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- misuse or dependence on alcohol and drugs (18%, mainly alcohol: 13%) - injury due to accidents (14%, such as fractures, cuts, concussion) - respiratory tract illnesses and symptoms (5%) - cardio-vascular illnesses (5%) - poisoning (4%, by drugs, alcohol, medication) • In these figures, the same person may be admitted more than once per year. In addition, more than one secondary diagnosis may be made per case. In 2008, corrected for duplication, the total amounted to 461 persons who were admitted at least once with cannabis misuse or dependence as the main or secondary diagnosis. Their average age was 30, and 77% were male. The percentage of cannabis patients was highest in the twenty to twenty-four age group (figure 2.7). Figure 2.6 Clinical admissions to general hospitals, related to cannabis misuse and dependence, from 1995 500 450 400 Number 377 399 476 350 300 250 247 249 230 246 322 299 200 150 193 154 184 195 193 100 50 39 38 26 29 29 24 38 33 46 56 62 54 69 57 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 Cannabis as secondary diagnosis Cannabis as main diagnosis Number of diagnoses, not corrected for duplication of persons or for more than one secondary diagnosis per admission. ICD-9 codes: 304.3, 305.2 (Appendix C). Source: Dutch Hospital Data, LMR, Prismant 2 Cannabis 51
Figure 2.7 Age distribution of cannabis patients in general hospitals. Survey year 2008 25 % 23 20 15 14 16 16 10 11 9 5 2 5 2 3 54 Age Percentage of patients per age group. Source: Dutch Hospital Data, LMR, Prismant. • In 2008 cannabis problems were also recorded as primary or secondary diagnosis in 13 day-care treatments. This is somewhat less than in 2006 and 2007 (25 and 20 day care treatments respectively). • In addition, the LMR recorded 14 admissions in 2007 for which “accidental poisoning with hallucinogens” was cited as secondary diagnosis (ICD-9 code: E854.1). From 2001 to 2007, there were 15, 8, 16 15 14 15 and 15 cases respectively. These may have involved cannabis, but equally LSD or magic mushrooms. According to the injury information system (LIS) of the Consumer Safety Institute , an average of 3,800 people are treated annually at the accident and emergency departments of hospitals on account of an accident, violent incident or self-mutilation related to drug use (henceforth called ‘accidents’). The drugs meant here are cannabis, cocaine, heroin, cannabis, ecstasy, amphetamine and magic mushrooms. The data have been averaged over the period from 2004 through 2008 (Valkenberg, 2009). • After cocaine, cannabis is the most frequently cited drug. Approximately one in six (16%) victims of an accident involving drugs indicates having used cannabis. If we count only the cases where the drug is known (65%), then cannabis accounts for 24% of all drug-related emergency room treatment. • These figures are likely to be an under-estimate of the true number of drug-related accidents, because the role of drugs is not investigated systematically. 52 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 48 and 49: Trends It is difficult to determine
Page 50 and 51: • The role of cannabis in all req
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
Page 99 and 100: • It is thought that risk behavio
Page 101 and 102: 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
Page 141 and 142:
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
Page 169 and 170:
Table 7.9 Estimated number of injur
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• On the basis of current researc
Page 173 and 174:
Figure 7.10 Deaths from alcohol use
Page 175 and 176:
• EU member states have different
Page 177 and 178:
• Surveys by the Continuous Surve
Page 179 and 180:
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
Page 185 and 186:
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
Page 191 and 192:
Table 8.6 Deaths from lung cancer a
Page 193 and 194:
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
Page 199 and 200:
Table 9.1 Criminal investigations i
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Table 9.2 Number of dismantled prod
Page 203 and 204:
Table 9.3 Characteristics of suspec
Page 205 and 206:
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
Page 213 and 214:
Table 9.9 Prevalence of new crimina
Page 215 and 216:
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
Page 223 and 224:
• 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
Page 233 and 234:
eintegration and rehabilitation of
Page 235 and 236:
I. Use and problem use Source Targe
Page 237 and 238:
II. Treatment demand and treatment
Page 239 and 240:
IV. Market information Source Targe
Page 241 and 242:
Source Target group/subject Sources
Page 244 and 245:
Appendix C Explanation of ICD-9 and
Page 246 and 247:
Appendix D Websites in the area of
Page 248 and 249:
Ministry for Health, Welfare and Sp
Page 250:
Appendix E Drug use in a number of
Page 254 and 255:
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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