Drug Abuse

2 Developments and objectives

The committee examined the broader developments surrounding Dutch drugs policy, drawing partly on information in the studies mentioned above. At issue is not merely the demand for drugs (drug use, problems) but also the supply (production and trafficking), and the context in which they arise. This chapter first briefly outlines the latest situation in terms of supply and demand, and the associated problems. This is then used as a basis for the committee’s reflections on the future aims of policy and how they can best be achieved.

2.1 Developments in demand

A balanced view of drug use

Levels of consumption and damage to health are still lower for drugs than for alcohol and tobacco. Drug use seems to have stabilised on average in recent years. In pointing this out, the committee is by no means seeking to trivialise the problems associated with drug use. It does however believe it is important to see them in perspective, to help avoid the onset of ‘moral panic’ and prevent calls for unnecessarily drastic general measures in response to the concerns about drug use expressed by many citizens of Europe. Though many of those concerns are entirely justified, they appear to be prompted more by a concentration of intractable problems among vulnerable groups of mainly young people who use drugs, than by figures on average use.

 

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Eight out of ten European citizens regard drug abuse as a cause for concern. Among the Dutch public, the figure is seven out of ten. As such, this issue one of their chief areas of concern, alongside tackling organised crime and terrorism (Euroflash).

One in eight Dutch 15 to 16­year­olds said they had were currently using cannabis (i.e. had used it within the last month), and one in 16 use it frequently. The level of use among Dutch adolescents is higher than in Ireland, France, the UK, Belgium, Italy and Germany, but lower than in Scandinavia, Portugal, Austria and Greece (ESPAD 2008).

See the National Drug Monitor, which shows that, after a large increase in the preceding period, the proportion of 12 to 18­year­olds currently using cannabis (within the last month) fell from 14% to 10% between 1996 and 2003. The rate has since stabilised at this level. Recent figures from Amsterdam appear to confirm this trend (Nabben et al., 2008).

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In this country, recent use among the general population is lower than the European average for all drugs except ecstasy. Figures presented to the committee suggest there has in fact been a slight downward trend in drug use among schoolchildren since 1996. Nevertheless, use of cannabis among young Dutch people exceeds the average for Western countries, in terms both of the proportion of current users and of more frequent users of cannabis. It appears that cannabis use has become ‘normal’, at least among certain sections of the young population. In comparison with their European peers, a relatively large number of young Dutch people regard cannabis as easy to obtain, and perceive the associated risks as less severe.

However, the picture that emerges on the basis of average use statistics for certain age groups is less than reassuring. Drug use is associated with certain social groups. This is particularly the case with cocaine and ecstasy, which are used in pubs and clubs and, in combination with particular dress styles and musical preferences, form part of certain lifestyle trends. This is a dynamic process, in which hype and fashion play a big role. As we shall discuss later, the use of soft drugs among certain groups of young people has assumed problematically high levels, and is also associated with alcohol consumption.

Problems: mixed picture

Rates of illness and death from use of hard drugs are relatively low in the Netherlands compared with other EU member states. This applies both to deaths as a result of HIV infection from contaminated needles to deaths due to overdoses (though there are still around a hundred cases a year). More generally, problematic use of both hard and soft drugs is relatively low compared with other countries. For some time now, the problems associated with heroin consumption have been abating: the average age of addicts has risen, as fewer young people take up the drug, and the mortality rate remains fairly low. Both here and in other countries, the number of people seeking help for cannabis addiction has increased sharply over the past few years. The number of requests for help with cocaine addiction has also risen. There have also been recent indications of a rise in problematic use of GHB.

Problematic use of cannabis appears to be particularly prevalent among young people who are disadvantaged by their background and/or situation. These youngsters display a combination of characteristics: they use cannabis, play truant, are likely to have frequent contact with care services or spend time in youth detention centres, have no stable home situation, and may even live on the streets. Crime and dropping out of school appear to be strongly associated with problematic use of drugs and alcohol. As we have said, this picture does not reflect the average Dutch youngster, but it is more prevalent, at problematic levels, among groups of young people who are vulnerable in several respects. Cannabis use is part of street culture in large towns and cities with a higher than average proportion of ethnic minority youth. Drug use is linked to boredom, and often becomes problematic among young people who are vulnerable and already ‘overburdened’ by other factors.

This concentration of cannabis use – and indeed alcohol use – has implications for the education sector. Drug use is simply a part of daily life for pupils at some schools, albeit by no means all. This situation is particularly prevalent in large towns and cities. Pupils regularly attend class under the influence of drugs or alcohol, cannabis suppliers hang around near schools, and older pupils go to coffee shops during the day. Drug use has therefore assumed a significance that transcends individual consumption, affecting the ability of the school to impart knowledge to its pupils. Teachers trying to encourage pupils to go on to take vocational training sometimes have to compete with the apparently more lucrative option of drug dealing. It is sometimes very difficult for parents and carers to ensure that young people who get caught up in a negative spiral of problematic use and problematic performance at school receive the help they need in time.

2.2 Developments in supply

Scaling up, professionalisation and criminalisation in the drugs market

In line with the growing demand for drugs over the past forty years, the drugs trade has expanded, becoming more professional and commercial. Career criminals have discovered that drug dealing offers greater rewards, with less risk of arrest and long sentences, than traditional forms of crime. The market has professionalised partly as a result of the fact that measures to tackle illegal trafficking were slow to get off the ground, and were only stepped up at a much later stage. The commercialisation of the lucrative drugs market is a development that can also be seen in the soft drugs market, where ‘grow shops’ and coffee shops have managed to raise their public profile, despite the ban on advertising. Street dealing – which can cause a great deal of nuisance for local residents – has also taken on a bigger role. Drug tourism in the border areas and in large towns and cities (which is sometimes also associated with small­scale dealing) has risen sharply, fostering large­scale cannabis production and trafficking in this country. Such operations have also developed into major, innovative export enterprises.

Cannabis production has undergone major development, with the advent of modern technologies that allow high­quality crops to be produced on a large scale for both domestic consumption and export. Cannabis production is now no longer concentrated in this country but has also spread to other European countries, often under the control of criminal organisations that are as enterprising as they are criminal.

The Netherlands is a link in the international drugs trade, due both to its general role in transit (with important transport hubs like the Port of Rotterdam and Schiphol) and its good infrastructure, and to the presence of groups from countries where drugs originate, or through which they pass (North Africa, Turkey, the Caribbean). Both these factors facilitate and benefit the logistics and organisation of drugs trafficking. The relatively light sentences handed down for such crimes are also cited as an additional explanation for the Netherlands’ role in the production and trafficking of drugs, as is the high quality of the products (cannabis and ecstasy).

Trade patterns have changed as new information and communication technologies have become available. At the ‘retail’ end of the trade, physical points of sale (coffee shops and non­tolerated points of sale) have become less important, as hard drugs are ordered by mobile and delivered by couriers on scooters – just like pizza delivery services. The Internet is also playing an increasing role in the drugs market, including in the distribution of equipment for growing cannabis.

Organised crime

All these developments have resulted in a much greater role in the production and trafficking of both hard and soft drugs for organised crime. There is no separation of markets on the supply side. On the contrary: the two are becoming increasingly linked with serious crime. The same applies to delivery and support services, such as grow shops which supply seeds, expertise, lamps and other equipment for growing cannabis. There are indications that this is not a specialised crime. The organisations involved target anything from which (in this country) they can easily earn large amounts of money, from exporting cannabis to trafficking in women. The existence of organised criminal gangs means there is a great deal of violence (murder, physical abuse, intimidation of vulnerable neighbourhoods and groups, such as people who are dependent on debt counselling services or who work in sheltered employment), and poses major risks in terms of professional ethics (for notaries and lawyers, for example). The proceeds of crime are being successfully invested, enabling criminal organisations to accumulate power in certain parts of some towns and cities and in the formal economy (including the real estate sector).

Drug­-related crime

Since the 1980s there has been a rise in drug­related crime: addicts who steal from shops, cars and homes in order to buy hard drugs. This used to be associated largely with the highly addictive drug heroin, and for decades a few thousand marginalised heroin addicts were responsible for much of the drug­related crime in this country. This type of crime is now declining sharply, as the addicts have grown older, their numbers have fallen and a policy of detention and care targeted at these individuals has begun to enjoy some success (thanks to the measures to tackle repeat offenders, the introduction of injecting rooms and treatment with methadone and heroin). There is no other direct, substantive link between drug use and crime. Only specific forms of multiple drug use, combined with alcohol consumption, potentially make users more likely to display aggressive behaviour (e.g. violence in the night­time economy, which is also caused by the liberal supplies of alcohol on offer: for many police officers, patrolling town and city centres at night is anything but ‘happy hour’).

Nuisance

Besides the nuisance caused by drug­related crime, drug use and drug dealing can cause severe annoyance to the people living and working nearby. Street trading in drugs can also be a public nuisance, as can cannabis­growing operations in residential properties (odour nuisance, illegal tapping of electricity, couriers), large amounts of rubbish in and around the premises where drugs are bought and sold, and traffic nuisance caused by visitors to drug houses and coffee shops. Although this can cause a great deal of annoyance to local residents and businesses and should be tackled, in terms of the bigger picture this is only a minor issue that has in fact declined in recent years. Public nuisance is currently associated mainly with drug tourism in the southern border regions, where drug runners also operate. For example, one in eleven residents of South Limburg say they experience nuisance from drug users (Veiligheidsmonitor).

2.3 Goal and methods

Goal: to limit the damage to the individual and to society

As a result of the developments described above, drugs policy has come to overlap more and more with policy on crime, public order, young people and education. Whereas, in the 1970’s, it was virtually a matter of considering the health implications of individual drug use, the context of drug use has now changed to such an extent that the policy needs to be thoroughly re­examined. The committee believes that a more integrated and comprehensive strategy is now required. This was already implied in the 1995 policy document on drugs, and is needed now more than ever.

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The situation outlined by the Hulsman working party of 1971, which partly formed the basis of our drugs policy, was one in which [a] the use of cannabis was not known to lead to brain damage, [b] there was no organised drugs trafficking in the Netherlands, [c] criminal prosecution appeared to do more harm than good, and [d] drug use did not lead to social problems, but was more an expression of non­conformity in a society that was in itself unhealthy.
, report by the Central Office of Public Mental Health. Meppel: Boom, 1971.

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The committee believes that the goal of drugs policy over the next few years should be to prevent and reduce drug use, certainly in so far as it causes damage to health and to society, and to prevent and reduce the damage associated with the drugs trade. An integrated approach is certainly needed, to prevent one specific aspect (e.g. ‘nuisance’) from dominating decision­making, and overshadowing other aspects (e.g. ‘health’).

This definition of the goal of drugs policy is in line with the traditional objectives of the policy, which has always focused on harm. Where there is no actual or likely harm, there is no need to make the use of psychotropic substances the subject of drugs policy. In such cases, the personal freedom to decide whether or not to use such substances should take precedence. The committee does however believe that the actual or potential impact on society must be more explicitly taken into account, alongside the actual or potential impact on the individual.

Methods: balanced measures

There is no ‘magic bullet’, no simple solution for the problems associated with drugs. The longstanding ‘war on drugs’ has not been a great success (RAND Corporation, 2009). The same might be said of legalisation, which would not necessarily cause the personal and social problems to disappear as use became ‘normalised’ (consider, for example, the effects of alcohol), and a legalised supply of drugs would not necessarily mean the end of the illegal market. It might indeed make it more difficult to combat. But legalisation does have certain advantages.

A balanced drugs policy is a matter of moderation, and cannot be expected to produce major successes in a short space of time. Prevention, care, regulation and enforcement must be deployed in a well­considered mix. This country has undertaken certain commitments in signing the international agreements that provide the framework for our drugs policy. In recent years, actual practice in other countries has differed less from our policy than was previously the case. There has been a certain degree of convergence in Europe in terms of member states’ efforts to achieve a more balanced mix of prevention, care and criminal law measures in drugs policy, as the EMCDDA in Lisbon has observed. The same applies to countries like Australia and the US, where rates of cannabis consumption are high. In many states in the US, reforms have been introduced in drugs policy that have helped shift the emphasis to limiting the harm associated with drugs.

New substances: a watchful eye

People have an innate desire to use psychoactive substances, and therefore have a tendency to try new substances, or devise new uses for existing ones. One example of the latter trend is young people buying a cheap dose of GHB – a substance that until recently was used only as a recreational drug – and developing an addiction to it. Although this does not seem likely to quickly develop into a national phenomenon, at local level the trend is causing concern and needs urgent attention.
Prescription opiates are becoming more and more prevalent on the drugs market in North America. This trend could spread to this country, though it is not inevitable. A wider problem is prescription drugs leaking onto the illegal drugs market.

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Prescription drug abuse rises to ‘epidemic’ level (Los Angeles Times, 11 July 2005)
‘The explosion in the prescription of addictive opioids, depressants and stimulants has, for many children, made the medicine cabinet a greater temptation and threat than the illegal street drug dealer, as some parents have become unwilling and passive pushers, according to a report published by Columbia University based on information supplied by doctors, pharmacists and members of the public.’ According to the Washington Post (7 July 2005), teenagers arrange 'pharming parties' where they swop drugs spirited from home or purchased off the streets or Internet.

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A new class of substances is now emerging, known as ‘cognitive enhancement drugs’. They improve memory, and help users to think faster or to comprehend complex problems. Similar to doping in sport, this is potentially attractive to students and highly educated professionals who wish to maximise their concentration levels and stamina. Students and scientists at American universities, in particular, are already taking substances to improve mental performance, and certain ethicists and lawyers who support such practices have argued against a ban. The drugs in question were originally intended mainly for medical purposes, such as the treatment of ADHD. They can easily find their way into areas outside medicine, however. Cognitive enhancement drugs are a new development which present Dutch policymakers, too, with the challenge of devising an appropriate policy in good time: either to declare them illegal and thus introduce enforcement measures under the criminal law, or take an approach based on harm reduction without criminalisation (as with tobacco and alcohol). Experiences with this new approach could help with the adjustment of policy responses to substances listed in the schedules of the Opium Act, if necessary.

Traditionally, policymakers monitor developments in the field of drugs, though they tend to focus mainly on ‘traditional’ drugs. They must also, however, be alert to new trends, and to the groups and subcultures where new uses emerge. Any future­proof drugs policy must be capable of detecting problematic aspects of use in good time, and responding appropriately. See chapter 5.

Restraint in tackling possession of drugs

One of the principles of Dutch drugs policy is that the use of drugs is not in itself a criminal offence. Possession of drugs is, however, an offence, though possession of a small quantity that is clearly for personal use is not usually prosecuted (at the public prosecutor’s discretion). This principle was based largely on a desire not to criminalise drug users, which would give them a criminal record and damage their prospects. There was also concern that users would fail to seek help when they needed it for fear of being arrested.

The committee has opted to retain this principle, because it clearly helps reduce the harm to individuals and society caused by drugs. In its view, however, it does not mean that possession of drugs may never be prosecuted. It might well be appropriate to prosecute for possession in certain circumstances, in order to stop young people sliding further into trouble, with timely interventions whereby both criminal prosecution and care serve the same purpose. The threat of prosecution can also be used to set a care programme in motion (see also chapter 3).

Conclusions

The committee concludes that the general trend in drug use does not give any great cause for concern. There are however major problems in certain areas that do need addressing: the concentration and social implications of cannabis use among young people; developments on the coffee shop scene, largely due to the numbers of foreigners they attract  and to the links between some coffee shops and organised cannabis production in this country;
the growing involvement of organised crime in the production and trafficking of cannabis, and  links with the trade in hard drugs.

The committee also believes that the dynamics of drug use and trafficking is such that the  authorities must be more vigilant, to enable them to identify and respond to new trends in  good time. The committee expects both researchers/academics and government to become  more alert to such trends.

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