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’.
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 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.