Netherlands National Drug Monitor - Research and Documentation ...

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Deaths In the Netherlands, smoking is still the main cause of premature death. In 2008 over 19,300 people aged over 20 died as direct consequence of smoking. This was almost the same number as in 2007. Lung cancer is the main cause of smoking related deaths. The death rate from this disease rose slightly between 2003 and 2008, particularly among women. These figures do not reflect deaths due to passive smoking. In 2008 alcohol-related conditions were the direct cause of 765 deaths; in almost a further thousand cases, alcohol-related conditions were registered as a secondary diagnosis. The rising trend in total deaths from alcohol-related conditions from the early 1990s did not continue during the period between 2004 and 2008. The death rate from smoking and alcohol-related conditions is many times greater than the death rate due to (hard) drugs. In 2008 129 drugs users died from the consequences of drug overdose, which was more than in 2007, when there were 99 deaths. In the past ten years, this number has fluctuated between around 100 and 140 cases. Only one in five victims is aged between 15 and 34. Ten years ago, as many as 47% of victims were in this young age group. By comparison with a number of other EU member states, the rate of acute drug-related deaths in the Netherlands is low. Market Increase in use of mixers in ecstasy and cocaine For many years, ‘ecstasy tablets’ at consumer level consist mainly of MDMA-like substances (in 2007 this was the case in 91% of the tablets tested). However, in late 2008 and in the first half of 2009 the was a sharp decline in the proportion of tablets containing MDMA, accompanied by a sharp rise in the percentage of tablets containing more or less comparable pharmaceutical substances (such as mCPP). In the first half of 2009 only 70 percent of ecstasy tablets tested contained MDMA. Other pharmaceuticals are increasingly being found in cocaine samples, particularly levamisol, a substance that is no longer registered for human medicinal use. The health risks of snorting or smoking cocaine that has been mixed with levamisol are not known exactly. In the US, cases of serious blood diseases have been reported. The average THC-content (the main active substance in cannabis) in Dutch-grown weed declined from 20 to 16 percent between 2004 and 2007, stabilising at this level in the years following. In 2009 the average percentage of THC in Dutch-grown weed was 15%. The price of Dutch-grown weed has risen slightly in recent years. In 2009 the average price was €8.10 per gram for the most popular variety, and €10.50 for the most potent variety. There are no indications that cannabis containing lead or glass particles is reaching the market via the coffee shops. Little is known about the presence of other substances such as pesticides in Dutch-grown weed, or about the extent to which these pose a threat to the health of cannabis users. Summary 21
Offences against the Opium Act Investigations into serious forms of organised crime are mainly drug-related As in earlier years, the majority of investigations into more serious forms of organised crime in 2007 and 2008 involved drugs. Most cases targeted organisations involved with hard drugs, and the most frequently cited drug is cocaine. The percentage of investigations dealing with hard drugs declined in 2008, whereas there was a rise in the percentage that involved soft drugs only – in particular Dutch-grown weed. Slight drop in new Opium Act offences in the law enforcement chain The overall picture for 2007 and 2008 shows a (very) slight drop in the number of new drug offences and the number disposed of. This applies both to the number of suspects charged by the police and the Royal Marechaussee Constabulary, and to the number of new drug cases appearing before or disposed of by the public prosecutor and the courts. 2004 was a ‘peak year’ in terms of drug offences in the law enforcement chain. Since then, the trend has been stable, with a recent (very) light decline. The decline is most marked in hard drug crimes. The gap between the number of hard drug and soft drug crimes has been narrowing since 2004. The percentage of both appearing before the public prosecutor was virtually identical in 2008. The number of Opium Act offences as a percentage of all crimes has remained fairly constant in recent years. It appears that drug offences follow the same trend as crime in general. Summonses and penalties Summonses are issued on two thirds of all drug offences. There was a decline in the percentage of summonses issued for drug offences in 2008 compared to 2007. A summons is more likely to be issued in cases involving hard drugs and especially those involving both hard and soft drugs than in cases involving soft drugs only. For the majority of offences, the court imposes a community service order or a partly suspended prison sentence. In recent years, the percentage of community service orders has been higher than the number of these detention orders. (Partly) suspended prison sentences are mainly imposed for smuggling, production or trafficking of hard drugs; community service orders tend to be imposed for smuggling, production or trafficking of soft drugs. The number of detention orders for Opium Act offences has increased in recent years, but the relative percentage has remained unchanged. 22 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 20 and 21: GHB. In 2008/2009 4.6 percent of fr
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-
Page 72 and 73:
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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