The MDHG (an abbreviation which originally stood for Medicosocial Service for Heroin Users) was formed 14 years ago by a group of people who were concerned with the results of the official drug policy. To this group belonged doctors, social workers, parents of heroin users, people living in the neighbourhood of the drug scene, those simply interested in the drug problem and, of course, users and ex-users.

This group viewed a repressive drug policy, as defined by criminal law, as a fundamentally inappropriate approach to the drug problem which, in fact, could be held responsible for the main part of that problem. So the group saw it as their task to formulate proposals for an alternative drug policy.

In the following years the MDHG, for a number of reasons, gradually developed from a think-tank into an organization which has attempted to represent the interests of heroin users. One of the main reasons for this change was that the MDHG could not continue to stand back and restrict itself to giving abstract advice on how to change drug policy. Gradually the MDHG was visited by a growing number of heroin users with, among other things, their complaints about police actions and dubious drugs and interventions. In this way, the MDHG became more and more involved in the actual daily problems of the heroin user. Consequently, the MDHG began to tackle actual problems, attempting, amongst other things, to focus the public’s attention on these problems while developing ideas and plans for more adequate strategies.

This development left the aim of the MDHG unaffected. As an interest group, the MDHG stands for the normalization of drug use which, among other things, encompasses decriminalization and adequate, accessible drug aid programmes. Within this, the MDHG remains an organization where users, ex-users and non-users work together.

The Dutch Drug Policy is generally characterized as liberal, pragmatic and rational. Normalization of the drug problem is seen as its main goal. ‘The Dutch Approach’ to this problem stands, on the one hand, for a less punitive Reaction in criminal law, than in most other countries and, on the other, for low-threshold aid programs. The relatively easy accessibility of methadone programmes and syringe exchange are frequently quoted as examples of the liberal quality of this approach. Within this, harm reduction is viewed as a desirable target if drug users do not want, or are unable, to cease their drug use. So, besides the supply of substitute drugs, field work, initial reception, material support and opportunities for social rehabilitation are considered important. (Ministry of Welfare, Health and Cultural Affairs, 1989)

In this respect this policy is considerably different from the drug policy in most other countries. The fact that Eddy Engelsman (the chief of the office for alcohol, drug and tobacco policy of the Dutch Ministry of Welfare, Health and Cultural Affairs) recently received the Bin Spear Award from the Drug Policy Foundation in Washington, USA, is an acknowledgement of this policy.

Therefore, at first sight, the conclusion could simply be that the Netherlands have accomplished quite a lot on the way to normalization. And indeed, in comparison with most other European countries, this judgment is undoubtedly correct.

However, if one goes beneath the surface of a generalizing comparison things become more complex.

Among other things, it should be made clear that the difference between Dutch Drug Policy and the approach of neighbouring countries is not as great as one might think (Atteveld, 1988). For instance, it is not so much the legal framework itself that marks this difference but the 'translation' of the legal provisions into practice.

An important feature of the Dutch prosecution policy is the expediency principle, "whereby the Public Prosecutions Department is empowered to refrain from instituting criminal proceedings if there are weighty public interests to be considered 'on grounds deriving from the general good'. Guidelines have therefore been established for detecting and prosecuting offences under the Opium Act.... The guidelines contain recommendations regarding the penalties to be imposed and set out the priorities to be observed in detecting and prosecuting offences." (Ministry of Welfare, Health and Cultural Affairs 1989, 2). This has resulted in a de facto legalization of cannabis products, with the exception of plantation or trafficking on a large scale.

The divergences in the law itself are, with one exception, confined to the maximum penalties. The exception is the explicit distinction between hemp products and 'drugs presenting unacceptable risks', for example heroin. This distinction has been part of the Dutch drug law since 1976, by which a less harsh criminal justice reaction to owning and trafficking of soft drugs than of hard drugs is sanctioned. The possession of up to 30 grams of cannabis is no longer seen as a crime, but as a misdemeanour.

How small this difference between the drug policy in the Netherlands and in other countries actually is, can be illustrated by the fact that in the Netherlands also, the prisons are inundated with offenders of the drug law and people sentenced for so-called drug-related crimes. An inquiry published in 1987 has shown that at least 36 per cent of Dutch prison inmates are sentenced in connection with their use of hard drugs. One part of this group are offenders of the drug law itself, the rest have committed one or other drug-related crime. (Erkelens, 1987). Furthermore, 60 percent of the growing need for prison capacity until 1990 must be explained by custodial sentences for breaches of the drug law. (van Vliet, 1946).

But, in our opinion, what has to be seen as alarming is the tendency towards the relative lead of the Netherlands in the field of liberal drug policy not being consolidated but, on the contrary, it is slowly but surely being reduced. If one takes a thorough look at the drug policy as it is put into practice in Amsterdam, one can see that the approach to the drug problem is defined more and more by measures based on 'constraint and pressure' (Trautmann, 1989; Engelsman, 1989). The main aim of these more repressive measures appears to be based on the maintenance of public order.

An important element in this move to a more repressive drug policy is the result of discussions in the Dutch Lower House on 'constraint and pressure in the field of drug aid' held 1987 and 1988 (Tweede Kamer 1988)2 Here, the recurring pleas for a less soft approach to drug users was translated in policy intentions, within which actual forced treatment of drug users is not included. After all, according to the politicians concerned, the existing legislation on enforced psychiatric treatment is providing solid ground on which enforced drug rehabilitation programmes, if considered necessary, can be based.

Lately, in Amsterdam a start has been made to put these intentions into practice. We will focus on four aspects of this development which illustrate the tendency to a more repressive approach to the drug problem: the 'streetjunkie project'; the 'binnenstadverbod' - which can be translated as 'city centre banning order'; the inconsistency between public order policy on the one hand and AIDS-prevention and syringe exchange on the other; and the decline of low threshold drug aid. The first two, especially, show how far the Municipality of Amsterdam is already prepared to go on the road to a repressive approach.

The 'project straatjunks' - a package of measures designed to push and force the group of so-called 'extremely problematic drug users' to kick the habit, (which is described by some policy makers as one of the most important action items within the current policy on hard drugs in Amsterdam) began in January 1989, initially for a period of two years (Gemeente Amsterdam, 1989). This project is aimed at 300 to 400 drug users who repeatedly cause public disturbance in the city centre.

What is new about this project is the approach to recidivists who repeatedly commit minor, punishable acts. Until this project started, these drug users would have normally been dismissed by the public prosecutor without immediate punishment (Gemeente Amsterdam, 1988, 7). To overcome this problem one is now trying 'to combine and define' these minor offences in such a way that detention on remand can be imposed regularly. After having committed a minor offence at least four times within one year, drug users who fall into this category- in the memorandum of the municipality they are called 'contaminators of the (judicial) circuit' - are given the choice between being imprisoned or undergoing a drug aid programme to get off drugs.

On condition that the drug user chooses the second option, the criminal prosecution is temporarily suspended. If, however, the user does not finish the imposed drug aid programme, he or she will still be sentenced to imprisonment. So, within this project the arm of the law is explicitly prevailing.

By this measure the municipality is trying to 'constrain and press' the drug user to undergo treatment. This is, of course, not forced treatment - but a forced choice between two options which do not represent real alternatives for most of the drug users.

For someone who is looking from the outside, who is comparing the current situation in the Netherlands with the situation in most of the other countries, this may not sound very serious. But for someone who has witnessed and taken part in the Dutch drug policy for years, things are different. One is then necessarily comparing the current situation with the past and, in this perspective, the streetjunkie project is one marker in the tendency towards a more repressive approach. We will return to this aspect later.

Another important part of the current drug policy in Amsterdam is the 'city centre banning order', by which drug users who repeatedly cause public disturbance may be refused entry to a substantial part of the city centre for a fortnight. By this measure, a considerable part of the old city of Amsterdam is defined as 'Distressed Area'. A drug user who is causing disturbance of public order, for example by hanging around with some others, by using heroin and so on, gets the following warning on a leaflet:

As the MDHG considered this measure contrary to the principles of legal order, it challenged the case before the Chief Administrative Judge of the Netherlands. The judge accepted the complaints lodged by the MDHG and ruled the drastic restriction of personal freedom of movement as being inconsistent with the law, especially because it is used as a sanction which can be imposed simply by a police officer in the name of the Mayor. The reaction of the municipality to this judgement was simply to re-introduce this measure with some slight changes so that it fits the precision demanded by the law. To the general public, this adjustment does not make much difference.

AIDS prevention and syringe exchange versus public order policy In Amsterdam particularly, AIDS prevention is of great importance, because here the AlDS-problem concerning drug users is the most serious in the Netherlands. Between 1982 and 1990, the total number of AIDS patients in Amsterdam has been 893, of whom 62 are intravenous drug users. The number of SHIV infected drug users in Amsterdam is estimated at over 800. That is about 30 per cent of the group of intravenous drug users who for their part constitute also about 30 per cent of the total number of drug users in Amsterdam (Buning, 1990).

On the basis of these figures, a considerable increase in the number of AIDS patients among drug users must be expected in the coming years. Thus, AIDS prevention among drug users deserves high priority. However, this part of drug policy is, in Amsterdam, subordinated to the public order aspect too.

One example of this is the difficulty in getting an adequate plan for syringe exchange realized. As the drug aid institutions in Amsterdam had initially been opposed to syringe exchange (they saw the supply of clean syringes as encouraging intravenous drug use), in 1984 the MDHG started to exchange syringes. In the following years the different drug aid institutions gradually changed their view and also began to exchange syringes. The number of dispensed syringes went up from 25,000 in 1985 to 820,000 in 1989.

Early in 1989, in the face of a growing number of HIV infected drug users, the Amsterdam city council declared itself in favour of a daily 24 hours syringe exchange. Nevertheless, since then, in practice the opportunities for drug users to exchange syringes have not expanded - but contracted. In May 1990, the only place in Amsterdam where syringes could be exchanged up till midnight (situated in the old city centre where most of the drug users traditionally congregate) had to close at five p.m. because the City Council gave in to pressure from local inhabitants who complained about public nuisance by drug users. There is now a small bus used for the syringe exchange which makes its daily rounds along certain stops, but not in the actual drug scene.

In the beginning, this service operated till midnight; but in the autumn of 1990 the opening hours were reduced to 9.00 pm. The underlying reason for this decision was again complaints by local residents about nuisance. However, in December 1990 the opening hour changed again. At the moment, this service is available till 11.00 pm.

The tendency towards a less liberal approach is not only apparent in more repressive measures by the police and the law, within which ‘solutions’ are, to an increasing extent, measures to reduce public disturbance. In the field of drug aid measures too this tendency has left its mark.

Of course, in Amsterdam there is still a wide variety of drug aid measures, from relatively low to high threshold programmes, which result in quite easy accessability to help. Within the range of drug aid measures one can find: medical services, such as different methadone programmes, one small-scale morphine programme, syringe exchange, etc. social services, as general psychosocial help, centres for homeless drug users, social rehabilitation programmes etc. and therapeutic help for those who want to quit using drugs.

Officially, ‘low-threshold’ is still a keyword in the Amsterdam drug aid approach, because the municipality recognizes that the object of an active AIDS prevention policy can only be achieved by reaching as many drug users as possible. But another fact is that the drug aid projects based on an ‘accepting’ approach are gradually disappearing.

This tendency became apparent at the beginning of the 1980s, when the two most explicit exponents of this approach in Amsterdam (which had been set up in the 1970s as part of a general development of alternative aid services) disappeared. Within these projects, drug users were accepted as they were, i.e. accepting their commitment to long-term drug use (Herwit-Lempp, e.a., 1991) Within this ‘accepting’ view, cessation of drug use is not seen as the sole aim of drug aid, but as only one prospect which is a possible result of social stabilization or rehabilitation, rather than a condition for it. These projects have since been closed because their approach had, according to the view of the policy makers, proved to be a failure. The Municipality of Amsterdam now view an approach based mainly on care, without an aid programme based on a well defined structure and certain requirements to the client, as inadequate.

The existing drug aid institutions in Amsterdam are generally bound to strict rules and registration, as can be shown by the development of the methadone programmes in Amsterdam. According to the original proposals of the MDHG, for a low-threshold methadone programme the drug users should get methadone or other substitute substances in the district where they live, preferably through his or her own general practitioner, without too much bureaucracy.

The reality now is regular urine analysis, daily visits (in the future maybe with the exception of the weekend), immediate on-site ingestion of the methadone, exclusion for a fortnight of drug users who take their methadone with them (for instance to inject it), thorough registration and some distance from where the client lives. All these aspects contribute to a situation where not much is left of a low-threshold approach. All these measures mean that low-threshold drug aid is gradually subordinated to the issue of getting the drug problem manageable (Mol/Trautmann, 1990). The programmes of the Municipal Health Service, which is responsible for the main part of the methadone supply and the Jellinek Centre, are, therefore, far less liberal than one would believe after reading the articles about the Amsterdam drug policy in this journal (Cohen,1989; Matthews, 1989)). Both institutions, for instance, as well as the street-cornerwork, render assistance to the street junkie project we have described above.

The basis of the current Amsterdam drug policy was established several years ago, as can be shown by the plans of the municipality of Amsterdam for an ‘integrated drug policy’ of 1983 and 1984 (College van B en W van Amsterdam 1983a/1984). The background to these plans had been the conclusion that drug policy until then had, in fact, been a failure.

To change this, a more integrated policy was thought to be necessary. The aim was, on the one hand, to suppress what is called ‘drug-related’ crime more successfully with new criminal measures and, on the other hand, to create conditions for a more decent existence of drug users. With regard to the latter, the municipality pleaded then for - among other things dispensing heroin to a group of 300 drug users, who were seen as most problematic in the context of a thoroughly controlled experiment (College van B en W van Amsterdam, 1983b/Trautmann, 1985).

If we compare the present situation with the past, the decline of the liberal approach becomes even more apparent when one considers that the plan to dispense heroin was designed for the same group of drug users as the streetjunkie project today. Both plans have been intended for the group of so-called ‘extremely problematic drug users’ (EPDs) who are unable to control their drug use and who regularly cause nuisance for a third party (Gemeente Amsterdam, 1988/College van B en W van Amsterdam, 1983b). So the aim of a more decent existence for drug users which, along with maintaining public order was an important aspect of drug policy in Amsterdam, seems gradually to be going beyond the scope of the policy makers.

One of the factors to this development of a less liberal policy is the social attitude towards drug users. The complaints about public nuisance by drug users put forward by local residents (particularly of the old city) have increased. The demand for tougher action against drug users by these residents has added weight to these moves.

As politicians are not indifferent to this pressure they are quick to find an approach to these problems which they think will bring about quick results. In Amsterdam the line of least resistance has been chosen - by giving in to the demand for more repressive actions. In Amsterdam, the Dutch Social Democratic Party (the PvdA) has gradually developed into advocating a more repressive approach. One of the reasons for this choice was the disastrous result of the party in the municipal elections at the beginning of 1990. The PvdA- having continuously been the largest party in the Amsterdam city council since the war - tumbled down from 21 to 12 seats. The reconsideration following this defeat has resulted in a reversal of policy, towards a populistic approach along the lines of ‘give the people what they want’.

Quality of life in the city is the new buzzword of the social democrats who, among other things, point to the ‘extremely problematic drug users’ as "important in the origin of feelings of insecurity". A tougher way to deal with this group was announced as, according to the PvdA, the liberal approach has not succeeded. "The course of legalized prescription (of heroin) we have tried to take, but it does not seem adequate for a quick result with regard to public nuisance. This solution has remained theory because of national and international impediments. Therefore, a tougher line with regard to junkies who commit penal offences has now to be extended. (PvdA Gemeenteraadsfractie, 1990, 10).

This tendency towards a pragmatically repressive approach is not a theme which is exclusively applied to drug policy. The prevailing ‘no nonsense’ mentality of the national government has led to a situation where the approach to different social problems is based, on the one hand, on a strict cost-benefit analysis and, on the other hand, on a primary interest to get (for the sake of public order) these problems under control. So, for instance, strict registration and the use of sanctions are seen as an adequate means to control a social problem not only for drug users, but also for the unemployed. ‘

Finally, one should not forget the consequences of European unification which undoubtedly influences the developments of Dutch drug policy. After all, the Netherlands are, with regard to their liberal drug policy, an exception. The Schengen agreement, within which the Benelux countries, France and Germany have already attuned their judicial policy, proves that the liberal qualities of Dutch drug policy are at risk.

It is only in an appendix that the freedom of the participating countries to develop their own policy is acknowledged.

The question, however, is whether this harder approach is consistent with the aim of normalization. After all, the actual drug policy appears to be contradictory. The repressive approach is in fact creating just the problems which should have been solved by, on the one hand, criminal law itself and, on the other hand, drug aid measures (Trautmann, 1985).

Criminalisation has proved to create rather than solve, the problems of not only drug users themselves but third parties as well. There is no simple causal link between drug laws and drug-related crime but there is no doubt that a reasonable part ,of this criminality is due to this law (Swierstra, 1990, 45-70,155-177).

Furthermore, the fact that drug users have to lead a risky ‘back street’ life is affecting the quality of their life to such a degree that total degradation can be the result. The adulteration of heroin - on account of the illegal market situation - plays a major role, as does the psychosocial effect of constantly being hunted and pushed around. One cannot overlook the fact that the necessity of drug aid measures, to a great extent, has to be explained as the consequence of criminalisation. A lot of drug aid work is an attempt to solve the problems which are caused by criminalisation.

The aim of drug aid measures (which according to the Municipality of Amsterdam is to create conditions for a more decent existence of users) can thus, in principle, not be brought into line with criminalisation. Criminal prosecution is standing in the way of a more decent existence for drug users.

In view of these contradictions, the plea for an improved integration of the two tracks of drug policy - criminal prosecution and drug aid measures - is quite curious. It is intriguing to see that in the Amsterdam proposal of 1983 for a regulated heroin prescription, one can find the basic recognition that the actual drug policy is, in fact, contradictory by combining repressive measures sanctioned by criminal law and aid measures as therapies, consultation medical assistance, etc. One of the arguments of the municipality for the heroin prescription experiment is the reference to the negative consequences of the criminalisation of heroin. (College van Burgemeester en Wethouders 1983b, pp. 14).

Nevertheless, one passes over these inconsistencies while looking for possible solutions to the intensification of the public order policy. Thus, a paradoxical solution is presented in a way Watzlawick has described as ‘more of the same’, i.e. a solution which, in fact, is itself the core of the problem.

The examples of the Amsterdam drug policy shown above are illustrations of these inconsistencies and their consequences. The ‘binnenstadverbod’, for instance, has serious consequences for drug users. Within the forbidden area exists a considerable part of the low threshold drug aid projects and the only syringe exchange facility open till five pm. If one is the subject of the banning order, one can’t reach these aid facilities. If one nevertheless enters the distressed area, one is at risk of imprisonment.

From the viewpoint of easy accessibility of drug aid programmes and adequate AIDS prevention, such a measure is incomprehensible. The fixation on the public order problem is interfering with the availability of clean syringes and other drug aid services. It is acknowledged that the tendency toward a more repressive approach is, in this respect, inconsistent with AIDS prevention in general. (Buning 1989). The difficulties involved in getting a 24 hours syringe exchange realized illustrate this inconsistency as the complaints about public nuisance outweigh the necessity of this health measure.

The street junkie project can serve as an illustration of the growing entanglement of the two tracks of the drug policy. The demand for a more responsive drug policy results in an entanglement within which the main focus is now more explicit on the side of criminal law. Consequently, aid is, to an increasing extent, lent within the framework of a policy which is primarily aimed at the maintenance of public order (Gemeente Amsterdam, 1988,5).

The consequences of these inconsistencies of drug policy today are generally disregarded. For instance, the fact that the entanglement of the criminal and the drug aid approach affects the basis for trust within the relationship between social worker and client and, by that the fundamentals of effective aid. A social worker operating within the framework of the street junkie project is functioning as a continuation of the law so he or she is, in the view of many drug users, compromised (Slats, 1990). This aspect particularly goes for the street-corner work which, in Amsterdam, is rendering full assistance to the street junkie project. After all, street-corner work is the low threshold aid approach par excellence. Considering its outreach method of working, trying to make contacts with drug users on the street, its success depends on the trust of the clients, more so than in other forms of aid.

In addition to this, there is enough reason to doubt whether drug aid measures based on ‘constraint and pressure’ provide a reasonable solution. The results of forced aid programmes are generally not very promising, as different publications about this matter have shown. (Fromberg, 1988).

The arguments for constraint and pressure as they are put forward today in Amsterdam are, not surprisingly, poor. This is illustrated by a memorandum of the Jellinek Centre on ‘involuntary treatment and treatment substituting imprisonment’, which is one of the foundations of the streetjunkie project. Jellinekcentrum, 1987). In this memorandum, a plan is outlined for a drug aid approach based on ‘constraint and pressure’ aimed at the group of ‘extremely problematic drug users’ who regularly cause nuisance and cannot be brought under control with the available measures of drug policy.

Even though the poor results of forced treatment and the fact that treatment results improve in proportion to the degree of voluntariness, the final conclusion is that the ‘dimension and nature of the problem legitimates the development of some new initiatives’ Jellinekcentrum, 1987, 5/22). From this we can see that ‘some new initiatives’, involuntary or forced treatment are meant. No further arguments are brought forward. The writers simply assume that a bit less voluntariness can do no harm. But it can de doubted if the difference between forced treatment or forced choice for treatment is a relevant one from the viewpoint of a drug user.

The fact that normalization is a main goal of Dutch drug policy does not mean that this policy naturally is in the interests of drug users. Judging by what is sometimes written about the positive aspects of the Dutch approach, it might seem that normalization is synonymous with ‘in the interests of drug users’. But both concepts can have different meanings.

To- answer the question "what measures are in the interests of drug users?", it should be a matter of course that drug users themselves have to be asked. For some people this may sound odd, because drug users are often seen as junkies who cannot make their own choices. But they are human beings like us all and so, at least, they have to be consulted about the measures that affect them. But, even in the relatively liberal social climate of the Netherlands, this is not so. It has to be stated that here, too, as in the field of mental health care, politicians and experts have the final say. The usual procedure is that decisions are made without consulting drug users and such decisions are presented as being taken for heir own good.

To define what the interests of drug users are, cannot easily be given in positive terms, but it seems indisputable that a repressive approach is contrary to their interests. The structurally marginal social position of drug users is - according to our interpretation of normalization - a clear indication that the normalization of drug se and drug users is still some way off.

If one chooses the interests of drug users as a point of reference, the picture of the actual situation is less rosy than that which is painted by policy makers . For drug users, the question of whether Dutch drug policy is based on normalization is not merely an academic one. After all, normalization is closely interrelated with the interests of drug users.

The question, however, is what do policy makers mean by normalization.

Reduction of an escalating problem or moving away from specific measures and treating the drug problem as a normal  problem - both can have different motives and both can be reached by different means. For example, the motives can be human considerations and the aim a decent existence for drug users. If we consider the Amsterdam approach as normalization, the primary interest seems to lie in ‘getting rid’ of inconvenient problems and ‘getting back to normal’.

This interpretation is not inconsistent with the outlines given by the interdepartmental steering committee on alcohol and drug policy. (Interdepartementale Stuurgroep Alcohol en Drugbeleid 1985). According to this committee, the main aim of the Dutch approach is to diminish ‘drugrelated’ problems, and a pragmatic strategy is one important aspect in that policy of normalization. From this point of view, normalization in the sense of limiting specific measures also means opening general aid and social facilities for drug users as well as using penal law as a remedy for all forms of crime - and thus for a drug-related crime, too.

However, it is still doubtful whether the latter can rightly be called ‘normalization’, especially when we consider the inconsistencies of drug policy, as mentioned above. After all, the criminal approach has to be held responsible for a considerable part of the drug problem.

Finally, it is questionable whether the choice of a more repressive approach is an adequate remedy for the public order problems caused by drug users. After all, it is in the interest of the residents of the distressed areas that the Municipality of Amsterdam chooses less liberal means. It is obvious that drug policy has to serve their interests, too, but it is questionable whether the interests of these local inhabitants are, by definition, contrary to the interests of drug users. Public nuisance in a specific district may, of course, diminish by an intensification of public order measures, but it is an empirical fact that the problem does not disappear but moves to another district and gradually spreads over different parts of e city. According to us, normalization in e sense of offering drug users the chance ) lead a normal life would have better prospects. It would serve their interests as well as the interests of local inhabitants.

In reality, Dutch drug policy (as practised in Amsterdam) reveals a move to more repression in which the aim of normalization plays a minor role. The basis If the actual policy is, in itself, inconsistent. ‘the practice based on this policy, wherein constraint and pressure’ and strict registration are central features, does not lead to a reduction of the drug problem. On he contrary, it would appear to exacerbate and further complicate the situation.

The basis of Dutch drug policy is, indeed, pragmatism. On pragmatic grounds, years ago the choice was made for drug aid projects based on the idea of acceptance as a workable approach. On the same grounds, the plan for dispensing heroin was later developed. And, finally, pragmatic reasons underlie the current pleas for ‘constraint and pressure’. Consequently, it is due to these pragmatic reasons that drug policy in the Netherlands does not get beyond the level of ad hoc measures, and that policy makers stay on the ‘two track’ policy as mentioned above, without realizing its inconsistencies.

This pragmatism has resulted in a rather short-sighted policy, within which one diligently searches for quick results in a struggle with a problem which, because of its consequences for public order, is seen as convenient. In this way, drug aid measures are rendered successful only if they help to get these consequences under control.

What can be observed today are the dialectics of progress in action. The Dutch drug policy is in a phase of restoration and establishment. There is no room- neither concerning the prevailing view of the problem nor concerning the financial means - for new ‘accepting’ drug aid projects. Consequently, Dutch drug policy is reduced to pragmatism which does not shun repressive measures.

As an interest group for drug users, the main aim of the MDHG can be described as normalisation and decriminalisation.

According to the MDHG, this is the only rational option for a more adequate and human drug and AIDS policy. A repressive drug policy is contrary to the interests of drug users and the general public. Normalisation and decriminalisation are means to diminish the problem created by criminalisation. A policy based on these guidelines will not, of course, solve the drug problem, but it will contribute to reducing this problem to the mere fact that there are  people who are using drugs. While it is obvious that drug use can originate problems, one should realize that drug use does not only include the use of an illegal drug as heroin, but also the use of alcohol, pharmaceutical drugs and so on.

To get closer to the aim of normalisation, measures have to be taken against the actual policy of criminalisation as well as for adequate and accessible drug aid programmes. Because of the difficulty with influencing the legal and political framework, within the work of the MDHG there is a certain distinction between long-term and short-term aims.

The most ithportant long term aim is, of course, decriminalisation itself. As an example of what can be done in this field one can take the conference the MDHG organised in May 1990 in Amsterdam. It was a debate between scientists, politicians, police officers, etc., on what can be done to realize decriminalisation. As a continuation of this we have made contact with different politicians, representatives of universities, the law and the police to discuss plans and strategies for decriminalisation. One subject in this discussion is, among other things, the prescription of heroin.

The work within the framework of short term aims for an interest group of drug users is, in general, more urgent. Some of our activities in this field have already been mentioned above - for instance, the fact that we started with the syringe exchange and that we have challenged the fourteen days banning order with the Chief Administrative Judge of the Netherlands.

Because the daily problems of drug users are various, the MDHG employs short term activities in various fields. Among other things, we have often instigated campaigns against repressive police actions and against inadequate or intolerable actions of drug aid projects. We have also developed several plans in the field of accepting drug aid policy.

Because it is of the utmost importance to reduce the risks involved in heroin use, the MDHG provides information about a safer way of handling heroin use, for the user, as well as for his social environment. In this context we have done a lot to get a 24 hour syringe exchange realized. Because our attempts to convince the municipality that a syringe exchange open 24 hours everyday has to be realized as soon as possible had no effect, we have written a letter to the Minister of State at the Ministry of Welfare, Health and Cultural Affairs to ask for help with this matter. On these grounds questions have been asked in parliament. Recently, the Municipality of Amsterdam finally announced that a syringe exchange machine will be installed soon. The MDHG sees that as only the first step to an adequate service.

The MDHG has tried by different means to do something about more adequate AIDS prevention and a better aid program for HIV affected drug users. In 1989, we presented a plan for a street-corner work project specially focused on AIDS prevention for drug users who have no contact with the existing drug aid project. This plan was supported by the NCAB (the Dutch Committee on AIDS Control) but the municipality did not agree with an autonomous project. However, autonomy was, according to the MDHG, a necessary condition for the success of such a project, because a reasonable number of drug users mistrust the existing drug aid projects, especially the municipal health service, which is responsible for the main part of the methadone supply and, thus, for the registration of drug users. Because the municipality wanted to incorporate our project within this health service we refused to co-operate.

Furthermore, the MDHG has published a book with the title ‘Positief verder’, which can best be translated as ‘Going on Positively’, wherein the experiences of HIV infected drug users are described and tips and information are cited This is meant as help for HIV affected drug users, as well as for helpers, family and friends.

In our various contacts with different drug aid institutions and the municipality, we emphasize the necessity of using all the contacts drug aid projects have with drug users to give information - in an active and stimulating way - about safer use and safer sex, to motivate people to use condoms and clean syringes and to distribute condoms and syringes. According to the MDHG, a lot of chances to do something about these things remain unused.

Atteveld J.M.A. van, 1988, Het Nederlandse drugsbeled in verhelijking met andere Westeuroese landen: liberaal? Tildschrift voor alcohol, drugs en and re psychotrqoe doffen, Vol 14, No. 1, 3-11.

Buning, E.C., 1989, Aids onder druggebruikers in Europa. Amderdam Drugs Tijdschrift, Vol ¢, No 3-4, 17-19.

Buning, E.C. 1990, AIDS related intervention among drug users in the Netherlands. The Internatlonal Journal on Drug Pollcy, Vol 1, No 5,1990,10-13.

Cohen, J. 1989 Drugs and AIDS Prevention and Education: Work with young people in the Netherlands. The Internatlonal Journal on Drug Pollcy, Vol1 No3.

College van B en W van Ams,terdam, 1 983a, Nota hard-drugs, een aanz t tot een geintegreerd beleid. Amsterdam .

College van B en W van Amsterdam 1 983a, Nota Inzake, de gereguleerde verstrekking van hard-drugs. Amsterdam.

College van B en W van Amsterdam, 1984, Nota hard-drugs, een aanzet tot een gelntegr erd beleld. Amsterdam.

Engelsman, E.L., 1989, Het Nederlandse drugsbeleid in West Europees perspectiet. In: Groenhuijsen, M.S. Kalmthout, A.M. van, (Ed), Nederlands drugsbelbeld In Wedeurooees oersoectlef. Gouda Quint by, Amhem, 137-143.

Erkelens, L.H., 1987, Ontwikkelingen in het Nederlands penitentiair drugsbeleid. Tijdschrift voor alcohol, drugs sn andere psychotrope stoffen, Vol 13, No 4, 1–7-114.

Fromberg. E. 1988, Tussen Hippocrates en

Hemmandad. De rol van dwang bil behandeling van verslaafden. KGOD, Bussum.

Gemeente Amsterdam (Municipality of A), 1988, Project Straatjunks. Amsterdam.

Gemeente Amsterdam, 1989, Notietie

‘Acthprogramma hardrugsbeleld -989’. Amsterdam.

Henwig-Lempp, J., Schuller, K., Stover, H., Trautman, E, 1991, Entkriminalisierte Zonen: Frei-Raume fur Drogenkonsumenten. Br nnpunk Soziahr Fragen No1 .

Interdepartementale Stuurgroep Alcohol en Dnugbeleid, 1985, Drugbeleid in deweging. Ministry of Welfare, Health and Cultural Affairs, Rijswijk.

Jellinekcentrum, 1987, Nota "Onvrijwillige Behnadeling en strafvervangende behandeling drugsverslasfden" Standpuntbepallng n beleldsvoornemens Jelilnekeentrum. Jellinekcentrum.

Matthews, A. 1989 Care and Cure: A visit to the

Jellinek Centre, Amsterdam. The Int rn tlonal Journal on Drug Pollcy, Vol 1 No. 3.

Ministry of Welfare, Health and Cultural Affairs, 1989, Fact Sheet (19-N1989). Rijswijk.

Mol, R., Trautman, F, 1990, De Amsterdamse methadonverstrekking - in het belang van de gebruiker. In: de jaren negentig. WGU, Utrecht, 201-205.

PvdA Gemeenteraadsfractie, (1990), Werkplan 1990-1991. Amsterdam.

Slats, J., 1990 STraatjunk. Een jaar lang ‘gedwongen’ kiezen tussen cel of kliniek - hoe succesvil is dit dure proefproject ? Vrij Neder…lnd, 24 Februari, 11.

Swierstra, K., 1990, Drugscarrieres: van crimineel tot convenioneel. Onderzoekscentrum voor Criminologie en Jeugdoriminologie, Groningen.

Trautman, F., 1985, Heroineverstrekking: een lichtpunt in een tegenstridig iverheidbeleid. Psychologle & Maatschapplj, Vol 9, No 2, 230-244.

Trautmann, F, 1989, The MDHG and the Amsterdam approach of the heroin problem - how liberal is the Dutch drug policy today ? in: Common study programme on Crlminal Judice & Critical Crlminology, selected papers 21987 -1989. Erasmus Universiteit, Rotterdam, 34-51.

Tweede Kamet (Dutch Lower House), 1988, Dwang en dtang in de hulpverlening aan verslaafden. Tweede Kamer 20415.

Vliet, H.J. van, 1986, Hedendaagse drugbestrijding; kosten en nsco’s. Delikt en Dellnkwent, Vol 16, No 5, 476-486.