Hague, and 1,150 homeless in Utrecht. In all municipalities, a total of 9,786 clients wereincluded in the program. An individual reintegration trajectory was considered successfulin case a "stable mix" had been reached. Criteria for a stable mix were stable housing,income, and being in contact with treatment for at least three months. By the end of2009 there were 2,679 stable mixes in Amsterdam, 1,771 in Rotterdam, 1,008 in <strong>The</strong>Hague, and 471 stable mixes in Utrecht. Compared to the total number of intakes andindividual trajectories, this amounts to 70% stable mixes in Amsterdam, 59% stablemixes in Rotterdam, 55% stable mixes in <strong>The</strong> Hague, and 41% stable mixes in Utrecht.<strong>The</strong> results are summarized in table 8.2.2. From the total of 9,786 intakes in the fourmain cities, a total of 5,929 stable mixes had been achieved by the end of 2009, amountingto an achievement of 61%.Table 8.2.2: Number of intakes among homeless people, achieved stable mixes, andpercentage of stable mixes from the number of intakes by the end of 2009in the four largest cities of the <strong>Netherlands</strong>, G4City of the G4 Intakes Stable mixes* %Amsterdam 3,814 2,679 70Rotterdam 2,989 1,771 59<strong>The</strong> Hague 1,833 1,008 55Utrecht 1,150 471 41Total 9,786 5,929 61*A stable mix requires stable housing, income, and being in contact with treatment for at least three months.Source: Strategy Plan for Social Relief Monitor, National Monitor on Homelessness (MMO), (Maas et al., <strong>2010</strong>).As already mentioned above, in February <strong>2010</strong> the Strategy Plan for Social Relief, in itssecond phase, was launched in the remaining 39 centre municipalities. <strong>The</strong>se municipalitiesare monitored by the Municipal Compass Monitor (Monitor Stedelijk Kompas), whichis also part of the National Monitor on Homelessness (MMO). <strong>The</strong> state of affairs has beenevaluated until the end of 2009, which counts as a zero measurement (Planije et al.<strong>2010</strong>). Inter alia, the following bottlenecks have been identified already: addicted homelesspeople show severe problems and are difficult to place, regions for social relief maynot overlap smoothly with regions for the police or the addiction care, and changes infinancial flows may lead to actual cuts for a municipality. <strong>The</strong> zero measurement furthershows the following: 37 from the 39 municipalities have a picture of the number of homeless people intheir municipality; 33 from the 39 municipalities have an indication of the number of people in their municipalitywho are at risk to become homeless; 32 from the 39 municipalities have an indication of the number of homeless youth intheir municipality.<strong>The</strong> Strategy Plan for Social Relief was developed first in the city of Utrecht and was implementednext in the other cities. A special evaluation has been conducted for Utrechtfor the period from 2000 to <strong>2010</strong> (Reinking et al. <strong>2010</strong>) and for the situation in 2009(Wolf et al. <strong>2010</strong>).Between 2000 and <strong>2010</strong>, the Community Health Service Utrecht (GG&GD Utrecht)developed two temporary and eight permanent hostels for a total of 183 addicted homelesspeople (Reinking et al. <strong>2010</strong>). Research among inhabitants of the hostels in 2005117
and 2009 has found that hostels roll back social isolation, provide rest, day structure,and safety. Moreover, staying in a hostel decreases drug use, public nuisance, and criminalactivities. Police data show that, between 2002 and 2006, the drug-related publicnuisance in the centre of Utrecht decreased with 40 percent. However, success of a hostelrequires persistent communication with the local residents and the neighbourhood,prolonged negotiations with all stakeholders, tolerating drug use in the hostel, and leadershipof the municipality.During July and August 2009, interviews were held with a total of 109 addicted inhabitantsin six hostels in Utrecht (Wolf et al. <strong>2010</strong>). <strong>The</strong> majority was male (78%), themean age was 45 years, the age range running from 30 to 63 years. <strong>The</strong> educationallevel was low. On average during their lifetime, the hostel inhabitants had been homelessfor eight years. It was found that the inhabitants experienced their physical health inbetween neutral and reasonable, that they experienced their psychological health as reasonable,and that they experienced their quality of life as reasonable. A majority of theinhabitants (84%) almost daily uses hard drugs like methadone (67%), cocaine (51%),heroin (28%), and heroin on prescription (13%). However, notwithstanding the continueduse of drugs, it was found that, due to the hostel, a majority of the inhabitants hadexperienced an improvement in their housing situation (70%), daily activities (59%),household (54%), and safety (52%). Unfortunately, a paradoxical side-effect of comingto rest in a hostel is that it makes the inhabitants more aware of their unfavourable situation.Nonetheless, the authors all in all conclude that the hostels did succeed in stabilizingthe situation of the formerly homeless chronic drug addicts.118
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Margriet van Laar, Guus Cruts, Andr
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ColophonThis National Report was su
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PREFACEThe Report on the Drug Situa
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9.6 New developments 14110 Drug mar
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these groups are relatively scarce.
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oasted by means of programs to prev
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Part A: New developments and trends
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Regulation Opium Act Exemptions (mi
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Medicinal cannabisOn 6 October 2009
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The Public Administration Probity S
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local circumstances into account. T
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The police district of West and Cen
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treatment for drug addiction. "Labe
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2 Drug use in the population2.1 Dru
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Table 2.1.3Annual prevalence and nu
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Cannabis and age (of onset)Figure 2
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ment of regular cannabis use (4 or
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Table 2.3.1Prevalence (%) of substa
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the ecstasy (see also § 10.3), som
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Table 2.3.2Prevalence of substance
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3 PreventionIntroductionIn the Neth
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CVGU). this Centre will support loc
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friends list in Windows live Messen
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entiate for group characteristics l
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in the number of problem opiate use
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emaining 131 problem hard drug user
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The largest difference in the propo
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Logistic regression analysis showed
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5 Drug-related treatment: treatment
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National performance indicatorsAn i
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11.3.1 Implementation of guidelines
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Institute for Quality in Health Car
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For most guidelines, the rate of im
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The question has remained how to im
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Name of Assessors: André van Gagel
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WHO guidelines coherence: only to b
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Figure 12.1.1:Number of deaths amon
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were about 341 deaths among the pro
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Part C: Bibliography and annexes185
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13 Bibliography13.1 ReferencesAarts
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Burns, T., Fioritti, A., Holloway,
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De Jong I, Dijkstra M, Van der Poel
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Ganpat, S., Wits, E., Schoenmakers,
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Ivens, Y. and Wittenberg, S. (2008)
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Malmberg, M., Overbeek, G., Monshou
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RIEC (2009). Bestuurlijke aanpak va
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Smolders, M., Laurant, M., Van Duin
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T.K.24077-255. Tweede Kamer der Sta
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T.K.32159-5. Tweede Kamer der State
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Van den Berg C, et al. (2007). Majo
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Van Veldhuizen, J.R. (2007). FACT:
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13.2 Alphabetic list of relevant da
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LMR, Landelijke Medische Registrati
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13.3 List of relevant internet addr
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http://www.tactus.nl/http://www.ggz
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Table 9.1.1: Investigations into mo
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14.3 List of abbreviations used in
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PPCRIOBRIScRIVMROMSCPSHMSOVSRMSTISV
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226