The Netherlands Drug Situation 2010 - Trimbos-instituut

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CVGU). this Centre will support local policy makers to attack problems in the nightlife(www.hetccv.nl; www.veiligengezonduitgaan.nl). The Centre will collect scientific informationabout measures that help to prevent alcohol- and drug-related incidents in thenightlife. Information about such measures can also be found at the website www.hntinfo.eu,the official website of the Healthy Nightlife Toolbox (HNT). The HNT "is an internationalinitiative that focuses on the reduction of harm from alcohol and drug useamong young people" (Voorham 2010). Funded by the European Union, the initiative wastaken by the Netherlands (Trimbos Institute), the United Kingdom (Centre for PublicHealth, Liverpool John Moores University), Hungary (National Institute for Drug Prevention),Belgium (VAD), and Spain (IREFREA). The website of the HNT offers an overview ofevaluated interventions in nightlife; a searchable database of reviewed academic literatureon healthy nightlife interventions; a handbook with guidelines, tips and advice tohelp develop alcohol and drug prevention in nightlife settings; and news with updates onnew publications and events on nightlife health. The website also offers a forum for professionalsto discuss issues related to prevention in nightlife.A quick scan showed that the local policies for alcohol and drugs are in most casesseparated from policies for public safety (public violence). However, substance use (especiallyalcohol and cocaine use) and safety (or violence) are closely related. Most frequentlyit concerns destructive behaviours, vandalism and physical threat (CCV2009a;CCV 2009b). The quick scan further showed that these behaviours are present inmost municipalities, and that there is an urgent need for information about effective approaches.Given this urgent need, the Ministry of Health, Welfare, and Sport and the Ministryof the Interior and Kingdom Relations asked the Dutch Centre for Crime Prevention& Safety (Centrum voor Criminaliteitspreventie en Veiligheid) and the Trimbos Instituteto initiate a Point of Support against Recreational Violence (Steunpunt Uitgaansgeweld).This point of support will set up expertise on the combined subjects of safety and healthin and around recreational settings. It will target a quick and efficient exchange of knowledgeand experience between professionals and municipalities.3.2 Selective prevention and indicated preventionThe former 2009 National Report of the Netherlands described several programs for selectiveand indicated drug prevention (Van Laar et al. 2010). Some examples of theseprograms are the "Coping Power Project", which is a Family Motivational Intervention,and the "Cannabis Show" (EDDRA_2010_NL_02). Some of these programs were experimentaland have not been implemented yet at a national level, although they showedpromising outcomes. The Cannabis Show is a byproduct (derivate) of the Cannabis IntelligenceAmsterdam (CIA), an intervention type that is actively involving participants in allparts of the intervention. CIA was developed by Jellinek Prevention in 2002. Six interventions(Cannabis Shows) have been carried out on nine locations of a specific school foryoung people with behavior and other disorders in the city of Amsterdam. Of the 485students from 9 school locations in Amsterdam that participated in the Cannabis Show,134 were both pretested and post tested: 65 in the intervention group and 69 in the controlgroup (Van der Spek et al. 2009;Van der Spek et al. 2010).Other 'new' interventions are the MOTI-4 and ACCU. The Moti-4 is an indicated preventiveintervention for young people between 14 and 24 years with (developing) problematicsubstance use or problematic gambling or gaming behaviour. The interventionconsists of four face-to-face conversations which aim to increase the self awareness ofthe adolescent and insight in the possible consequences of the problematic behaviour, in47
order to reduce substance use or problem behaviour and/or to motivate them to seektreatment (http://www.loketgezondleven.nl/i-database/interventies/m/13471/).In 2010 the Trimbos institute started a pilot to study the effectiveness of the'Adolescent Cannabis Check-Up' in reducing cannabis use in young people of 14-21 yearswho use cannabis weekly or have symptoms of a cannabis use disorder. This brief interventionconsists of a screening by telephone and two structured sessions and has beenshown to be effective in an Australian population of young cannabis users (Martin & Copeland,2004).Recently, a report has been published about substance use and sexual behavior amongadolescents having a low educational level (Schrijvers et al. 2010b). It is concluded thateffective preventive interventions for this target group are rare and that existing interventionsare poorly tuned to factors that relate to healthy behavior. The authors giveseveral recommendations: include the family and the social environment in, start thepreventive activities at an early age, spread the preventive activities over several settingslike the school, the neighborhood and at home, and support these activities by lawenforcement. As an example of support by law enforcement, the authors recommend tomonitor the illegal selling of alcohol to minors.The Drugs Information and Monitoring System (DIMS)Initiated in 1992, the Drugs Information and Monitoring System (DIMS) monitors thecontents of drugs delivered by users (see former National Reports). The information revealedby DIMS is disseminated to several organisations and networks to support theiractivities to prevent risky situations. Information is given to, for example, the CoordinationCentre for the Assessment and Monitoring of New drugs (CAM), the Drugs InformationLine (DIL), the European Early Warning System, and the EMCDDA.As described in § 10.3, in 2009 ecstasy samples were on average less pure than informer years, which might be related to a temporary reduction in the availability of itsprecursor PMK. A quick scan by DIMS showed that, nonetheless, most ecstasy usersdid not switch to the use of other drugs.The DIMS did not give insight yet into drug-related emergencies or incidents amongdrug users. To monitor these incidents, the DIMS has now been supplemented by theMonitor drug-related emergencies (Monitor drugsincidenten). The first results about thedrug-related emergencies during 2009 have been published (Vogels 2010). The monitorreceives its information from health-care organisations like hospitals, ambulance services,police medical-services, and first-aid services, in different regions of the country. Theemergencies can be reported by professionals at the special websitehttps://www.drugsincidenten.nl (see also § 6.2). Regularly, the participants receivefeedback from the monitor.The Drugs Information LineThe Drugs Information Line (Drugs Informatie Lijn, DIL) offers objective informationabout drugs to the general public by answering questions asked by phone or by e-mail.Compared to 2008, there was an increase in the number of contacts in 2009. There werea total of 4,031 contacts for drugs, 2,964 by phone, 981 by e-mail, and 86 otherwise(Van der Gouwe et al. 2010). The number of contacts about GHB has almost doubled.In 2009, the DIL also started the chat box Bzz at the websitehttp://www.chatmetbzz.nl/. Bzz targets young people from 13 to 16 years who are inneed of reliable information about sexual health, alcohol and drugs, and who want toremain anonymous. Some 55,000 youngsters have now added this chat box to their48
Page 1 and 2: Margriet van Laar, Guus Cruts, Andr
Page 3 and 4: ColophonThis National Report was su
Page 6: PREFACEThe Report on the Drug Situa
Page 9 and 10: 9.6 New developments 14110 Drug mar
Page 11 and 12: these groups are relatively scarce.
Page 13 and 14: oasted by means of programs to prev
Page 16: Part A: New developments and trends
Page 19 and 20: Regulation Opium Act Exemptions (mi
Page 21 and 22: Medicinal cannabisOn 6 October 2009
Page 23 and 24: The Public Administration Probity S
Page 25 and 26: local circumstances into account. T
Page 27 and 28: The police district of West and Cen
Page 29 and 30: treatment for drug addiction. "Labe
Page 32 and 33: 2 Drug use in the population2.1 Dru
Page 34 and 35: Table 2.1.3Annual prevalence and nu
Page 36 and 37: Cannabis and age (of onset)Figure 2
Page 38 and 39: ment of regular cannabis use (4 or
Page 40 and 41: Table 2.3.1Prevalence (%) of substa
Page 42 and 43: the ecstasy (see also § 10.3), som
Page 44 and 45: Table 2.3.2Prevalence of substance
Page 46 and 47: 3 PreventionIntroductionIn the Neth
Page 50 and 51: friends list in Windows live Messen
Page 52: entiate for group characteristics l
Page 55 and 56: in the number of problem opiate use
Page 57 and 58: emaining 131 problem hard drug user
Page 59 and 60: The largest difference in the propo
Page 61 and 62: Logistic regression analysis showed
Page 64 and 65: 5 Drug-related treatment: treatment
Page 66 and 67: National performance indicatorsAn i
Page 68 and 69: From May 2010 FACT will be offered
Page 70 and 71: using cannabis, it is developed by
Page 72 and 73: clients received treatment in Amste
Page 74 and 75: Figure 5.3.1: Distribution of new c
Page 76 and 77: Figure 5.3.3: Gender distribution b
Page 78: Table 5.3.1: Clinical admissions to
Page 81 and 82: In 2009, 692 new HIV diagnoses were
Page 83 and 84: Other risk behaviour included tatto
Page 85 and 86: Of the 168 new AIDS diagnoses in 20
Page 87 and 88: The Municipal Health Service (GGD)
Page 89 and 90: addiction care centre (hepatitis B
Page 91 and 92: o Chronic carriership was found in
Page 93 and 94: (4%), and hallucinogenic mushrooms
Page 95 and 96: Table 6.2.2: Information requests r
Page 97 and 98: 6.3 Drug-related deaths and mortali
Page 99:
Figure 6.3.2: Trends in age distrib
Page 103 and 104:
Figure 7.2.1 Number of syringes exc
Page 105 and 106:
The expert group also discussed the
Page 107 and 108:
Iriszorg is further experimenting w
Page 109 and 110:
In line with the national policy th
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"The proportions of non-Western eth
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drugs. However, there is a narrow b
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Table 8.2.1: Programs for social re
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Evaluation researchFor the city of
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and 2009 has found that hostels rol
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against money laundering and other
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Table 9.1.1: Investigations into mo
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amounts, which are considered as me
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Opium Act offenders in prisons (fig
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cases is increasing. The proportion
Page 131 and 132:
property crimes is decreasing, wher
Page 133 and 134:
country. They offer a combination o
Page 135 and 136:
mated 250 to 1,150 detainees in the
Page 137 and 138:
Table 9.3.3: Types of assistance of
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Figure 9.3.1: Number of persons per
Page 141 and 142:
It is important that detainees are
Page 143 and 144:
The coming Law on Compulsory Mental
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Over half (53%) of the coffee shops
Page 147 and 148:
Research on organised crime shows t
Page 149 and 150:
Table 10.2.1: Number of dismantleme
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Table 10.3.2: Content of tablets so
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caine samples solely contained anot
Page 155 and 156:
nabidiol (CBD) - in contributing to
Page 157 and 158:
156
Page 159 and 160:
11 History, methods and implementat
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diction care was published in 1997
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example, there may be a climate in
Page 165 and 166:
tion transfer between physicians an
Page 167 and 168:
methadone treatment, and guidelines
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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
Page 188 and 189:
13 Bibliography13.1 ReferencesAarts
Page 190 and 191:
Burns, T., Fioritti, A., Holloway,
Page 192 and 193:
De Jong I, Dijkstra M, Van der Poel
Page 194 and 195:
Ganpat, S., Wits, E., Schoenmakers,
Page 196 and 197:
Ivens, Y. and Wittenberg, S. (2008)
Page 198 and 199:
Malmberg, M., Overbeek, G., Monshou
Page 200 and 201:
RIEC (2009). Bestuurlijke aanpak va
Page 202 and 203:
Smolders, M., Laurant, M., Van Duin
Page 204 and 205:
T.K.24077-255. Tweede Kamer der Sta
Page 206 and 207:
T.K.32159-5. Tweede Kamer der State
Page 208 and 209:
Van den Berg C, et al. (2007). Majo
Page 210 and 211:
Van Veldhuizen, J.R. (2007). FACT:
Page 212 and 213:
13.2 Alphabetic list of relevant da
Page 214 and 215:
LMR, Landelijke Medische Registrati
Page 216 and 217:
13.3 List of relevant internet addr
Page 218:
http://www.tactus.nl/http://www.ggz
Page 221 and 222:
Table 9.1.1: Investigations into mo
Page 223 and 224:
14.3 List of abbreviations used in
Page 225 and 226:
PPCRIOBRIScRIVMROMSCPSHMSOVSRMSTISV
Page 227 and 228:
226
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