Dragons and syringes

Heroin in the Netherlands 1970 – 2011

Mario Lap*

Heroin enters the scene (1970 – 1973)

Before 1970 non-medical opiate consumption in the Netherlands was mostly restricted to members of the medical profession using morphine and palphium (doctors, nurses, pharmacists)[1] and of the Chinese community, smoking opium in opium dens such as in Amsterdam’s Binnen Bantammerstraat. Some non-medical opiate use also existed in the former colony of the East Indies, now Indonesia, independent since 1948, where the Dutch maintained an Opium and Cocaine Monopoly mainly for exportation.[2]

There is remarkably little reliable literature on the early days of the heroin scene in the Netherlands[3] and sensational stories abound. An example of the latter type of story holds that American agents (CIA) introduced heroin into the Amsterdam scene in 1971 by giving it away for free for a while before asking for money for it.

We believe that heroin was introduced into the Dutch scene owing to a variety of factors[4]

1. members of the Amsterdam trend setting scene of artists and students, travelling to for example India and the far East coming back with opiate experiences and sometimes a habit
2. American Vietnam army deserters and veterans in Amsterdam, pushing, using and dealing heroin
3. Tourists and foreign friends introducing the substance
4. The availability of good quality heroin at a relatively low price via Chinese organised crime syndicates ie. the Triads and other channels, The Netherlands with its ports, Amsterdam, Rotterdam and international airport, providing for direct and frequent connections to the countries where opiates were produced. About 70% of the heroin in those days came from the Golden Triangle.[5]      

Heroin use in these early days was usually intravenous and those sniffing it were looked down on as sissies by the injectors. Heroin, initially only white, was after a year or two available in 2 forms, white heroin[6] and brown/beige heroin, the latter nicknamed brown sugar[7] In order to be able to inject this ‘brown sugar’, citric acid was added. In the early seventies heroin was rarely smoked. Possibly the first larger Amsterdam heroin using scene was a commune of mainly French, Dutch and American hippie style artists and musicians living in a large squatted former monastery on Keizersgracht in Amsterdam and a farm near Tours, France. Probably the best-known member of this group was the Velvet Underground singer Nico.

Before I go into societal and government reaction to the heroin phenomenon and aspects such as dependency and petty crime, we want to try and explain another process taking place at more or less the same time. As it would soon play an important part in what was by then seen as “the heroin problem” in the Netherlands.

Surinam, drained again (1970 -1975)

Surinam[8] (Dutch Guyana), a former Dutch colony obtained it’s independence in 1975, just before which a large proportion of the population (approx. 300.000) left the country to live in the Netherlands driven both by economical motives and fear of an uncertain future in Surinam. In 1984 a coup d’état by Surinam’s army, followed by the murder of  some journalists, union leaders and lawyers as well as a civil war, drove even more people from their home country. Surinam was lead by an army leader, Mr. Bouterse who is the elected president today, not only responsible for murder but also accused of large scale illegal international cocaine trafficking by the Netherlands and the USA.

A number of the new Surinamese immigrants in the Netherlands got involved in small scale drug dealing in the streets (called hussling) as well as the use of heroin[9] and soon the Surinamese group made up a significant part of the Dutch heroin using population. But almost none of these new Surinamese users got involved in injecting the substance. Instead they smoked or chased the drug, a way of administration of the substance that we will explain later in this article. 

It would take a lengthy anthropological discourse to fully explain this phenomenon but for this article we will stick to the following conclusion. Injecting as such, but certainly injecting drug use by means of self administration, forms a strong taboo in the creole Surinamese culture and the few users that did inject were rejected by the Surinamese scene ending up in the “white” heroin scene. In order to be (re)accepted in the Surinamese scene and even community they’d have to stop injecting and resort to smoking, sniffing or chasing heroin.

Government and society reactions

It is important to realize that drug use as such, including heroin use, was never made, and is therefore not, a crime in the Netherlands today.[10] But as it is obviously impossible to use heroin without possessing it, we will now try and explain the Dutch legal situation and policy regarding heroin use and especially the 1976 drug law change followed by a description of some relevant events and initiatives in Dutch society in the seventies.[11]

The possession of heroin for personal consumption as such can be punished with a maximum of 1 year imprisonment (Opiumwet Article 10.6). But by means of a prosecutional guideline a definition was created called “possession of a limited amount for personal consumption”, in casu: 0.5 gram of heroin. In cases of such possession police and justice authorities generally refrain from prosecution allowing for the conclusion that heroin use in the Netherlands is decriminalized. How and why does this work?

Bringing in an arrestee for the simple possession of let’s say one gram of heroin wouldn’t and won’t make the average policeman popular with his commander in chief or public opinion for what it is worth.  It won’t make a court case and therefore it results only in an arrestee released, needing more heroin and a gram of seized heroin. And often petty but annoying crimes committed in order to acquire money to score new heroin. But bringing in an arrestee with one gram of heroin after having observed him sell even small amounts is an entirely different case. Trafficking is usually prosecuted even when only a small amount is actually seized. [12]

The legal system at the basis of this practice, which is a key element of Dutch criminal law and drug policy, is called the expediency principle[13].    

In order to understand the environment in which events took place, the reader should realize that the sixties had brought a liberal climate to the Netherlands and especially Amsterdam, where tolerance of ‘deviant’ behavior started to become the norm. At the same time heroin was seen as a societal but mostly public health problem reaching it’s peak in the late seventies . This context allowed for progressive initiatives in for example outreach youth work but also in the drug field.

The most striking examples of such initiatives are the HUK (huiskamer = living room) and Princenhof (day and night) projects.  The Princenhof started in 1971 and the HUK started and led by Erik Fromberg in 1974, were both a combination of low threshold care and user meeting point. In today’s terms, they were the first User Room projects where (injecting and non-injecting) use was allowed and monitored by peers and staff including nurses. And often a phenomenon called the “house dealer” was allowed, providing for some control over the heroin consumed by the visitors. The HUK was followed by other similar initiatives such as in Rotterdam (Paulus Church, 1982)[14] but did not last itself whereas the Princenhof was first changed into a night care facility/shelter but still functions as the main Amsterdam user room, now one of the programs of Amsterdam’s Rainbow foundation which also runs the Red Light area’s needle exchange and a shelter.[15]

In the scope of this article we do not believe it necessary to describe the various methadone treatment and detoxification programs started in the Netherlands in the seventies on which a lot of literature is readily available.[16]

We will produce a specific article on the history and development of the Dutch user organizations such as the Junkiebond, LSD and MDHG, shortly. It will be based on the preserved documentation and grey literature as well as interviews. We would like to finish this chapter by mentioning the 2 important commissions (Hulsman Commission, private 1971)[17] and (Baan Commission, government 1972[18]) which have led to the 1976 Drug law change and the numerous symposia, letters, commissions and articles calling for a medical heroin program.

It actually took until 1996 for a Dutch heroin program to start, encouraged by the Swiss example and results. [19]  In this program both injectable and chaseable heroin is dispensed to clients. The average age of heroin consumers in the Netherlands is today 50+.[20]

Chasing the dragon  

Chasing the dragon (chinesing in Dutch) is a mode of heroin use or heroin use ritual which is best described as “inhaling the fumes of heroin vapor with a tube as heated liquid heroin flows along a piece of tin foil.” [21] [22]It is often described as smoking whereas it is in fact vaporization and not smoking. Today chasing the dragon is by far the prevailing method of using heroin in the Netherlands and injecting heroin has become the exception. How and why is this the case where elsewhere in Europe injection is still the main mode of heroin use? Firstly as before mentioned, the Surinamese users almost all chased and did not inject. They were introduced to this way of using by Chinese dealers/users. This is an example of the so-called primary diffusion of the chasing ritual[23].  Also heroin using members of another Dutch minority group the Moluccans or Ambonese, children of ex-Dutch colonial soldiers from the former colonies in the Moluccan islands in the Indonesian archipelago, like the Surinamese, mostly did not resort to heroin injection. They chased the dragon instead like their Surinamese fellow users. Gradually this method was transferred to other pockets of heroin users or heroin user scenes. We believe that this secondary diffusion of the chasing ritual was facilitated and made possible by the following factors:

1. Injecting users experiencing vein problems and seeking another way of administration

2. The relatively constant availability of good quality chaseable heroin

3. The relatively low price of good quality chaseable heroin

4. The interchange between the various Dutch heroin using groups and scenes

5. Fear of overdose and other injection related risks

Conclusion

We believe that this Dutch example demonstrates that less repression of heroin use most likely results in less risky modes of heroin use and that fiercer repression leads to riskier methods. At the same time less repression has not resulted in higher numbers of consumers. On the contrary, heroin consumption has mostly become an issue in geriatric care in the Dutch context.

Now, although we by no means support moral judgements over heroin self-administration by injection or injecting as such, for example calling it a form of auto- mutilation, we do believe chasing heroin to be a generally safer method of heroin use than injecting. We believe the Dutch epidemiological data[24] as well as the general condition of the average Dutch heroin user, support this argument but are obviously open to debate.

We may also conclude from this example that peer, fashion and culture driven processes are far stronger than any policy, legislation or prevention program. There is nothing any policy or prevention program has done initially to drive heroin users from the needle to chasing the dragon. We had no clue and a lot of Dutch luck. Which by no means implies we can do nothing. On the contrary, we believe that, proper, non-stigmatized information and low threshold care services combined with decriminalization of use are vital for a healthier drug policy reducing substance use related risks.

Promoting chasing as a harm reduction campaign in our view is potentially a useful strategy but strongly depends on the availability of chaseable heroin, relatively low prices and low repression. Furthermore changing drug administration rituals by means of drug service programs is a substantial challenge not to be underestimated.[25]

A design for a functional regulation of heroin is not in the scope of this article but we may conclude that also in the relation of heroin and criminal law, it is difficult to distinguish between remedy and disease. In our view, administrative/medicinal legislation/regulation is by nature better suited for public health issues such as substance use and the Dutch policy is but an example of damage control under self inflicted hazardous conditions. 

Finally as heroin is now generally seen as unfashionable, uncool and a even a loser’s drug in Dutch youth culture and we almost haven’t seen any new, young heroin users for many years now, what does this mean for the future? Very little or nothing. If heroin would suddenly become hip, fashionable and sexy again tomorrow, we believe there is not much that any policy can do about it.

Literature :

Epidemiology of Opiate Addiction in the USA, Ball & Chambers, 1966

https://abuse-drug.com/lib/Table/Epidemiology-of-Opiate-Addiction-in-United-States/

Opium and the people, Berridge & Edwards 1981

https://abuse-drug.com/lib/Table/Opium-and-the-People/

From Chasing the Dragon to Chinezen, Peter Blanken, JP Grund

https://abuse-drug.com/lib/Table/From-Chasing-the-Dragon-to-Chinezen/

Report Contact Center foundation (Verslag stichting Kontakt Sentra, Drs. E. Fromberg, 1976 (Dutch)

Drug use as a social ritual, JP Grund, 1993

https://abuse-drug.com/lib/Table/Drug-Use-as-a-Social-Ritual/

HIV risk behavior among injecting drug users, Christina Hartgers, 1997

https://abuse-drug.com/lib/Table/HIV-risk-behavior-among-injecting-drug-users/

Dancing on, The Switch, John Peter Kools 1995

Waiting for the Man, Harry Shapiro, 1999, Helter Skelter

Day and Night Center The Princenhof , Amsterdam (Tages‑ und Nachtzentrum "Het Princenhof" Am­sterdam), Franz Trautmann in: Krauß, G.M./Steffan, W., "... nichts mehr rein­drücken". Drogenarbeit die nicht bevormundet, Weinheim/Basel 1985, S. 73 ‑82. (German)

The Drugtakers, Jock Young 1971

https://abuse-drug.com/lib/Table/The-Drugtakers/

Drugs, Set and Setting, Norman Zinberg

https://abuse-drug.com/lib/Table/Drug-Set-and-Setting/