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7 Alcohol Alcohol is made from fermenting grains or fruits. It is drunk in the form of beer, wine or spirits. One glass of wine, beer or a measure of spirits contains approximately the same amount of alcohol. This is because the size of the glass used is reduced according as the alcohol content of the drink is higher. In social situations, drinkers experience alcohol as relaxing and convivial. In less sociable situations, alcohol can exacerbate an aggressive mood. Excessive use (even where incidental) can result in accidents – at work, at home and in traffic. Alcohol is an addictive substance. With regular use, habit and tolerance are increased. Excessive use of alcohol can lead to a number of illnesses, particularly diseases of the liver and the cardio-vascular system, cancer, brain damage and mental disorders. 7.1 Recent facts and trends The main facts and trends concerning alcohol in this chapter are: • According to sales figures, the consumption of alcohol per head of the population in the Netherlands has remained stable for years (§ 7.2). This also applies to the number of people who only occasionally drink alcohol (§ 7.2). • By contrast, the percentage of heavy drinkers aged 12 and older declined slightly between 2001 and 2008 (§ 7.4). • Alcohol use (ever use, current use, binge drinking) among pupils attending mainstream secondary schools declined between 2003 and 2007. This decline was limited to the younger age groups of 12-14; among 15 to 18 year olds, there was no change (§ 7.3). • With regard to ever use and current use of alcohol, pupils in special education don’t differ from their peers in mainstream education; however binge drinking is more common among the former (§ 7.3). • By comparison with their European peers, Dutch school-goers in 2007 were still among the heaviest drinkers, despite a decline in (frequent) alcohol consumption (§ 7.5). • Despite a statutory ban, juveniles aged under 16 are still easily able to procure alcoholic beverages; however, the percentage of those who actually ordered or bought alcohol has declined in recent years (§ 7.8). • The number of alcohol clients receiving treatment from (outpatient) addiction care services rose further between 2006 and 2008 (§ 7.6). • The registration data of general hospitals show an increase between 2006 and 2007 and again between 2007 and 2008 in the number of admissions involving an alcoholrelated condition. The increase in the number of juveniles up to age 16 admitted for alcohol-related reasons was most marked between 2006 and 2007 (§ 7.6). 7 Alcohol 143
• Total deaths from alcohol-related conditions (primary and secondary causes of death together) remained stable between 2004 and 2008 (§ 7.7). 7.2 Usage: general population Alcohol use is widespread in Dutch society. • According to the findings of National Prevalence Surveys (NPO), the percentage of people in the population aged 15 to 64 that used alcohol in the past year dropped slightly from 87% in 1997 to 85% in 2001 (Rodenburg et al., 2007). This drop was most marked among females and among respondents in the 25-44 age group. • Between 2001 and 2005 the percentage of recent drinkers remained stable at 85%. • The number of people who had taken alcohol in the past month remained stable throughout the years at around 78%. • The percentage of drinkers who had consumed six or more drinks in one day during the past six months (binge drinking) dropped from 40% in 2001 to 35% in 2005. This decline took place both among males and females and particularly among respondents aged from 15 to 24. • The age of onset is the age at which an individual first uses a substance (see also appendix A: age of onset). Among recent users of alcohol, the age of onset in the 15 to 24 age group was 14.6 years on average. In the population aged 15 to 64 the age of onset averaged at 16.5. According to a survey conducted by Statistics Netherlands (CBS) in 2008, approximately four out of five people (81%) aged 12 and older ‘sometimes drink alcohol’. In 2001 the figure was 82%. The percentage of drinkers has remained fairly stable for years (Statistics Netherlands, 2009c). Sales figures give an indication of the amount of alcohol consumed annually per head of the population (Table 7.1) (Alcohol producers’ association, 2008b; Vintners’ association, 2009). • Alcohol consumption was highest in the Netherlands during the second half of the 1970s and in the 1980s. Then followed a slight decline, which did not continue from the early 1990s. • In 2006, 7.9 litres of pure alcohol were consumed per capita – the same amount as in 2005. • The consumption of spirits and beer remained unchanged in 2006 and wine drinking rose slightly from 21.3 litres in 2005 to 21.5 litres in 2006. • After a sharp drop in 2003 (minus one third compared to 2002) sales of ready-mixed drinks (‘alcopops’) stabilised in 2004. However, in 2005 there was another sharp drop (by 31% compared to 2004). This decline continued in 2006 (down a further 19%). Accordingly the consumption of these drinks has plummeted by more than two-thirds since 2002 to 114,746 hectolitres. 144 Netherlands National Drug Monitor - NDM Annual Report 2009
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Netherlands National Drug Monitor N
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Colophon Project Manager Dr. M.W. v
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Preface This is already the tenth A
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5.4 Problem Use 113 5.5 Usage: Inte
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List of abreviations and acronyms 2
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NEMESIS NFU NIGZ NMG NPO NRI NVIC N
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Summary Below is an outline of the
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The number of hospital admissions c
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GHB. In 2008/2009 4.6 percent of fr
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Deaths In the Netherlands, smoking
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Offences by drug users Drug users c
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Opiates Ecstasy Amphetamine Alcohol
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1 Introduction The National Drug Mo
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use, particularly cannabis, under-r
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information is available, this is b
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2 Cannabis Cannabis (Cannabis Sativ
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Figure 2.1 Cannabis users in the Ne
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Figure 2.2 Cannabis use among secon
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Cannabis and problem behaviour •
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Table 2.4 Cannabis use among pupils
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Table 2.5 Current cannabis use in s
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• The sharp increase in treatment
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Trends It is difficult to determine
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• The role of cannabis in all req
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- misuse or dependence on alcohol a
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At the Ambulance Transport Centre (
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• So far, epidemiological studies
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Quality and price The Trimbos Insti
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3 Cocaine Cocaine works as a stimul
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Age, gender and urbanisation level
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Special groups In certain groups of
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Table 3.3 Cocaine use in special gr
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and 7.7% in the U.K (England and Wa
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Table 3.5 Cocaine use among school-
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Figure 3.2 Number of (outpatient) a
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Figure 3.4 Admissions to general ho
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The Netherlands Cause-of-Death stat
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• Little is known as yet about a
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4.2 Usage: general population Heroi
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• In the province of Gelderland,
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Figure 4.1 Estimates of the number
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and syringes exchanged has been reg
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• Between 2001 and 2004 the numbe
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- misuse of or dependence on alcoho
Page 93 and 94: same time it should be noted that t
Page 95 and 96: International comparison The Europe
Page 97 and 98: The total number of chronic hepatit
Page 99 and 100: • It is thought that risk behavio
Page 101 and 102: the ICD-9 classification. Drug deat
Page 103 and 104: Amsterdam GGD Amsterdam reports the
Page 105 and 106: Figure 4.9 Number of drug-induced d
Page 107 and 108: • Pupils attending REC-4 schools
Page 109 and 110: 5.3 Usage: juveniles and young adul
Page 111 and 112: • In 2008, key observers in Amste
Page 113 and 114: Table 5.3 Use of Ecstasy and amphet
Page 115 and 116: Table 5.4a Use of amphetamines and
Page 117 and 118: Table 5.5a Ecstasy use among school
Page 119 and 120: Ecstasy • The number of (outpatie
Page 121 and 122: Figure 5.3 Numbers registered with
Page 123 and 124: • The same person may be admitted
Page 125 and 126: • The number of requests for info
Page 127 and 128: According to the EMCDDA, in other E
Page 129 and 130: Figure 5.6 Concentration of MDMA in
Page 131 and 132: Table 5.9 Number of samples contain
Page 133 and 134: • Consumers who had drug samples
Page 135 and 136: 6.2 Usage: general population The r
Page 137 and 138: GHB use is more common among juveni
Page 139 and 140: • GHB use among school-goers is l
Page 141 and 142: Table 6.4 GHB incidents registered
Page 143: • Of the liquid samples sold as G
Page 147 and 148: Figure 7.1 Alcohol consumption amon
Page 149 and 150: Ethnic background • Among seconda
Page 151 and 152: Table 7.3 Percentage of current dri
Page 153 and 154: Table 7.4 Alcohol use in the social
Page 155 and 156: Holiday-makers • Research conduct
Page 157 and 158: Figure 7.3 Heavy drinkers by gender
Page 159 and 160: The countries with the lowest perce
Page 161 and 162: • In France it is more likely tha
Page 163 and 164: Figure 7.6 Age distribution of prim
Page 165 and 166: • In 2008, 337 day-care admission
Page 167 and 168: • In approximately 1,200 admissio
Page 169 and 170: Table 7.9 Estimated number of injur
Page 171 and 172: • On the basis of current researc
Page 173 and 174: Figure 7.10 Deaths from alcohol use
Page 175 and 176: • EU member states have different
Page 177 and 178: • Surveys by the Continuous Surve
Page 179 and 180: Figure 8.1 Percentage of smokers in
Page 181 and 182: 8.3 Usage: juveniles and young adul
Page 183 and 184: Special education Table 8.3 shows t
Page 185 and 186: Table 8.4 Smokers in the EU-15 plus
Page 187 and 188: medication, Champix ® , which was
Page 189 and 190: among passive smoking men, the elev
Page 191 and 192: Table 8.6 Deaths from lung cancer a
Page 193 and 194: Since 1 January 2003 it is no longe
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Table 8.8 Cigarette prices and taxe
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eported. These refer to 2007 in the
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Table 9.1 Criminal investigations i
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Table 9.2 Number of dismantled prod
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Table 9.3 Characteristics of suspec
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Figure 9.2 Number of Opium Act case
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Table 9.5 Opium Act cases as a perc
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Disposals by the courts (in the fir
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• Financial orders (Public Prosec
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Table 9.9 Prevalence of new crimina
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10.2 Drug use among offenders Drug-
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• In some two-thirds of cases opi
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I, II Table 10.2 Number of times th
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• The ISD has a capacity of 1,000
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• Although there are some female
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Clinical admission Admission to a h
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Mellow Type of music at raves that
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Secondary diagnosis A secondary or
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Dismissal on policy grounds Decisio
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eintegration and rehabilitation of
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I. Use and problem use Source Targe
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II. Treatment demand and treatment
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IV. Market information Source Targe
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Source Target group/subject Sources
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Appendix C Explanation of ICD-9 and
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Appendix D Websites in the area of
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Ministry for Health, Welfare and Sp
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Appendix E Drug use in a number of
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References Adlaf, E.M., Korf, D.J.,
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Coumans, A.M. (2005). Survival on t
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Ganpat, S., Wits, E., Schoenmakers,
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Knibbe, R.A., Joosten, J., Derickx,
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Monshouwer, K., Smit, F., De Graaf,
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Rigter, H., Van Laar, M. (2002). Ep
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Tweede Kamer der Staten-Generaal (2
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Van Leeuwen, F.E. (1999). Epidemiol
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In the Netherlands various monitori
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