International - The Netherlands

The Netherlands - Data

(2007) "ESPAD surveys, among students aged 15–16, have been carried out regularly for many years. The results concerning illegal drug use show an increasing trend for cannabis use since 1988, which stabilised between 1996 and 2003. In 2007, the lifetime prevalence rate of cannabis use was 28 % which is a similar result as in 2003. The percentage of students using other drugs such as ecstasy, amphetamines, cocaine or heroin is much lower. Inhalants were the most popular, with lifetime prevalence reported at 6 %, followed by ecstasy (4 %), cocaine and LSD (3 %), amphetamines (2 %) and heroin (1 %). Results indicated 25 % for the last year prevalence of cannabis use (23 % in 2003), 15 % for the last month prevalence of cannabis (13 % in 2003)."

(2007) "In 2007, a total of 8 718 clients entered treatment, out of which 6 078 were first time treatment clients. Data suggest that 37.2 % of all clients entering treatment reported cannabis as their primary drug, followed by 31.8 % for cocaine and 19.7 % for opioids. Among clients entering treatment for the first time, a slightly different distribution was identified with 44.9 % requesting treatment for cannabis followed by 29.1 % for cocaine and 11.8 % for opioids."

(2007) "The HIV prevalence rate in 2007 among injecting drug users (IDUs) is estimated at between 0.8 % and 5 %. Injecting drug users were defined as those who injected once or more in their lifetime and who have used hard drugs on at least one day per week in the past six months.

The infection rate among IDUs for the HBV antigen was reported at around 30.6 % in 2007."

(2007) "In 2007, 99 drug-related deaths were registered (112 in 2006, 122 in 2005). Looking at the distribution by age and sex, the majority of cases were male (79.3%) and the mean age was 39.5 years.

The total number of drug-related deaths increased from 1996 to 2001. This rise may be partly due to the switchover of ICD-9 to ICD-10 in 1996, and to the increasing number of cocaine intoxications."

(2007) "In 2007, a total of 12 715 clients were in opioid subtitution treatment of whom an estimated 12 000 were on methadone maintenance treatment."

(2005 - cannabis in The Netherlands) "The sale of cannabis is illegal, yet coffee shops are tolerated in their sale of cannabis, if they adhere to certain criteria: no advertising, no sale of hard drugs, not selling to persons under the age of 18, not causing public nuisance and not selling more than 5 grams per transaction (AHOJ-G criteria). Three extra criteria are: no alcohol vendor, no more than 500 grams in stock and -- in some cities -- a minimum distance to a school or to the Dutch border. In recent years, government policy has aimed to reduce the number of coffee shops. However, the decision whether or not to tolerate a coffee shop lies with the local governments. At the end of 2005, the Netherlands had 729 officially tolerated cannabis outlets (coffee shops). This is a 1.0 percent overall decrease compared to the situation in 2004 (737 coffee shops, see paragraph 10.1). In 2005, the majority of the 467 municipalities in the Netherlands pursued a zero policy (72%) or a maximum policy (22%) with regard to the number of tolerated coffee shops."

(1997, 2001, & 2005 - drug usage in The Netherlands) Prevalence of drug use in the Dutch population 15-64 years of age:

(2005) "The number of problem opiate/crack users seems to have remained relatively stable in the past ten years (3.1 per 1000 people aged 15-64 years). In the past decade, local field studies among traditional groups of problem opiate users have shown a strong in-crease in the co-use of crack cocaine, a reduction in injecting drug use, and an increase in psychiatric and somatic comorbidity."

(2005 - The Netherlands) "In 2005, the prevalence of last year cannabis use was about 2.5 times higher among men than women (7.8% as against 3.1%). This male-female ratio was marginally smaller in previous years (almost 2). Apparently the gender gap is not narrowing."

(2003 - The Netherlands) "In 2003, the Opium Act was amended to legalise the medical use of cannabis. Since September 2003, prescribed medical cannabis is available at pharmacies for patients with indicated disorders."

(2001 - The Netherlands) "The number of opiate addicts in the Netherlands — between 26,000 and 30,000 — is stable, and low compared to other EU countries (2.6 per 1,000 inhabitants in the Netherlands; 4.3 per 1,000 inhabitants in France; and 6.7 per 1,000 inhabitants in the United Kingdom)."

(2001 - The Netherlands) "Prevalence rates for cannabis use were roughly twice as high among men than women (in 2001: LTP 21.3% vs. 12.8%; LMP 4.3% vs. 1.8%). This also applied to the percentage of users who ever tried hard drugs1 (LTP: 6.2% vs. 3.7%). However, there was no gender difference for the percentage of current users of hard drugs (LMP: 0.8%). Increases in use between 1997 and 2001 were evident both among men and women. Yet, the change in last month prevalence of ecstasy use was largely due to women (0.1% in 1997 and 0.5% in 2001)." (Note: LTP = Life Time Prevalence; LMP = Last Month Prevalence)

(2000 - cannabis in The Netherlands) "Cannabis use among Dutch schoolchildren aged 10-18 years has fallen for the first time in 16 years, a national survey of risk behaviour among 10,000 young people has shown.

"The school survey, carried out by Trimbos, the Netherlands Institute for Mental Health and Addiction (www.trimbos.nl), showed that about one in five young people had used cannabis at some time in their lives but less than a tenth had used it in the previous four weeks (“current users”)."

(1999 - cannabis in The Netherlands) "Cannabis is by far the most popular illicit drug in the Netherlands. The total number of cannabis users in the Netherlands is estimated at some 320,000. The estimated number of cannabis dependent persons may vary between 30,000 and 80,000. Until 1996 cannabis use showed a steep increase among pupils. However, between 1996 and 1999 prevalence rates stabilised. Prevalence rates of hard drugs, such as cocaine, amphetamines, ecstasy and opiates are much lower. Use of these drugs also stabilised among pupils. Changes in policies, availability, attitude or lifestyle have been put forward to explain these trends but the precise factors remain to be determined. Drug use is higher certain subpopulations [sic], including visitors to house-parties, discotheques and cafes (particularly ecstasy), young people with multiple psychosocial problems and (juvenile) delinquents in judicial institutions. There are indications that cocaine sniffing is increasing among 'outgoing' youth in Amsterdam. The number of opiate addicts is estimated at between 25,000 and 29,000. Most of these users also consume other substances. Cocaine is becoming the main drug in smal networks of (young) marginalised drug users."

(1999 - The Netherlands) "The use of illegal drugs is still low among this age group. Cannabis scores highest, but the use of hard drugs and synthetic drugs is almost non-existent in this age group and deaths and overdoses are rare. Cannabis use increased steeply from 1988 to 1996, but lifetime and last month prevalence stabilised afterwards (until 1999) at 19% and 15%. Boys are more frequent users than girls. The first experimental drugs for young people are predominantly tobacco and alcohol. This pattern remained stable over the last five years or even tended to decrease. Young alcohol users also use cannabis and tobacco more frequently."

(1998 - injectible drug use in The Netherlands) "Injecting behaviour among drug users in the Netherlands has decreased in the past decades.

"From 1986 to 1998 the prevalence of injecting among drug users recruited in the Amsterdam cohort on HIV and AIDS declined from 66% to 36% (Van Ameijden & Coutinho, in press). This is largely due to increased injection cessation rates and reduced relapse into injection.

"According to a recent cross-sectional study among young problem drug users in Amsterdam (mean age 25 years), 39% had ever injected drugs and 22% was a current injector (Welp et al., 2002). Compared to a sample of young drug users from the Amsterdam cohort study recruited between 1985 and 1989, a history of injecting had declined from 83% (1985-1989) to 56% (1998).

"According to LADIS (2000) 13% of the opiate users in treatment was an injector."

The Netherlands - Law and Policy

(policy - The Netherlands) "The national drug policy in the Netherlands has four major objectives:

"• To prevent drug use and to treat and rehabilitate drug users.

"• To reduce harm to users.

"• To diminish public nuisance by drug users (the disturbance of public order and safety in the neighbourhood).

"• To combat the production and trafficking of drugs.

"The primary aim of Dutch drug policy is focused on health protection and health risk reduction."

(policy) "Public health is the starting point of drug policy in the Netherlands. Its primary aim is to protect the health of individual users and their environments by reducing the harms associated with drug use. Experimental drug use, although discouraged, is not necessarily considered a problem. Perhaps Dutch drug policy is best known for its tolerant approach to cannabis use. The Dutch “coffeeshops,” or cannabis cafes, which sell hashish and marijuana in small quantities for personal use, have become something of an international symbol for the nation’s policy. It is not solely with respect to cannabis, though, that Dutch policy is tolerant. Users of hard drugs, such as heroin and cocaine, are also treated with relative lenience by the police. Even street dealing is tolerated to some extent, provided it does not lead to public nuisance"

"... new guidelines prescribe higher enforcement priority and harsher penalties for the production and trafficking in hard drugs, with an additional focus on synthetic drugs (ecstasy, amphetamine, LSD), which the Netherlands has gradually become major producers of."

(policy - cannabis in The Netherlands) "The government increasingly seeks the international debate. In December 2001, an international conference on municipal cannabis policies was organised by the Dutch Minister of Justice. This Cities Conference in Utrecht was attended by 120 participants from 50 European cities from 20 countries. It was concluded that in many of these cities a de facto policy of decriminalisation of the possession of small amounts of cannabis has taken place. Thus, the gap between official policy and practice is widening (Ministerie van Volksgezondheid, Welzijn en Sport, 2002a, p.17-18)."

(policy - cannabis in The Netherlands) "In the Netherlands, cannabis use is not legalised, only tolerated by the authorities. According to the Opium Act, possession of marijuana for personal use is a crime. However, the law distinguishes between drugs, to ensure a separation of markets; substances are classified as 'hemp' (cannabis products) and 'drugs of unacceptable risk' (other drugs). Toleration of hemp has led to a number of 'coffee shops' coming into existence over the years. Under guidelines issued by the Public Prosecution Service in 1996, these will not be prosecuted for selling cannabis under certain conditions (no minors, no more than 5g, no nuisance, no advertising, no hard drugs). However, under Dutch law possession of drugs remains prohibited and punishable, particularly when above the tolerated quantities. The maximum sentence for the possession or sale of no more than 30 grams of hemp is 1 month in prison (and/or a fine), but a prison sentence of 4 years (and/or a fine) applies to imports and exports or professional cultivation. the maximum sentence for hard drugs is 1 year in prison (and/or a fine) for the possession of 'user quantities,' while it is 12 years in prison (and/or a fine) for imports or exports. These maximum sentences can be raised by one third if the offence has been committed more than once."

(law) "In the Netherlands, the criminal law, prosecution and police action are governed by the expediency principle, and the legal approach to drug use is enshrined in the Board of Procurators General Directives. Contrary to popular opinion, possession of all drugs is punishable under the ‘Opium Law’ (⁵⁴). Article 11(5) of the Law, interpreted by the 1996 Board of Procurators General Directive, provides that no penalties shall be applied where the quantities of hashish or marijuana in a person’s possession do not exceed 5 grams. Indeed, sale, possession (and use) of cannabis in coffee shops will not be liable to prosecution if the coffee shop satisfies certain conditions, known as the ‘AHOJ-G criteria’: A) prohibited drugs may not be advertised; H) ‘hard’ drugs may not be sold; O) the coffee shop must not cause a ‘public nuisance’; J) drugs may not be sold to minors (under 18 years of age), who must also not be allowed into the shop; and G) maximum sale of 5 grams per person per transaction (⁵⁵). Currently, the Government is discussing the adoption of a Plan to discourage cannabis use in Netherlands (⁵⁶)."

(law) "Dutch drug legislation is based upon the principle of the separation of the markets for cannabis and other illegal drugs. Thus, illicit substances, according to the Opium Act, are divided into two lists: substances presenting unacceptable risks (list I) and other substances (list II) such as cannabis, also known under the non-legal terms of ‘hard’ and ‘soft’ drugs. Penalties for offences involving list II substances are lower than those for list I.

"In the Netherlands, the possession of small amounts of drugs for personal use is tolerated in certain cases. However there are situations where the use of drugs is prohibited (i.e. use in schools). The possession of small quantities of drugs for personal use (less than 0.5 grams of hard drugs (list I) and less than five grams for cannabis (list II)) will generally not lead to prosecution, unless it causes public nuisance. Possession of drugs for commercial purposes will be prosecuted and penalties may range from one month imprisonment and/or a fine, to eight years and/or a fine, depending on the quantity and the type of drug. The maximum penalty may be even higher if the crime has been committed more than once. The sale of cannabis in ‘coffeeshops’, while technically illegal, is tolerated under strict conditions.

"Within the framework of the Opium Act, importing and exporting of any classified drug is considered a serious offence and can be punished by a penalty ranging from four years of imprisonment and/or a fine to up to 16 years of imprisonment depending on whether a ‘hard drug’ or a ’soft drug’ was involved. In 2001, a special law was introduced which aims to deliver treatment in prison-like institutions to drug users who are ‘prolific’ offenders. In 2004, a new similar act for all prolific offenders came into effect."

"Dutch drug policy gives priority to a public health approach. In some cases, this resulted in a certain degree of tolerance and non-prosecution, instead of strict law enforcement. We give some examples:

"• The Drugs Information and Monitoring System (DIMS): this service co-ordinates pill testing at special test locations (not at parties) to determine health risks, to get insight in available new drugs and in trends in substance use (see also 10). Participants of DIMS will not be prosecuted (Staatscourant 2000, nr.250).

"• Safe Injection Rooms/User Rooms: in some municipalities hard drug users can use drugs in protected rooms, specially created for them by the local authority (see also 10). Drug dealing in or around user rooms is forbidden (Staatscourant 2000, nr.250).

"• Coffee-shop policy: Coffee shops are alcohol free outlets resembling bars, pubs or cafés, where adults - eighteen years or older - may individually purchase cannabis up to five grams (Staatscourant 2000, nr.250). Yet, suppressing large-scale commercial production of cannabis is a high law enforcement priority."

"Coffeeshops are tolerated with a view to protecting public health. The purpose here is to create a distinction between the markets for soft and hard drugs so that people who wish to use cannabis do not gradually slip into contact with hard drugs. The regulations governing coffeeshops are very rigorous. No alcohol or hard drugs may be sold or consumed there, and they are not allowed to advertise. Cannabis may only be sold to people who are aged 18 or over."

"The coffeeshops must adhere to what are known as the AHOJ-G criteria: no advertising, no sale of hard drugs, no public nuisance, no entry to young people under 18 years of age, and no sale of large quantities (more than five grams per transaction). The maximum level of stock for selling is set at 500 grams, although local authorities are entitled to impose lower limits."

(policy - cannabis in The Netherlands) "There is no evidence that the depenalization component of the 1976 policy, per se, increased levels of cannabis use. On the other hand, the later growth in commercial access to cannabis, after de facto legalization, was accompanied by steep increases in use, even among youth. In interpreting that association, three points deserve emphasis. First, the association may not be causal; we have already seen that recent increases occurred in the United States and Oslo despite very different policies. Second, throughout most of the first two decades of the 1976 policy, Dutch use levels have remained at or below those in the United States. And third, it remains to be seen whether prevalence levels will drop again in response to the reduction to a 5-g limit, and to recent government efforts to close down coffee shops and more aggressively enforce the regulations."

"Prevailing laws [The Netherlands]

"The most important provisions regarding drugs are laid down in the Opium Act. Since 1976, the Act has made a distinction between hard drugs (drugs with an unacceptable risk to public health, including heroin, cocaine, LSD and ecstasy) and drugs that entail a less significant risk (hash and marijuana). Fresh magic mushrooms were added, along with dry magic mushrooms, to the provisions of the Opium Act, List II, on 1 December 2008. As a result, the sale of fresh magic mushrooms is now prohibited.

"Possessing, dealing in, selling and producing drugs are criminal offences. Use is not.

"• Offences are punished more severely if hard drugs (drugs with unacceptable risks) are a factor.

"• The possession of drugs for the purpose of dealing is also more severely penalized that possession for one’s own personal use (see level of punishment).

"• The police and the judiciary give priority to tackling the large-scale drug trade and the production of drugs, which means that small-scale dealers and users are not systematically pursued (see the principle of expediency).

"• The sale of small quantities of soft drugs in coffeeshops is an offence, but in practice prosecutions are only generally made if the coffeeshop in question does not adhere to what are known as the AHOJ-G criteria (see AHOJ-G criteria).

"• The aim of allowing controlled sales outlets for cannabis is to separate the markets so that cannabis users do not come into contact with hard drugs and a criminal subculture when making their purchase."

(policy) "In all major Dutch cities syringe exchange services are available anonymously."