No fewer than six randomised controlled trials – in Switzerland, the Netherlands, Germany, Spain, Canada, and England – concluded that heroin assisted treatment is more effective than conventional treatments in a subgroup of heroin users.
Building on a long history and culture of tolerance, the Dutch responded to illicit drugs with decades of pragmatic measures free of judgment. A central element of modern Dutch drug policy was a crucial decision to establish a legal and practical separation of cannabis—judged to pose "acceptable" risks to consumers and society—from hard drugs associated with unacceptable risk. This policy effectively decriminalized possession and use of cannabis and opened the door for tolerated outlets for small-scale cannabis sales that eventually took the form of the well-known Dutch "coffee shops."
There is no reliable evidence that tougher criminal sanctions deter drug use or offending. On the contrary, criminalisation worsens the health and wellbeing of drug users, increases risk behaviours, drives the spread of HIV, encourages other crime and discourages drug users from seeking treatment. A report by Australia21, Alternatives to Prohibition, subtitled Illicit drugs: how we can stop killing and criminalising young Australians, sets out the lessons learnt about the failed war on drugs from other countries, especially Sweden, Switzerland, the Netherlands and Portugal.
The prescription of substitution drugs, such as methadone and buprenorphine, has become a mainstream, first-line treatment for opioid dependence, with around 700 000 of Europe’s 1.3 million problem opioid users receiving substitution treatment today. But a small minority of entrenched opioid users repeatedly fails to respond to interventions of this kind. Findings from international trials now suggest that the supervised use of medicinal heroin can be an effective second-line treatment for this small, and previously unresponsive, group. In this latest EMCDDA Insights report, experts describe the development as ‘an important clinical step forward’.
Media reports of two deaths at the weekend in the same party venue have once again been accompanied by police suggestions that the drug responsible is ecstasy that may be from a "contaminated" batch. Speculation as to the cause of these tragic deaths is unhelpful, and recent experience with mephedrone has shown such preliminary comments are often quite wrong, we will know the truth only when toxicology results are reported.
Na een lange periode van pragmatisme en gedurfde vernieuwingen van het drugsbeleid, waarmee Nederland ook internationaal een pioniersrol innam, is er – zoals de Commissie Van de Donk constateerde – al jarenlang sprake van beleidsverwaarlozing. Die feitelijke stilstand dreigt met de huidige kabinetsplannen om te slaan naar achteruitgang. Er zijn een aantal goede redenen om daarover ernstig bezorgd te zijn, niet alleen ten behoeve van de verworvenheden hier in Nederland, maar ook bezien vanuit recente internationale ontwikkelingen.
Eberhard Schatz, Katrin Schiffer, John Peter Kools
15 January 2011
This paper, written in collaboration with the Correlation Network, briefly describes the history and the basic elements of the Dutch drug dependence treatment policy, including recent trends in drug use and the current drug treatment system implemented in the four largest cities in the Netherlands. Building on more than 30 years’ experience, the Dutch approach focuses on an integrated treatment system, which provides comprehensive support and services to the most vulnerable groups, including homeless people, problematic drug users and chronic psychiatric patients. At the same time, a strong emphasis is given to public order and crime reduction.
The academic journal Nueva Sociedad recently released an issue to promote the debate in Latin America on drug policy reform. TNI contributed with the paper "Drug policy reform in practice: Experiences with alternatives in Europe and the US".
The main purpose of this evaluation was to determine to what extent the principal goal of Dutch drug policy has been achieved, as stated in the 1995 Policy Document on Drugs (Drugsnota). This asserts the primacy of protecting public health, and thus gives priority to drugs prevention and to the management of the individual and social risks that arise from drug use.
The head of the UN Office on Drugs and Crime (UNODC), Antonio Costa, recently visited Amsterdam on 24 April. Accompanied by some officials of the Netherlands Ministry of Health and of the City of Amsterdam and UNODC staff, he dropped in on the coffeeshop De Dampkring (the Atmosphere) and a user room (for inhalation and injection of heroin and cocaine). He wrote his personal account for his blog Costa’s corner but it was never published. Apparently it proved to be too controversial with his Dutch host. It now has popped up on the Transform drug policy blog and the ENCOD website.