Netherlands National Drug Monitor - Research and Documentation ...

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1 Introduction The National Drug Monitor In the Netherlands there are several monitoring organisations that follow developments in the area of substance abuse. Scientific papers are also frequently published about usage patterns, prevention and treatment methods. In this veritable sea of information, the National Drug Monitor (NDM) provides policymakers and professionals working in practice as well as various other target groups with an up-to-date overview of the situation. The primary goal of the NDM is to gather data about developments in substance use in a coordinated and consistent manner on the basis of existing research and registered data, and to process this information and translate it into a number of core products, such as Annual Reports and thematic reports. This aim is consistent with the current quest for evidence-based policy and practice. The NDM was set up in 1999 on the initiative of the Minister for Health, Welfare and Sport. 1 Drug use, however, is not exclusive to the domain of public health but also involves aspects of criminality and public nuisance. Since 2002, the Ministry of Justice has also supported the NDM. The NDM embraces the following functions: • Acting as umbrella for and coordinator between the various surveys and registrations in the Netherlands concerning the use of addictive substances (drugs, alcohol, tobacco) and addiction. The NDM aspires towards the improvement and harmonisation of monitoring activities in the Netherlands, while taking account of international guidelines for data collection. • Synthesising data and reporting to national governments and to international and national organisations. The international organisations to which the NDM reports include the WHO (World Health Organisation), the UN and the EMCDDA (European Monitoring Centre for Drugs and Drug Addiction). Within the NDM, the collection and integration of data are central. These activities are conducted on the basis of a limited number of key indicators – or barometers of policy – which are agreed by the EU member states within the framework of the EMCDDA. Data are collected on the following: • Substance use in the general population • Problem use and addiction • Treatment demand from addiction care • Illness in relation to substance use • Deaths in relation to substance use. 1 Introduction 27
The thinking behind these five key indicators is that the seriousness of the drugs situation in a country is reflected by the extent of drug use in the general population, the number of problem drug users and addicts, the extent of demand for treatment and the rate of illness and deaths associated with drug use. However, trends in these indicators may be influenced by factors other than problem drug use alone. For further information, see Box 1. Where available, data are recorded on supply and market, such as the price and quality of drugs. The NDM also reports on registered drug crimes and how law enforcement agencies respond to these crimes. This is also conducted on the basis of a series of indicators, for which the WODC collects data (Meijer, Aidala, Verrest, Van Panhuis & Essers, 2003; Snippe, Hoogeveen & Bieleman, 2000). What do the epidemiological key indicators signify The key indicators of the EMCDDA are intended to reflect the status of drugs problems and to enable improved monitoring of developments. They are also designed to contribute to a broader analysis of policy outcomes, although this remains problematic (Van Laar & Van Ooyen, 2009). The EMCDDA has developed protocols for five drug indicators, which the EU member states have to use in the data collection (EMCDDA, 2009). This is aimed at improving inter-country comparability at European level of data on drug use and its consequences. Although distinct progress has been made in this respect, the goal has not yet been fully reached. Therefore differences between countries, particularly smaller ones, should still be interpreted with caution. This Annual Report also describes the situation concerning the consumption of alcohol and tobacco within the context of these indicators; with a few exceptions, these data have not been collected in an internationally standardised manner. Substance use in the general population (including school-goers) Population studies on substance use can shed light on the extent of usage and on risk groups. If conducted at regular intervals and in the same way, these studies can also reveal trends. Various groups of users are distinguished, in describing alcohol or drug use. The largest group comprises people who have ever in their lives consumed alcohol and/or drugs – even years previously (ever use). A better indicator of current developments is found in the percentage of people who have lately used a substance - in the past year or month (recent and current use). The way in which the surveys are conducted (e.g. written, by telephone or faceto-face) and the circumstances surrounding the interviews (e.g. the presence of a parent), may influence people’s willingness to ‘admit’ to having used a substance. However, in view of the relatively liberal climate in the Netherlands regarding drug 28 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 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 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
Page 74 and 75: Figure 3.4 Admissions to general ho
Page 76 and 77: The Netherlands Cause-of-Death stat
Page 78:
• Little is known as yet about a
Page 81 and 82:
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
Page 181 and 182:
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.,
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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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