Trimbos-instituut - Netherlands Institute of Mental Health and Addiction. - http://www.trimbos.nl/

Drug use in the Netherlands is not exceptional

Utrecht, 17 September 2001.
Compared with other countries, the level of drug use in the Netherlands is not exceptional. The trend of increasing numbers of consumers of cannabis, cocaine, and ecstasy among young people is levelling off, or may have been reversed. There are signs that cocaine may become a problem in certain population groups in the Netherlands. On no one of the generally accepted measures of drug use, the Netherlands heads other countries in the European Union.
In 2001 the concentration of the major active ingredient of cannabis - THC - in Dutch marihuana was slightly higher than in 2000, while the reverse is true for Dutch hashish. The number of coffee shops has decreased substantially in the past few years.
The number of heavy consumers of alcohol is on the rise since 1990 and is high among young people, especially men between 18 and 24 years.

These trends have been signalled in the Annual Report 2001 of the National Drug Monitor (NDM), which was presented to the Dutch Parliament on September 18, the day of the Queen’s speech. The Annual Report 2001 was written on the authority of the Ministry of Health and describes trends in the use of drugs, alcohol and tobacco in the Netherlands. An international comparison is part of the report. The main findings are summarised below.

Cannabis
Experience with cannabis is less common in the European Union (EU) than it is in Australia and the USA. Ever (lifetime) use of cannabis in the USA (35% of the population excluding children and the aged) is higher than in England & Wales (25%), which top the list of the EU member states on this measure. The Australian figure is even higher (39%). The lifetime prevalence for the Netherlands is 19% (a middle position in the EU ranking order).
Among secondary school students in the Netherlands, the level of cannabis use went up between 1988 and 1996 as in all western countries, but then stabilised with a trend downwards, i.e. a lower prevalence rate. Lifetime prevalence of cannabis use among secondary school students 15 and 16 years of age is higher in the USA (41% have ever used this drug) than in the EU. Of the EU member states, the UK (35%), France (35%) and Ireland (32%) have the highest rates in this respect. The Netherlands is number four (28%).
Since the early 1990s, the demand for outpatient drug treatment owing to cannabis problems has risen in the Netherlands. Since 1997 this trend has levelled off. In 2000, some 3400 ‘treatment seekers’ were recorded for whom cannabis was the main problem drug. This is about 8% of all drug clients, a similar percentage as in 1999.
The average content of THC in Dutch marihuana was slightly higher in early 2001 than one year before (11 and 9 percent, respectively). In contrast, the average THC content of Dutch hashish was lower compared with the previous year (16 and 21 percent, respectively).
From 1997, the number of coffee shops in the Netherlands has decreased with 32%. Of all Dutch municipalities 81% has no coffee shop.

Cocaine
The lifetime prevalence rate of cocaine in the Dutch population excluding children and the aged is 2,4%, which means position 3 in the EU after Spain (3,3%) and England & Wales (3,0%). This can be compared with the USA (12,0%) and Australia (4,3%).
Lifetime prevalence rates of cocaine among 15 and 16 years old school students in the EU member states vary between 1% and 3%. In the UK and the Netherlands it is 3%, in the USA 8%.
Cocaine has gained in popularity among certain groups of users, especially problematic hard drug users with a preference for ‘crack’, the ready-made to-smoke form of cocaine. This drug is consumed by eighty to ninety per cent of the opiate addicts, and for some of them crack is the main preferred substance of use. Interest in cocaine, for sniffing, seems also to be growing among young people involved in club culture in Amsterdam.
The demand on outpatient drug treatment services due to cocaine problems has increased in the past years. In 2000, a little over 6000 people were in treatment for primary problems with cocaine, which is almost one-quarter of all drug clients. For 7000 other clients, cocaine was the secondary problem.
The amount of cocaine seized by the police and customs in EU countries has been highest in Spain in the past five years, followed by the Netherlands.

Opiates
Opiate use is negligible among the general population and among school pupils in the Netherlands.
The estimated number of ‘problematic’ opiate users (addicts) in the Netherlands remains stable at between 25 000 and 29 000. Total population is 16 million.
In 2000, over 15 000 opiate users were in treatment at outpatient drug treatment services. These users still dominate the group of all drug clients (58 percent) but their share in treatment demand is stable.
Each year some forty Dutch citizens die from an opiate overdose, especially heroin. This is fairly low compared with the figures of drug related deaths in other countries.
The frequency of HIV infection among Dutch injecting drug users is lower than in other countries due to the exceptionally high rate of Dutch opiate addicts not administering the drug intravenously, i.e., they do not inject themselves. HIV is the virus that eventually may cause AIDS. In the Netherlands there is a steep decline in the number of new AIDS cases attributed to intravenously injected hard drugs.

Ecstasy
In the EU, lifetime experience with ecstasy is highest in Ireland (5%) followed by the Netherlands (4%). The US rate is 6%. (Amphetamine is related to ecstasy. Internationally, amphetamine use in the Netherlands is low.)
Ecstasy remains the main party drug for young people in the Netherlands. Compared with other drugs, the demand for treatment owing to the use of ecstasy or amphetamine is rare. In 2000, the number of ecstasy and amphetamine clients was 241 and 623, respectively, comprising 1% and 2% of all drug clients. Treatment demand related to these drugs is declining.
The proportion of ‘ecstasy’ tablets consisting mainly of MDMA is on the rise in the Netherlands, while the proportion of tablets containing amphetamine as the main ingredient is decreasing (in 2000, 89 percent and 2 percent, respectively, of all tested pills).
There is a strong rise in the number of seized ecstasy tablets. In 1998, the police and customs confiscated 3,5 million and in 2000 almost 22 million ecstasy tablets.

Alcohol
The consumption of alcohol per head in the Dutch population is stable.
Alcohol use by Dutch pupils between 15 and 16 years old is fairly high compared with teenagers of the same age in other European countries: 20% had consumed an alcoholic beverage ten times or more in the month before the interview.
There has been an increase in the number of heavy drinkers among men between 18 and 24 years old. In 1999, 46% of this age group consumed six alcoholic beverages on one or more days per week compared with 38% in 1990. Heavy alcohol use also has increased among women of this age (from 6% in 1990 to 16% in 1999).
About 820 000 people in the Netherlands meet the criteria for the diagnosis alcohol dependence or alcohol abuse. The vast majority of these problem drinkers remain outside the scope of outpatient drug treatment services. In 2000, over 22 000 alcohol clients were registered in addiction care services.
In 1999, at least 775 people died from alcohol use, which is slightly more than in previous years.

Excerpts from the English translation of the 2001 Annual Report of the National Drug Monitor will be published on the internet by the end of 2001.

For more information: Harald Wychgel (31) 30 297 11 16 or Henk Maurits (31) 30 297 11 38, PR Officers for the Trimbos Institute.