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Trends It is difficult to determine the trends in cannabis use on account of a lack of repeat and comparable measurements in and between countries. • In thirteen of the EU-15 plus Norway for which data are available, cannabis use has generally risen since 1990 in a majority of nine countries; it has declined in only one country; and has remained more or less stable in a minority of three countries, including the Netherlands. In most cases, the rise in use occurred mainly in the 1990s, whereas in the past decade recent cannabis use declined in France, the U.K., Germany and Greece. In the Netherlands recent cannabis use remained at more or less the same level between 1997 and 2005. • Likewise in the US, cannabis use declined at the start of this century. Between 2002 and 2007, recent use in the general population aged 12 and older dropped from 11 to 10 percent. The decline occurred chiefly among juveniles aged from 12 to 17. • In Australia recent cannabis use in the general population aged 14 and older rose from 13% in 1995 to 18% in 1998, after which it declined to 9% in 2007. Juveniles The data from ESPAD, the European School Survey Project on Alcohol and Other Drugs lend themselves better to comparison. In 1999, 2003 and 2007, surveys were conducted among fifteen and sixteen year old secondary school pupils (Hibell et al., 2000, 2004, 2008. Table 2.8 shows cannabis use in a number of EU countries, Norway, Switzerland and the US. The US did not take part in the ESPAD but conducted similar research. • The percentage of school-goers that had ever used cannabis in 2007 was highest in Spain, followed closely by Switzerland, the US France and the U.K.. Dutch schoolgoers were in sixth place. • Spain topped the list for current use, followed by Switzerland, France and the Netherlands. • The percentage of school-goers that had used cannabis six times or more in the past month was lowest in Greece and the Nordic countries Norway, Finland and Sweden, and highest in Spain, followed by Switzerland, France, the Netherlands, the US and Italy. • In 2003 Dutch school-goers occupied a better position in the rankings. This is not because cannabis use in the Netherlands has increased, but because between 2003 and 2007 declines (some remarkable) took place in other countries such as the U.K., Ireland and France. • Regular cannabis use (10 time or more in the past year) is associated with low selfesteem, an increased chance of depression, anomia, anti-social behaviour, running away from home, self-harm and suicidality. These associations were, however, also found with other substances, such as alcohol and tobacco. 2 Cannabis 47
Table 2.8 Cannabis use among school-goers aged 15 and 16 in a number of EU member states, Norway, Switzerland and the US. Survey years 1999, 2003 and 2007 Country Ever Use Current Use Six or more times in the past month 1999 2003 2007 1999 2003 2007 1999 2003 2007 Spain II - 36% 36% - 22% 20% - - 8% Switzerland - 40% 33% - 20% 15% - 10% 6% France 35% 38% 31% 22% 22% 15% 9% 9% 6% Netherlands 28% 28% 28% 14% 13% 15% 5% 6% 6% United States I 41% 36% 31% 19% 17% 14% 9% 8% 6% Italy 25% 27% 23% 14% 15% 13% 4% 6% 6% Belgium III - 32% 24% - 17% 12% - 7% 4% United Kingdom 35% 38% 29% 16% 20% 11% 6% 8% 4% Ireland 32% 39% 20% 15% 17% 9% 5% 6% 4% Denmark II 24% 23% 25% 8% 8% 10% 1% 2% 2% Germany IV - 27% 20% - 12% 7% - 4% 2% Austria - 21% 17% - 10% 6% - 3% 2% Portugal 8% 15% 13% 5% 8% 6% 2% 3% 2% Greece 9% 6% 6% 4% 2% 3% 2% 1% 1% Norway 12% 9% 6% 4% 3% 2% 1% 1% 1% Finland 10% 11% 8% 2% 3% 2% 1% 0% 0% Sweden 8% 7% 7% 2% 1% 2% 0% 0% 0% Percentage of ever use, current use (past month) and six times or more in the past month. I. The US did not participate in ESPAD but conducted comparable research. II. The data for Denmark and Spain are less representative. III. Belgium in 2007: data only for Flanders. IV. Germany: data for six of the sixteen federal states. - = not measured. Source: ESPAD. 2.6 Treatment demand Addiction Care The National Alcohol and Drugs Information System (LADIS) registers the number of people who seek treatment from outpatient addiction care, including rehabilitation programmes and the addiction clinics that are merged with the outpatient addiction care services (Ouwehand et al., 2009; IVZ, 2009). (See in appendix A: LADIS client) • The number of clients registered on account of a primary cannabis problem more than quadrupled between 1994 and 2008 (Figure 2.4). From 2006 to 2007 there was an increase of 23% and between 2007 and 2008, there was a further rise of 5%. • Per 100,000 inhabitants aged 15 and over, the number of primary clients rose from 16 in 1994 to 62 in 2008. 48 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 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 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
Page 83 and 84: • In the province of Gelderland,
Page 85 and 86: Figure 4.1 Estimates of the number
Page 87 and 88: and syringes exchanged has been reg
Page 89 and 90: • Between 2001 and 2004 the numbe
Page 91 and 92: - misuse of or dependence on alcoho
Page 93 and 94: same time it should be noted that t
Page 95 and 96: International comparison The Europe
Page 97 and 98: 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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