The Netherlands Drug Situation 2010 - Trimbos-instituut

February 2010, a total of 225 homeless people made use of the winter-cold regulation, ofwhom 105 were interviewed. It was found that 24% of them had used opiates or cocaineduring the past month, compared to 45% during the winter of 2005-2006. Among thehomeless, less drug users will have been found due the successful efforts that have beenmade to arrange better housing for this group.In case a drug user is promoted from social relief to a hostel, that drug user may experienceless social exclusion with regard to the housing situation. Nonetheless, some experienceof social exclusion may still remain on other domains. Research has been conductedin July and August 2009 among a total of 109 inhabitants (respons 77%) of sixhostels in the city of Utrecht (Wolf et al. 2010). Almost daily substance use was found formethadone (67%), cocaine (51%), heroin (28%), and prescribed heroin (13%), whichmakes 84% of the hostel inhabitants a harddrug user. From the hostel inhabitants, 72%had no fixed daily activities. Other indications of social exclusion were given by the factthat 14% had no contact with family, and 18% had no contact with friends. Moreover,40% had been arrested during the past year and 38% had been a victim of crime. Furthermore,issues for which the inhabitants were in need of help but declared not to receivethat help were found with regard to housing (35%), finding work (20%), physicalhealth (17%), dental care (13%), daily activities (13%), and taking care of oneself(12%).Besides a bad housing situation, having less access to health care also counts as a formof social exclusion. This aspect of social exclusion has been signaled recently among Moroccandrug users. On behalf of the Mainline Foundation (Stichting Mainline), field researchersconducted structured in-depth interviews between October 2006 and February2007 among 23 Moroccan drug users. During the past three years, these drug users hadused cocaine, heroin, or methadone at least three days a week, and had not completedan inpatient drug treatment during the past year (Voets 2008). Their average age was40.4 years (range 20-57 years) and they had come from Morocco to the Netherlandsbetween 1956 and 1994. Cocaine was used the most, followed by heroin and methadone.It was found that most "Moroccan drug users do use general food and accommodationservices and, to a lesser extent, public medical services". However, nearly "none of themmade use of drug treatment clinics". "They were not interested in the assistance of theseclinics. They said they were not ready to quit drugs, or thought that they could kick thehabit without professional support." It appeared that the Moroccan drug users are morein need of practical care with regard to issues like housing, daily activities and aftercareafter detoxification. They do not expect the treatment clinics to offer this kind of practicalcare.Baza and Sabir have interviewed Moroccan drug addicts from the city of Utrecht (Baza etal. 2010). According to these researchers, there is a high threshold in this group to seektreatment and more dropout during treatment due to former negative experience withtreatment, a negative image of counselors, not feeling understood with regard to culturalbackground, rules maintained by the institutes, and not being ready yet for treatment.Baza and Sabir therefore recommend that counselors do not primarily focus on abstinence,but first take care about housing, benefits, and daily activities. This way addictscan come to grips again with their life.In the Netherlands, the pragmatic policy used to be to avoid, as much as possible, thesocial exclusion of people who only use drugs, but do not produce, transport, or deal111