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GHB. In 2008/2009 4.6 percent of frequenters of large-scale parties and raves reported past month use of GHB. Among clubbers and disco-goers, the percentage of current users was between one and two percent. GHB use, particularly daily use can lead to dependency, and sudden cessation can result in rather severe withdrawal symptoms. Treatment demand on account of GHB addiction has increased in a number of addiction care organisations in recent years, but national data are lacking. GHB is difficult to dose, and there is a high risk of overdose. It is estimated that the number of GHB victims receiving emergency treatment quadrupled between 2003 and 2008 to 980. It is unclear how many deaths may be linked to GHB. In 2008 four cases were registered in the Causes of Death Statistics, that were linked to GHB. In 2008 users paid around six euro per 5 ml dose of the drug. Alcohol and tobacco: usage and treatment demand Decline in alcohol use among 12-14 year-olds; rise in treatment demand In 2008 81 percent of the general population aged over 12 reported ‘sometimes’ drinking alcohol. This percentage has been stable for some years. Heavy drinking (defined as at least six units of alcohol on one or more days per week) occurs in ten percent of the population - 17 percent among males and four percent among females. This means a total of 1.4 million heavy drinkers. By comparison, in 2001 fourteen percent of the population aged over 12 were heavy drinkers. This slight downward trend is visible in all age groups up to 65 and in both males and females. There are large differences between age groups, particular in relation to heavy drinking. In 2008, 37% of males and 12% of females in the 18-24 year age bracket were heavy drinkers. Alcohol use among school-goers in mainstream secondary education declined between 2003 and 2007, but only in the 12-14 year age group. In 2007, 32 percent of this cohort were current drinkers, compared to 47% in 2003. Alcohol use remained stable among 15-18 year olds (76% in 2003 and 75% in 2007). There was also a decline in the percentage of school-goers aged 12-14 that had engaged in binge drinking during the past month (5 or more units in one session), during the period from 2003 to 2007 (28% in 2003 versus 19% in 2007). Binge drinking occurred in 2007 in over half of 15-18 year old school-goers, which is the same as in 2003 (57% and 56% respectively). The popularity of alcopops and breezers has declined. While 29 percent of school-goers aged 12-18 drank these weekly in 2003, in 2007 the number was down to 16 percent. Compared to other European countries (EU-15) Dutch school-goers of 15 and 16 are ranked among the largest consumers of alcohol. For “drinking alcohol at least ten times in the past month” only Austria scored higher than the Netherlands (30% and 24% respectively). It seems parents tend to underestimate the amount of alcohol their child is consuming. Summary 19
Despite a legal ban on selling alcohol to underage customers, youngsters below the age of 16 can still procure alcoholic beverages easily enough, if they attempt to do so. However, their chance of success has declined in off-licence liquor stores. Between 2001 and 2007 there was also a decline in the percentage of underage drinkers that reported actually procuring alcohol (illegally). However, in 2007 half of the youngsters (49%) aged 13-17 had procured alcohol in licensed premises in the month prior to the survey. Only 2% had done so in off-license stores. Only a small percentage (3%) of the circa 1.2 million problem drinkers in the Netherlands seek treatment from the addiction care services; however this number is growing. In 2008 over 33,000 clients were treated for a primary alcohol problem. This is as many as in 2007, but 10 percent more than in 2006 and 48 percent more than in 2001. The peak age group seeking treatment in 2008 was 40-54. In hospitals, the number of admissions for a main diagnosis of alcohol misuse or dependency rose from over 5,600 in 2007 to almost 6,000 in 2008 (+6%). Almost twice as many admissions were linked to a secondary diagnosis involving alcohol, rising from nearly 12,000 to over 13,700 (+15%). Among juveniles aged under 17 admitted to hospital for alcohol-related reasons, an increase was registered from 263 in 2001 to 711 in 2008 (+170%). No further drop in number of smokers among the youth Between 2004 and 2007 the percentage of smokers in the Dutch population aged over 15 remained largely unchanged. From 2007 to 2008 there was a slight decline in the percentage of smokers from 27.5% to 26.7%. There was also a slight drop in the percentage of heavy smokers (at least 20 cigarettes per day), from 7.2 to 6.7 in the population aged over 12 years. After a sharp drop between 1996 and 2003, the percentage of current smokers among secondary school-goers in mainstream education stabilised at 19 percent in 2007. No differences were found between boys and girls in this respect. In 2008 a total of 1.4 million people attempted to quit smoking. Treatment demand for tobacco addiction consists largely of self-help and GP consultations. The market for nicotine replacement products (patches, chewing gum, tablets) expanded further between 2007 and 2008. Various campaigns were run to encourage people to give up smoking. For the year 2005 an estimated 90,000 people aged over 35 were admitted to hospital for smoking-related illnesses. The decline in smoking among school-goers may ultimately yield considerable health gains, particularly in a drop in the number of COPD and lung cancer cases. 20 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 18 and 19: The number of hospital admissions c
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
Page 70 and 71:
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
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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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