Netherlands National Drug Monitor - Research and Documentation ...

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At the Ambulance Transport Centre (CPA), the Amsterdam Municipal Health Service (GGD Amsterdam) keeps a log of the number of requests for emergency treatment related to alcohol use. • In 2008 the CPA Amsterdam registered 2,145 alcohol-related ambulance journeys. • The number of alcohol-related ambulance journeys dropped slightly between 2001 and 2003 (1,957 in 2001; 1,887 in 2002; 1,733 in 2003) and rose until 2006 (1,825 in 2004; 2,056 in 2005; 2,165 in 2006). • In 2007 and 2008 the number of registrations stabilised at 2,138 and 2,145 respectively. • About six out of ten patients (59%) were transported to a hospital emergency department. In the other four out of ten cases, the ambulance staff provided first aid at the scene. According to the injury information system (LIS) of the Consumer Safety Association, some 15,000 people annually receive emergency treatment in a hospital for injury caused by an accident, violence or self-harm involving alcohol (Table 7.5) (Valkenberg, 2009). The data are estimates for the whole country, based on figures from a representative sample of hospitals. • The number of emergency room admissions resulting from accidents, violent incidents or self-harming in which alcohol was involved, increased by 46% from 2004 to 2008. The remaining LIS data have been averaged over the period from 2004 through 2008. • Nearly three-quarters of all victims are male (69%; 11,000). • 16% are aged between 0 and 19 years (which means 2,360 juveniles annually); 26% are aged 20 to 29 and 37% are in the 30-49 age group. • The likelihood of emergency room treatment is greatest in the 20-24 age group (15% of all cases), followed by age 15-19 (14%). Each week an average of 45 victims aged 20 to 24 are treated in a hospital emergency department for the consequences of alcohol use. • Over half of the accidents (57%) take place in private circumstances (Table 7.7), such as a fall when intoxicated, or alcohol poisoning. In second place are road accidents (particularly falls from bicycles), followed by self-harm (often involving a combination of alcohol and drugs and/or medicines) and injury through violence. • Nearly half (47%;7,200) of the victims of an accident involving alcohol had fallen – often from a bicycle, moped or motorcycle (17%; 2,600). Over a third (35%; 5,400) had suffered alcohol poisoning. Nearly one in ten victims were injured after contact with an object such as cutting themselves on glass or bumping into something (9%; 1,300) • Four out of ten (40%, 6,200) victims were admitted to hospital after emergency room treatment. The percentage of people admitted to hospital following an accident involving alcohol is relatively high. This is an indication that accidents involving alcohol are serious. This compares with an admission rate of 11% on average for accidents in private circumstances, 18% for road traffic accidents and 60% for self-harming. 7 Alcohol 165
• In approximately 1,200 admissions annually, drugs had been used in addition to alcohol. Self-harm occurs relatively frequently in a combination of alcohol and drugs (25% of cases, compared to 16% of cases involving only alcohol or only drugs). • These figures are probably an under-representation of the true scale of alcohol-related accidents, because the influence of alcohol on accidents is not systematically investigated. Table 7.7 Type of alcohol-related incidents that were treated in the emergency department in Dutch hospitals (annual average for 2004-2008) Type of incident Number Percentage Private circumstances 8 800 57% Road accident 3 200 21% Self-harm I 2 400 16% Injury through violence 920 6% Total ±15 000 100% I Such as suicide attempts by using alcohol and medicines. Source: LIS, Valkenberg (2009). The National Poison Information Centre (NVIC) of the RIVM provides doctors, pharmacists and government organizations with information about poisoning (Van Velzen et al., 2009). • In 2008, 2,103 cases of exposure to alcohol were reported to the NVIC. This was 6% more than in 2007 (table 7.8). The increase is partly a consequence of the fact that notifications made via the website were included in the data for the first time in 2008. • These figures do not provide a clear picture of the absolute number of intoxications, however, because alcohol poisoning is not a notifiable condition. Moreover, doctors are generally familiar with the symptoms of alcohol use and overdose. The more familiar doctors are with the symptoms and treatment of intoxication with a particular substance, the less likely they are to consult the NVIC. • Some three-quarters of the cases involved a combination of alcohol and medicines. • The number of information requests for alcohol poisoning involving juveniles aged between 13 and 17 has increased in recent years from about 4% in 2002 to 8% in 2005. No further rise has been registered since 2005. In 2008, the rate was seven percent. Alcohol poisoning among juveniles is mostly the result of drinking spirits with friends. 166 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
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same time it should be noted that t
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International comparison The Europe
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The total number of chronic hepatit
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• It is thought that risk behavio
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the ICD-9 classification. Drug deat
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Amsterdam GGD Amsterdam reports the
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Figure 4.9 Number of drug-induced d
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• Pupils attending REC-4 schools
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5.3 Usage: juveniles and young adul
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• In 2008, key observers in Amste
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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 and 144: • Of the liquid samples sold as G
Page 145 and 146: • Total deaths from alcohol-relat
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: • In 2008, 337 day-care admission
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
Page 195 and 196: Table 8.8 Cigarette prices and taxe
Page 197 and 198: eported. These refer to 2007 in the
Page 199 and 200: Table 9.1 Criminal investigations i
Page 201 and 202: Table 9.2 Number of dismantled prod
Page 203 and 204: Table 9.3 Characteristics of suspec
Page 205 and 206: Figure 9.2 Number of Opium Act case
Page 207 and 208: Table 9.5 Opium Act cases as a perc
Page 209 and 210: Disposals by the courts (in the fir
Page 211 and 212: • Financial orders (Public Prosec
Page 213 and 214: Table 9.9 Prevalence of new crimina
Page 215 and 216: 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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