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The number of hospital admissions citing cocaine misuse or dependence as the main diagnosis is limited, but has shown a slight rise in recent years. In 2006, 2007 and 2008 respectively there were 90, 114 and 131 admissions of this nature. The number of admissions citing cocaine problems as a secondary diagnosis is larger. In 2006, 2007 and 2008 respectively, there were 514, 607 and 617 cases. Viewed over the longer term, there has been a gradual rise in incidences. Percentage of young opiate users receiving treatment remains limited Heroin is not popular among the youth. In 2007 0.8% of school-goers aged 12 to 18 in mainstream education had tried this drug, and 0.4% reported past month use. According to the most recent estimate for 2008 there are approximately 17 700 problem opiate users in the Netherlands, within a margin of 17 300 to 18 100. This is less than a decade ago. The Dutch population of opiate users is in the process of ageing. The proportion of young opiate clients (15-29) receiving treatment for addiction declined from 39% in 1994 to 6% in 2005 and 2006, stabilising at 5% in 2007 and 2008. Between 2001 and 2004 the total number of clients with a primary opiate problem declined from almost 18,000 to 14,000, and remained around this level until 2007. In 2008 there were 12 711 fewer opiate clients (down by almost 8%) than in 2007 and only 5% were new incident addicts. The remainder were already registered for treatment with the addiction care services. While there was a decline in the number of admissions to general hospitals citing opiate problems as a secondary diagnosis between 2002 and 2006, the number stagnated in the years following. Between 2006 and 2008 a slight rise (+14%) was evident. The number of hospital admissions with opiate problems as the main diagnosis remains low (79 in 2008). The number of newly notified cases of HIV and hepatitis B and C among injecting drug users has been low for years. However, the number of existing infections, particularly of hepatitis C, is high – at least in municipalities that have data on this. The vast majority of regions in the Netherlands lack data on the prevalence of hepatitis C among drug users. Increase in amphetamine clients, but total number remains low There is a downward trend in the percentage of ever users and current users of amphetamine among school-goers in mainstream education between 1996 and 2007. This decline was most marked between 1996 and 1999. In 2007 1.9% of school-goers aged 12-18 had ever used amphetamine, and 0.8% had used it in the past month. By comparison with other European countries, the percentage of amphetamine users among Dutch school-goers is relatively low. Amphetamine is somewhat more popular among juveniles and young adults in the social scene (than among school-goers), but considerably less popular than ecstasy. In 2008/2009 7% of party-goers at large-scale raves and parties were current users of amphetamine. Despite indications of the drug’s growing popularity among the provincial Summary 17
youth, the percentage of current amphetamine users among clubbers remains highest in the more urbanized west of the country (5.4%) and lowest in the more rural south (1.7%). Between 2001 and 2007 the number of amphetamine users seeking treatment trebled, and then stabilised in 2008 at 1, 446 addiction care clients. Throughout this period, the share of amphetamine in treatment demand for drug addiction remained low (between 2 and 4%). The number of admissions to general hospitals with a main diagnosis of misuse and dependency on amphetamine-like substances (including ecstasy) remains limited. In 2008 there were 54 such admissions. There was an increase from 2006 to 2007 in the number of secondary diagnoses related to misuse and dependency on amphetamine-like substances, from 88 to 136. This rising trend continued at a slower pace in 2008 (145 admissions). These trends in treatment demand may possibly be associated with an increase in the number of problem users of amphetamine, but there is a lack of data to verify this. Ecstasy use seldom a reason for seeking treatment Between 1996 and 2007 ecstasy use among the school-going youth showed a downward trend. In 2007 2.4% of school-goers aged 12-18 in mainstream education had ever tried ecstasy and 0.8% had used it in the past month. After cannabis, ecstasy remains the most popular illegal drug among juveniles and young people in the social scene. In 2008/2009 a quarter (24%) of the attendees at large-scale parties and festivals were current ecstasy users. Almost one in five (18%) had used the drug that evening, although this percentage varied considerably between venues. Among frequenters of clubs and discos, the percentage of current ecstasy users varied from 5% in the more rural north to 12% in the more urban west of the country. It is not known how many people develop problems from ecstasy use. Few ecstasy users seek treatment from the addiction care services. The number of ecstasy clients as a percentage of all drug clients in addiction care has been low for years, at only 1%, and is declining slightly. In 2008 there were 191 clients with a primary ecstasy problem, and in 2007 there were 239. Three times as many clients cite ecstasy as a secondary problem (571 in 2008). Ecstasy use can cause a disruption to brain function, particularly in the verbal memory. However, the effects tend to be minor, and other factors may possibly play a role (overheating, other drugs, pre-existing illnesses and conditions). Increase in GHB incidents GHB use is rare in the general population and among school-goers in mainstream education. In 2007 0.6% of school-goers aged 12-18 had ever used GHB. Higher percentages are found among pupils at special schools and among juveniles in care. 7.1 percent of 16 year-olds attending REC-4 schools and 7 percent of juveniles in care had ever tried GHB. Likewise, juveniles and young adults in the social scene have more experience with 18 Netherlands National Drug Monitor - NDM Annual Report 2009
Page 1 and 2: Netherlands National Drug Monitor N
Page 3 and 4: Colophon Project Manager Dr. M.W. v
Page 6: Preface This is already the tenth A
Page 9 and 10: 5.4 Problem Use 113 5.5 Usage: Inte
Page 12 and 13: List of abreviations and acronyms 2
Page 14 and 15: NEMESIS NFU NIGZ NMG NPO NRI NVIC N
Page 16 and 17: Summary Below is an outline of the
Page 20 and 21: GHB. In 2008/2009 4.6 percent of fr
Page 22 and 23: Deaths In the Netherlands, smoking
Page 24 and 25: Offences by drug users Drug users c
Page 26 and 27: Opiates Ecstasy Amphetamine Alcohol
Page 28 and 29: 1 Introduction The National Drug Mo
Page 30 and 31: use, particularly cannabis, under-r
Page 32 and 33: information is available, this is b
Page 34 and 35: 2 Cannabis Cannabis (Cannabis Sativ
Page 36 and 37: Figure 2.1 Cannabis users in the Ne
Page 38 and 39: Figure 2.2 Cannabis use among secon
Page 40 and 41: Cannabis and problem behaviour •
Page 42 and 43: Table 2.4 Cannabis use among pupils
Page 44 and 45: Table 2.5 Current cannabis use in s
Page 46 and 47: • The sharp increase in treatment
Page 48 and 49: Trends It is difficult to determine
Page 50 and 51: • The role of cannabis in all req
Page 52 and 53: - misuse or dependence on alcohol a
Page 54 and 55: At the Ambulance Transport Centre (
Page 56 and 57: • So far, epidemiological studies
Page 58 and 59: Quality and price The Trimbos Insti
Page 60 and 61: 3 Cocaine Cocaine works as a stimul
Page 62 and 63: Age, gender and urbanisation level
Page 64 and 65: Special groups In certain groups of
Page 66 and 67: Table 3.3 Cocaine use in special gr
Page 68 and 69:
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
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Table 5.4a Use of amphetamines and
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Table 5.5a Ecstasy use among school
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Ecstasy • The number of (outpatie
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Figure 5.3 Numbers registered with
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• The same person may be admitted
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• The number of requests for info
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According to the EMCDDA, in other E
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Figure 5.6 Concentration of MDMA in
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Table 5.9 Number of samples contain
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• Consumers who had drug samples
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6.2 Usage: general population The r
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GHB use is more common among juveni
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• GHB use among school-goers is l
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Table 6.4 GHB incidents registered
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• Of the liquid samples sold as G
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• Total deaths from alcohol-relat
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Figure 7.1 Alcohol consumption amon
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Ethnic background • Among seconda
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Table 7.3 Percentage of current dri
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Table 7.4 Alcohol use in the social
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Holiday-makers • Research conduct
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Figure 7.3 Heavy drinkers by gender
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The countries with the lowest perce
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• In France it is more likely tha
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Figure 7.6 Age distribution of prim
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• In 2008, 337 day-care admission
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• In approximately 1,200 admissio
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Table 7.9 Estimated number of injur
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• On the basis of current researc
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Figure 7.10 Deaths from alcohol use
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• EU member states have different
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• Surveys by the Continuous Surve
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Figure 8.1 Percentage of smokers in
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8.3 Usage: juveniles and young adul
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Special education Table 8.3 shows t
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Table 8.4 Smokers in the EU-15 plus
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medication, Champix ® , which was
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among passive smoking men, the elev
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Table 8.6 Deaths from lung cancer a
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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.,
Page 256 and 257:
Coumans, A.M. (2005). Survival on t
Page 258 and 259:
Ganpat, S., Wits, E., Schoenmakers,
Page 260 and 261:
Knibbe, R.A., Joosten, J., Derickx,
Page 262 and 263:
Monshouwer, K., Smit, F., De Graaf,
Page 264 and 265:
Rigter, H., Van Laar, M. (2002). Ep
Page 266 and 267:
Tweede Kamer der Staten-Generaal (2
Page 268 and 269:
Van Leeuwen, F.E. (1999). Epidemiol
Page 270:
In the Netherlands various monitori
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