Vienna Convention of 1988, the Convention of Strassbourg of 1990 and the 1971 Convention on psychotropic substances, accompanied by the legislation implementing them, last year. The Minister of Justice signed an agreement on asset sharing and mutual assistance in confiscation procedures with the United States of America and the United Kingdom. 4. PRACTICAL LAW ENFORCEMENT _Organisation_of_police_services_/_Assessment_of_current_effectiveness_of_law _enforcement_services/problem_areas/possible_proposals_for_new_policies_ Since time immemorial, its geographical location has made the Netherlands a transit country for drug smuggling. For this reason, the police and the public prosecutors office have always accorded highest priority to combating wholesale trafficking. With a view to the ratification of the Schengen Agreement, a number of measures have been taken to intensify external frontier controls: - officials of the Royal Military Constabulary and customs authorities who are no longer needed along the internal frontiers have been transferred to Rotterdam and Schiphol, and some will be employed to combat cross-frontier offences within the Schengen area; -10- - at the end of 1992 a multidisciplinary team was set up at Schiphol (comprising customs, police and Royal Military Constabulary) to combat drug smuggling; - the container checks set up and coordinated by the customs authorities is being further refined and harmonised in consultation with officials responsible for checks in other major European ports. The Dutch police has recently undergone reorganisation, and the country is now divided into 25 regions. A 26th force also exists, including the National Criminal Intelligence Service (CRI), which plays a coordinating role in the fight against drugs. The CRI is responsible for maintaining contacts with drugs liaison officers detached to this country and with the police officers sent to various other countries (Pakistan, Thailand, Venezuela, Colombia, the Netherlands Antilles, Turkey and several European member states) by the Netherlands. This year (1994) sees the launching of Europol in The Hague, an organisation that will strive to improve international cooperation in the fight against drugs. Much has been achieved in terms of legislation over the course of the past 4 years: - the scope for confiscation has been greatly expanded in the case of serious drug offenders, making it possible to seize the illicit gains from drug trafficking (based on the 1992 Strasbourg Convention); - measures have been introduced to curb the laundering of money - witnesses who have been threatened are now given police protection; - the coercive measures available to the police have been expanded to include, for example, more sophisticated telephone tapping equipment. Infiltration into criminal organisations and controlled deliveries have been routine practices in police investigations for some considerable time. Within the territory covered by the Schengen Agreement, regional liaison networks wiil be set up in Benelux and France to combat drug tourism. Consultations held in this framework wili aim to improve cooperation between different police forces and courts. 5. INFORMATION/EDUCATION/PREVENTION 5.1 _General_principles_ The basic premise of information/education is that information on the risks of drug use and on the risks attaching to the use of alcohol and tobacco should be presented together. This general information has been incorporated in the broader framework of the primary school subjects "promotion of healthy behaviour" and "promotion of social skills" (such as: increase consciousness of social influences and to learn skills to resist these influences) in order to be able to cope with the risks of life in general. Secondary school pupils are also encouraged to act responsibly in this respect. The significance of information as a means of preventing drug (and alcohol) abuse should not be overestimated, however. Various studies have shown that publicity is ineffective in preventing the problem of drug abuse, particularly where it seeks to emphasize the dangers invoived by presenting warning, deterring or sensational facts. Publicity of this kind, which is likely to be one-sided and often counter-productive, is therefore rejected by the Dutch government which is likewise -11- disinclined to conduct mass media campaigns on the subject, which are unavoidable untargeted. Since the level of drug consumption in the Netherlands is rather low the message would mainly reach those who are not inclined to use drugs. Research into the lifestyles of heroin addicts in the Netherlands has given rise to new attitudes towards prevention and widened understanding for the reasons why people turn to drugs; it has also called into question the possibility of prevention, especially by means of information. Moreover, it was found that to start using drugs does not automatically lead to addiction. A large number of people experiment with drugs without actually becoming addicted. There are many types of users with many different lifestyles. Measures to prevent occasional users from becoming addicted are therefore extremely important and preventing problems is accordingly given at least equal emphasis as preventing the use of drugs. In view of the above, the Dutch government believes that drug use should be shorn of its taboo image and its sensational and emotional overtones. The image of the user and addict should be demythologised and reduced to its real proportions, for it is precisely the stigma paradoxically enough, that exercises such a strong attraction on some young people. In spite of the more general principles of prevention there is education/information to risk groups: "heavy" experimenters and those who live in surroundings where drug use is considered "normal". Many city-funded care facilities (e.g. street workers) carry out such prevention activities, making use of specific methods and materials (see also item 6.2). 5.2 _Organisation_and_policy_of_services_responsible_for_prevention_activities_ The national government only creates good conditions for the development, implementation and evaluation of health education. For example by financing two institutes: the National Centre on Health Education in Utrecht, which stimulates health education throughout the country (information and documentation, increasing of expert knowledge, development of methodology, research) and the National Institute on Alcohol and Drugs (NIAD), aIso in Utrecht, with a similar function. NIAC primarily develops programmes and materials for the prevention departments of drug treatment institutions (CADs, see item 6.2.), which on their part carry out activities directed to intermediaries, such as school teachers, youth workers, general health professionals (GP's) etc. The vocational training for health education professionals takes place in several government funded universities. A Bill (1990) on General Health Prevention charges the municipalities (in many larger cities implemented by municipal health services) to develop health prevention activities to the general pubiic. Taking into account the abovementioned general principles it is the freedom of each individual school to decide how to carry out their health education programmes by their own teachers. They may -and many do- make use of the programmes developed by the beforementioned local programmes or National Institutes. Usually parents are not involved, neither is the police. The involvement of the police would only reinforce the negative and sensational aspects associated with drug use and the creation of new myths. 5.3 _Prevention_of_HIV_infection/Aids_among_drug_misusers_ Keeping close contact with drug addicts (see item 6.1.) is a prerequisite for an effective Aids prevention policy. The supply and use of sterile needles and syringes -12- in exchange for used ones and the supply of condoms is one way of limiting the spread of HIV but is not a panacea. It must be embedded in a broader care system. Persuasive face-to-face counseling, in order to change addicts' risky behaviour in favour of safer practices, is essential. 5.3.1 _Needle_exchange_schemes_and_outreach_work_ There are about 130 needle and syringe exchange schemes now running in 60 municipalities. The schemes exhibit several differences in terms of size, type of agency that is responsible, accessibility, outreach activities, opening hours etc.. In 1992, 1,000,000 syringes were exchanged in Amsterdam. Exchange schemes may be part of methadone programmes run by drug treatment agencies or municipal health services. The special programmes for street prostitutes in the larger cities also provide syringes. In a few municipalities pharmacists exchange needles and syringes. Some schemes deliver syringes and containers at private homes of isolated drug users and drug dealers. Some schemes are mobile, making use of minibuses and vans that make stops at several locations. Also, outreach workers provide syringes in the street or at private homes. Some cities experiment with slot machines for needle exchange, to provide syringes after the regular opening hours. 5.3.2 _Epidemiology_of_Aids:_ As of October, 1993, the total (dead and alive) number of Aids cases in the Netherlands was 2783. The table below shows the cumulative Aids cases per transmission group: Homo/bisexual 2131 (76.0 %) IV drug user 260 ( 9.0 %) \ 10 % Homo/bisexual IV drug user 28 ( 1.0 %) / Haemophiliac/coagul. disorder 46 ( 1.7 %) Transfusion recipient 38 ( 1.4 %) Heterosexual contact 220 ( 7.9 %) Mother-to-child 13 ( 0.5 %) Other/unknown 47 ( 1.7 %) The proportion of injecting drug users among the number of Aids patients slowly increases. There is no evidence of an explosive development. 6. TREATMENT AND REHABILITATION 6.1 _General_principles_of_treatment_and_rehabilitation_policy;_assessment_of _the_programmes_ It is tried to make greater and more efficient use of general, particularly primary, care facilities. Projects have been set up to encourage addicts and former addicts to make use of general facilities, including health and social services and youth welfare and housing facilities that are available to all members of the public, as a means of preserving or re-establishing social integration. -13- Every effort is made to reach and assist as many addicts as possible, which approach can claim a success rate of between 70% and 80% (Korf and Hoogenhout, 1990). Assistance is not aimed solely at combating addiction and the behaviour associated with it, since people who do not feel the need to get off drugs or are not capable of doing so, would remain beyond the reach of help. This could lead to further social isolation, degradation and marginalization. There are forms of care and treatment which are not primarily intended to end addiction as such but to improve addicts' physical well-being and help them to function in society, the inability to give up drug use being accepted as a fact for the time being. This kind of assistance is called 'harm reduction' and may take the form of field work, initial reception, the supply of substitute drugs -mainly methadone-, material support and opportunities for social rehabilitation. Failure to provide this type of care and support, would simply make matters worse and increase the risk to the individual and to society. For those who want to achieve a drug-free existence a wide variety of services is also available. The broad ambit and easy aecessibility of care is essential to the effective implementation of AIDS prevention measures. 6.2 _General_organisation_of_services_/_Types_of_treatment_offered_ a. The Medical Consultation Bureaus for Alcohol and Drug Problems (CADs) are autonomous non-governmental institutions, the entire costs of which are paid directly by 23 municipalities and 19 probation boards. 75% of these funds are provided by the Ministry of the Interior through these municipalities and 25% by the Ministry of Justice through the probation boards. The CADs are also active in the field of probation; one aspect is the initial reception of drug addicts in police stations, where an effort is made to establish contact that may lead to the acceptance of further aid during and after detention. Although the CADs primarily provide non-residential mental health care, their services are oriented towards social work, as the majority of their staff (appr. 900 in all) are social workers. The objectives of individual CADs may vary from kicking the habit (drugfree), to stabilising the functioning of addicts by supplying the substitute drug methadone on a "maintenance basis" (stable dosage). "Reduction based" methadone programmes are also applied (gradually reduced dosages to nil). A variety of methods is used, including psychotherapy, group therapy, material assistance, family therapy, counselling, and advising groups of parents. An increasingly important area of the CADs' work is prevention (see item 5.2), including AIDS control (needle-exchange, information and education). The nationwide network of CADs comprises 16 main branches, 44 subsidiary branches and 45 consulting rooms. The total budget for 1993 amounted to appr. FL. 80 million. b. Several municipal authorities have set up their own methadone programmes which are run by the municipal health services (budget: appr. FL. 7 million). Methadone is now supplied either by a CAD or the municipal health service in virtually all municipalities with a drug problem. Like the CADs the municipal health programs have a central role in the field of AIDS prevention. Methadone is being supplied to 7,000 addicts on an average day in appr. 60 municipalities. c. The social welfare projects for drug users are part of a wide range of social welfare services aimed at young people, and directed primarily to prevention or risk -14- reduction. Multiple risk groups are not uncommon, such as the unemployed, ethnic minorities, and young people from marginal groups. These projects are also subsidized by the municipalities, because the choice of projects can best be made at local level. The projects listed below concentrate on different types of aid and are geared to young peopie in particular: they are easily accessible and are designed to have the widest possible outreach. - projects aimed at preventing the social isolation of addicts; - projects aimed at making contact with addicts and referring them to general of specialised aid agencies; - social assistance and crisis centre projects; - day and night centres where psychosocial assistance is provided; - social rehabilitation projects for addicts and former addicts, comprising such facilities as supervised accommodation, vocational and other training, assistance in adjusting to work, and aftercare. The total budget for these services for 1993 amounted to appr. FL. 55 million for almost 90 projects in 45 municipaiities. Assistance to addicts of Surinamese origin (Latin America) has increased considerably, drug use among Moluccans (Asia) is decreasing sharply, whilst youngsters from the Mediterranean countries, including Morocco, are turning to drugs in greater numbers. Some 550 people are employed in these services. d. Residential facilities for the drug-free treatment of drug addicts and alcoholics are situated throughout the Netherlands, providing a total of 1,060 beds for the two categories of patients between which no sharp distinction is made. These facilities may take the form of an independent clinic or therapeutic communities or special units in general psychiatric hospitals. Various types of treatment are available: - crisis intervention and detoxification which may last between two days and three weeks; - clinical treatment lasting from three months to a year, aimed at overcoming addiction. These facilities cost about FL. 80 million (as of 1993) and are funded from contributions made under the Exceptional Medical Expenses (Compensation) Act, which is part of the public health insurance system. 6.3 _Assessment_of_treatment_and_rehabilitation_programmes_ - The number of addiets and drug deaths are considered to be indicators of the effectiveness of drug policies: see item 1.2. - The medical supply of methadone by drug treatment agencies in the Netherlands has been evaluated (Driessen, 1990, 1993). At present, drug counselors view reduction of health risks (HIV, Hepatitis B) and improvement of the social situation of clients as rather more important goals than just ending drug use. Nevertheless, a fourth of the clients follow a reduction programme that involves reducing the methadone dosage every week. - The accessibility of the treatment sector has significantly improved during the last decade. About 75% of the current addicts now come into contact with any type of treatment agency, as compared to about 40% in the early eighties. This is a success in itself! Methadone is also provided more frequently: 75% of the clients receive methadone -although not daily-, vs. 40% some 10 years ago. The researchers qualify the dosages as low. - A fourth of the clients receiving methadone has been integrated into society. They have found employment or are completing studies. A third of the clients appears to be in control of their addiction and uses little or no more heroin. A fourth of the clients suffers from serious physical and social problems. Next to methadone they use a lot of other substanees, are often in bad health and are unable to adapt themselves to the demands of treatment. Of all methadone clients, 20% have been imprisoned during the last year. Next to the provision of methadone, other forms of help are also being used. Of all clients, 42% applies for medical assistance and 30% applies for social work. In addition, more therapeutic forms of assistance are available, such as psychotherapy and family therapy. However, only 1 to 4% of the clients make use of these kinds of therapy. - Some results of a study of clients of methadone programmes outside the four large cities in the Netherlands: - a majority of clients use methadone on a regular basis; - almost all clients (95 %) use heroin as well, but only a minority (37 %) on a daily basis; - 75 % of the clients use cocaine, 10 % of them do so on a daily basis; - half of the clients are not criminally active; half are employed at least during part of the year; - 83 % have a stable housing situation; half have a stable relationship with a partner; - 6 % of the clients report to be seropositive for HIV (7 % of the injecting clients, 4 % of non-injectors); - 45 % are still at risk for HIV-infection, due to unsafe use and/or unsafe sex (Driessen, 1992). - Swierstra (1990) found in a long term follow-up study that the use of hard drugs is related to a specific way of life, upon which the addict may become even more dependent than upon his drugs. Two-thirds of his respondents have stopped taking drugs and are no longer criminally active or, when still addicted, hardly so. This process is still going on among the respondents: a continuing decrease in criminality, a continuing increase in abstinence. Methadone appeared to have played an important role in bridging a problematic period in their lifetime. - It is known from drug free facilities that many of their patients have had long experience with methadone, being of decisive importance to eventual kicking the habit. The existence of 'harm reduction' facilities did not prevent an increasing number of addicts who do want to kick their habit from making use of drug-free facilities; in Amsterdam this number of addicts has doubled during the last ten years. - Grapendaal and Leuw (1991) found that in their Amsterdam study among drug addicts, more than 40% of the sample had not used heroin or only little less than half a gram, in the previous week. A strang correlation could be established with methadone use. They also state that -only- a minority of 25% conducts a lifestyle of heavy drug use and frequent criminal behaviour. 7. DRUG POLICY DEBATE IN PARLIAMENT In March and April 1993, the drug policy was discussed at length in Parliament. On the basis of this debate, it has been decided that the government will maintain the current drug policy, considering its relatively good results. Consequently, the primary aim of the policy remains the safeguarding of health, while the Minister for Welfare, Health and Cultural Affairs remains responsible for coordinating the governments drug policy. However, some amendments have been deemed necessary. First of all, to prevent public disorder as well as to ensure separation of drug markets, the supervision of the so-called cannabis coffeeshops will be tightened up. Secondly, the government has decided to make a more intensive use of the existing instruments for placing problematic drug users under constraint. In other words, to give them the choice between prison or treatment. In December 1993, the State Secretary for Welfare, Health and Cultural Affairs and the Minister of Justice have presented a note to Parliament, outlining a plan of action to take more addicts out of the justice system and to offer them help. This approach will help reduce the pressure on the justice system. The action plan explicitly acknowledges that the policy will be effective only if there are sufficient monitoring facilities and/or after-care projects for the reinsertion of these persons into society. 8. INTERNATIONAL COOPERATION 8.1 _Cooperation_within_the_United_Nations_system_ The Netherlands has been a member of the UN Commission on Narcotic Drugs since many years and has chaired this Commission in 1991. 8.2 _Regional_and_bilateral_cooperation_within_Europe_(including _money-laundering_ Cooperation and mutual assistance have been set up to implement the specific provisions of the Schengen Agreement, the Benelux Agreement on Extradition and the European Convention on Extradition and Mutual Assistance. In addition the Netherlands signed several bilateral agreements on this matter, for example with the United Kingdom. There have also been established regular bilateral consultations on drug policy with the United Kingdom. The Netherlands are member of different technical police working groups of the Pompidou group, as f.i. the Airport and maritime seaport group. 8.3 _Drug_liaison_officers_ See also item 2. The National Criminal Intelligence Service (CRI) has appointed drug liaison officers stationed in Thailand, Pakistan, Venezuela, Colombia, Interpol Lyon, the Netherlands Antilles and in Turkey and Spain. Under the aegis of the CRI a number of police officers from 11 countries have been stationed in the Netherlands, thus ensuring fruitful cooperation between their countries and the Netherlands' authorities. 8.4 _Drugs-related_assistance_within_and_outside_Europe_ The Netherlands is closely involved in international efforts to suppress production, trafficking and consumption of narcotic drugs. It encourages developments in this direction and has been participating in projects of the United Nations International Drug Control Programme (UNDCP). These projects are aimed at different aspects of the problem, such as strengthening the social and economic intrastructure, demand reduction (e.g. projects in Bolivia and Colombia), and supporting the drafting of legislation (Surinam). The Netherlands belongs to the Major Donors Group of UNDCP with a contribution to the regular annual budget of Fl. 700.000 in 1994. Also, The Netherlands is a member of the UN Commission on Narcotic Drugs (CND). --- Please send your local info for the Drug Price report; anonymously by mailing through a Cypherpunk remailer, Charcoal or rich%[weeds hacktic nl] at [anon.penet.fi] -----BEGIN PGP PUBLIC KEY BLOCK----- Version: 2.2 mQCNAivX82sAAAEEAMLMJWpye3A5FBqCdLMwDM+IzPwK6PzLod+8wUNZllWvD+wS 1Ao8BYNHE8KjWxX+uV9THt1aRkgImty/VBtamStH8zrMJ40xIddeIlV8rkpgwau6 hv2tJSdNpRc5BAzny1spgitv6BMF5J1YNMnLcRFGj6LE202F9kkIFFhJlb3nAAUT tCpSaWNoYXJkIHYuZC4gSG9yc3QgPHJpY2hAd2VlZHMuaGFja3RpYy5ubD4= =VSSK -----END PGP PUBLIC KEY BLOCK-----