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The Netherlands' Drug Policy

Paper to be presented at the hearing of the Special Committee on illegal Drugs, Ottawa, November 19, 2001-09-28

Bob Keizer[1]
Drug policy advisor,
Ministry of Health, Welfare and Sports of The Netherlands

1. Introduction 

In this paper I shall briefly describe the background to Dutch drug policy, the main elements of that policy, the results it has achieved and the points that have been raised for discussion. For more detailed information, I refer to the other papers that will be presented today. Those requiring more facts can consult the many excellent sources of information that are available on this subject: the fact sheets of the Trimbos Institute and the details that the Trimbos Institute also publishes within the framework of the National Drug Monitor (www.trimbos.nl), and the article “Pragmatism versus Ideology: Dutch Policy Continued”, by  Marcel de Kort and Ton Cramer (Journal of Drug Issues 1999, volume 29, no. 3). For information about Dutch policy from a European perspective, see the Annual Reports of the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)  (www.emcdda.org). 

In order to understand Dutch drug policy, one first needs to know something about the Netherlands itself. After all, a drug policy needs to be in keeping with the characteristics and culture of the country that produces it. The Netherlands is one of the most densely populated countries in the world. A population of around 16 million lives in an area a quarter the size of Vancouver Island. Trade and transport have traditionally been key industries in our country, and the Netherlands is universally regarded as the "gateway to Europe". The Dutch have a strong belief in individual freedom and in the division between "church" (in other words, morality) and state. We believe in pragmatism. At the same time, the Netherlands is characterised by a strong sense of responsibility for collective welfare. It has an extremely extensive system of social facilities and health care and education systems that are available to all. The Netherlands has long been a country of great political diversity, and its present government is made up of liberals, social liberals and social democrats. Our administrative system is decentralised to the local authorities to a large extent (particularly where drug policy is concerned).


2. The basic principles of Dutch drug policy

These characteristics of our country are reflected in our present drug policy, which was formulated in the mid-seventies. A wide range of addict care facilities is available. Dutch policy does not moralise, but is based on the assumption that drug use is a fact and must be dealt with as practical as possible. The most important objective of our drug policy is therefore to prevent or to limit the risks and the harm associated with drug use, both to the user himself and to his environment. Partly because of this, the Ministry of Health is responsible for co-ordinating drug policy. The cornerstone of this policy is the law (the Opium Act), which is based on two key principles.  Firstly, it distinguishes between different types of drugs on the basis of their harmfulness (hemp products on the one hand, and drugs that represent an "unacceptable" risk on the other). Secondly, the law differentiates on the basis of the nature of the offence, such as the distinction between possession of small quantities of drugs intended for personal use, and possession intended for dealing purposes. Possession of up to 30 grams of cannabis is a minor offence. Possession of more than 30 grams is a criminal offence. Drug use is not an offence. This approach gives us scope to pursue a balanced policy through our application of criminal law.

Dealing in small quantities of cannabis, through the outlets known as coffee shops, is tolerated under strict conditions. This tolerance is a typically Dutch policy instrument which is based on the power of the Public Prosecutor to refrain from prosecuting offences. This principle is formulated in the law and is called the “expediency principle”. The small-scale dealing carried out in the coffee shops is thus an offence from a legal viewpoint, but under certain conditions it is not prosecuted. These conditions are: no advertising, no sales of hard drugs, no nuisance must be caused, no admittance of and sales to minors (under the age of 18), and no sales exceeding 5 grams of cannabis per transaction. The stock of the Coffeeshop should not exceed 500 grams of cannabis.

The idea behind the Netherlands' policy towards the coffee shops is that of harm limitation. This is based on the argument that if we do not prosecute small-scale cannabis dealing and use under certain conditions, the users – who are mainly young people experimenting with the drug – are not criminalised (they do not get a criminal record) and they are not forced to move in criminal circles, where the risk that they will be pressed to try more dangerous drugs such as heroin is much greater. 

Many people think that drugs are legally available in the Netherlands, and that we make no effort to combat the supply side of the drug market. Nothing could be further from the truth. There is continual, intensive co-operation between the addict care system, the judicial authorities and the public administrators. With the exception of small-scale cannabis dealing in coffeeshops, tackling all other forms of drug dealing and production has high priority. The police and customs officials regularly seize large hauls of drugs and collaborate closely with other countries in the fight against organised crime. Last year, about 40.000 kg of cannabis and about 660.000 marihuana plants have been seized; 1372 nursery gardens have been dismantled; 5,5 million tablets of XTC have been seized. I refer to the separate fact sheet on Justice-data that will be presented today. The punishability of drug-related offences is comparable with that in many other countries, and the extent to which we enforce our drug laws is also closely comparable with that in our neighbour countries. The Netherlands has one of the largest prison capacities in Europe, and 17 % of the cells are occupied by violators of our drug laws. It has been estimated that between 25 and 44% of the prison population consists of drug addicts or drugusers.


3: Results 

We have pursued this policy for over 25 years now. What results has it achieved, measured in terms of its most important objective: harm limitation? The sources I referred to earlier can be consulted for statistics on cannabis use, especially the paper of Mr. Korf that will be presented today.  

- Cannabis use: As in all other countries the number of regular hemp smokers in the Netherlands has increased in recent years, and the age at which users start has gradually decreased. People who have problems with cannabis use are also making increasing demands on the addict care system during the last few years, although they are only estimated to comprise 1% of regular cannabis users. There are also signs that cannabis use is stabilising and even is decreasing. However, it is striking that international comparative studies show that both the trend towards increased use and the present scale of use are comparable with those in the countries surrounding the Netherlands, such as Germany, France and Belgium, and certainly lower than those in the United Kingdom and the United States[2]. These statistics suggest that there is almost no connection between the increase in cannabis use and the policy pursued in respect of the users.

- Hard drug users (heroin and cocaine):  Thanks to a high standard of care and prevention, including the large-scale dispensation of methadone and clean hypodermics, a situation has developed in the Netherlands which is only comparable with that in a handful of other countries. The number of hard drug addicts (heroin/cocaine) stabilised roughly ten years ago, at the level of  2.5 per 1000 inhabitants. This means that the Netherlands is among the three countries with the smallest number of problem addicts in the European Union (after Finland and Germany)[3].

- Although we have seen a rise in cannabis use for ten years, the number of problem addicts has been stable over the same period. From this, we can therefore conclude that the “stepping stone” theory has not proved to hold true in our country.

- The population of hard drug users in the Netherlands consists of more or less the same group of people, as evidenced by the fact that each year, their average age goes up by almost a year. At the moment, it is roughly 40. Not many young people are taking up heroin or crack. The health damage caused by hard drug use has remained limited. The number of drug deaths[4] and addicts infected with HIV is low[5]. A further consequence of our policy is that a relatively large percentage of the drug users in our country are reasonably well integrated into society.

- Like our neighbour countries, we have noticed an increase in XTC use in recent years. The rate of current use among young people is around 1.4%. Here, however, there are signs that the use rate has been decreasing recently.


4. Recent developments and points for discussion 

It will be clear from all of this that, bearing in mind our objective of harm limitation, our policy is reasonably successful. So does this mean that the Netherlands' drug policy is an ideal policy? No, far from it. We are continually confronted with a host of problems, and this means that we are also continually having to modify our policy. Here is a summary of the most significant policy developments and political topics for debate that have arisen in the last few years:  


a.  Coffee shops 

It became clear in the early 'nineties that a number of problems were occurring around the coffee shops. These included problems such as (petty) criminal acts committed by owners and customers,  customers hanging around and the comings and goings of the customers' cars, which sometimes caused a nuisance to people living in the neighbourhood. The latter was particularly true in the border regions, where more and more foreigners took to visiting the coffee shops to buy cannabis. In response to this, compliance with the conditions was monitored more strictly and the number of coffee shops was also reduced in a number of municipalities. In 1997 the number of coffee shops was estimated at 1179; in 2000 only 813 remained. To reduce drugs tourism, the Dutch authorities also decided to reduce the amount of cannabis that could be sold from 30 grams to 5 grams per transaction. 

I must emphasise that the reason for doing this was not that we no longer believed in the coffee shop phenomenon, but that the authorities wanted to gain greater control over it. 

The coffeeshop policy is the primary responsibility of the local administration. Many of the problems surrounding the coffee shops can be traced back to the fact that the local administrators and police authorities did not really know how the policy should be pursued. That is hardly surprising, since the coffee shops are still operating in an administrative no-man's-land. Sales of cannabis "at the front door" are not legal, but they are tolerated, and purchases "at the back door" do not fall under this policy of tolerance. In practice, this means that the coffee shop owner is forced to buy the cannabis on the illegal market. This remains an awkward situation from the administrative point of view. What it means is that something which is forbidden is nonetheless tolerated. All the same, the mayors, police chiefs and politicians of the Netherlands still continue to support the concept. Their argument for doing so is that it is better to control half of the problem than nothing at all. This is reflected in the fact that the mayors of the bigger cities seldom use their powers to close all the coffee shops in their municipality. The reason for this is that both the administrators and the police authorities consider that the benefits of the coffee shops outweigh their disadvantages. Closing the coffee shops will certainly lead to an increase in dealing on the streets, in private homes and in school playgrounds, which will undoubtedly be accompanied by hard drug sales, while the rate of use among the population will not decline, bearing in mind the figures for use in other countries. 

This dilemma (pragmatism versus administrative logic) characterises the current situation in Dutch cannabis policy. The Dutch parliament recently debated this topic at length. In response to an initiative put forward by 60 Dutch mayors, the parliament proposed that an experiment in the "regulated" supply of cannabis should be started: that is, a system for cultivating and distributing cannabis which could only be supplied to a limited number of coffee shops. In this way the circle could be completed and organised crime could be kept out of it.

The government rejected this proposal. Its main reason for doing so was that an experiment of this kind could conflict with the international treaties and would also come in for heavy criticism from our neighbour countries; moreover, an experiment of this kind would require a large number of extra control measures and would therefore be very costly. However, the debate did result in a promise by the government to actively investigate the extent to which other countries are also wrestling with similar problems and dilemmas. To achieve this, a “City Conference” is planned for December 2001 in the Netherlands, where a large number of European towns will be able to exchange experiences with each other.  


b. Drug dealing and production  

In the last few years it has become increasingly clear that some international drug dealing and production activities are being carried out from or through the Netherlands. This mainly applies to the production and transit of XTC and cannabis. 

We have been tackling XTC dealing and production more intensively in recent years, by improving our control over the trade in precursors and setting up a special police unit, the Synthetic Drugs Unit (USD). The Dutch Parliament recently approved a comprehensive plan to step up the fight against XTC production still further.

As far as cannabis production and dealing is concerned, we have refined our legislation and intensified our detection efforts. Cultivation of cannabis for personal use is tolerated de facto (up to 6 plants), but we do make intensive efforts to detect cultivation on a large scale. As a result of this policy, the quantities of cannabis seized (particularly cannabis grown in the Netherlands) have increased significantly. Proportionately speaking, the Netherlands seizes much more cannabis than most other European countries.

In this context I should also explain that the cannabis grown in the Netherlands is characterised by an increasing average THC content. In 1999, cannabis grown in the Netherlands had an average THC content of  app. 9%, compared with an average of 5% in cannabis grown abroad (although cannabis with high THC content is just as well grown in other countries). However, a recent study (2000) found that this figure was app. 11% for cannabis grown in the Netherlands. We do not know whether this is a temporary trend, or whether it represents a structural change. Nor do we have scientific information about the effects that using this cannabis may have on health. We intend to carry out further research into this question, and we shall continue to monitor developments in the market closely.  

As I have already said, it is a misconception to think that we pursue a tolerant policy towards large-scale drug dealing and production. Nonetheless, the central question is, and remains, this: is large-scale drug dealing and production occurring in the Netherlands because of our policy of tolerance towards users and our coffee shop policy, or is it independent of them?

There is some evidence to support this first view when we look at the 'eighties, a time when we – like many other countries – were not sufficiently alert to the role of organised drug crime. However, this is not true of the 'nineties, as evidenced by my earlier remarks about the efforts of the Dutch police, customs officials and judicial authorities. From the (little) research that has been carried out into the question of whether the Netherlands' drug policy attracts criminals, it appears to be more likely that organised crime simply uses the Netherlands' good infrastructure, the presence of a high-quality chemical industry, the absence of border controls and the massive volume of legal goods flows to conduct its own trade. Every year, Rotterdam transships more than 6 million (!) containers. You need not be a mathematical genius to recognise that even with the strictest detection methods, there is a strong chance that a significant proportion of the trade will not be checked. 


c. Changing drug trends; changes in the addiction problem 

There have been marked changes in the patterns of use in recent years. I have already referred to the increase in cannabis use and the use of XTC and other synthetic drugs (although the latest surveys indicate a stabilisation). This has led to a more flexible policy. For instance, in the last few years we have invested much more heavily to develop innovative prevention programmes. Educating young people, mainly at school, with the emphasis on stating the facts wherever possible, can still be regarded as our most important policy tool.

Education plays a key role in our approach to XTC use as well, and we have also started a large-scale study into the harmfulness of XTC and the behaviour patterns of users,  because we actually knew little about XTC. We have also set up an early warning system to enable us to find out quickly about new pills in the market. Pill testing is an important element of this system. It is thanks to this policy that we have suffered relatively few XTC deaths in the Netherlands.

Another trend is that the addict care service has had to cope with growing numbers of addicts with psychiatric problems and groups of addicts in poor physical condition. Experience has shown that treatment whose goal is to promote abstinence is of little use for this group. The care we provide will have to change radically, both in its nature and in its organisation. Improving effectiveness and quality therefore have high priority. One example of this is the strictly scientifical experiment with heroin dispensation, on medical grounds. The aim of this is to improve the addicts' medical and social condition. This experiment, in which 600 addicts are taking part, will be evaluated early next year. If the results are positive, the Health Minister will propose that the dispensation programme should be transformed into a regular form of treatment. Other examples of  care innovations are rapid detoxification under anaesthesia and the administration of high-dose methadone 

Some comments on the importance of research and monitoring in the area of drug policy are in order at this point. The importance of developing and financing these tools is often underestimated by politicians and policy-makers. However, without them it is impossible to keep track of the developments in the drug market and to analyse whether the measures used have actually had an effect. Luckily, the Dutch Health Minister has recognised the importance of this and has made it possible for us to carry out structural policy monitoring and research.


d. Nuisance caused by hard drug users 

In the early ‘nineties the behaviour of heavily addicted drug users began attracting more and more criticism from members of the public. There was a small category of hard drug users who were a constant source of considerable social and judicial nuisance. This took the form of petty crime, disorderly conduct, and making the public feel unsafe. This group comprises roughly 20% of the addict population. The government responded quickly by developing an extensive programme and providing a relatively large budget to fund it. The politicians realised that a drug policy only works if it is supported by the public, and that support was in danger of being lost.

The projects involved developing better shelter facilities for problem addicts and a more rigorous approach to the nuisance they caused. The municipal authorities and the addict care organisations had the primary responsibility for this. A host of new facilities emerged, such as experimental user rooms (where drug use is tolerated), social hostels, and new forms of addiction clinics specifically developed for this group of problem addicts. The Netherlands also began experimenting with forcible treatment and re-education of the hard core of nuisance addicts. This comprises 350 places for people who have frequently been guilty of petty crime. Recent surveys indicate that the nuisance is diminishing.


5. The Netherlands and the rest of the world 

Dutch drug policy came in for a good deal of criticism from other countries in recent years. The Netherlands, which is heavily dependent on trade with other countries and has also always played an active role in the international community, took this criticism seriously right from the start.

The criticism focused on two main areas. There were well-founded complaints – about trans-border drug trading, for example – but also complaints about the underlying philosophy of the Netherlands’ policy. Some countries felt that we had the wrong attitude and that we were setting the wrong example to the world.

In the early ‘nineties the bulk of the criticism came from Germany. So we entered into an intensive dialogue with the Germans. From this we quickly discovered that there was widespread ignorance about the Dutch situation, and that there was also much less criticism at the local, regional level in Germany than the national politicians wanted us to believe. This is important, because drug policy in Germany is primarily the responsibility of the Bundesländer (the federal states). It emerged that the problems in many of the major cities, such as Hamburg, Bremen and Frankfurt, have far more in common with the problems in Dutch cities than German federal politicians officially admitted. A host of Dutch-German alliances subsequently sprang up between the addict care organisations, the police and the public administrators. This in turn caused Germany to adopt a much more moderate stance at the political level. The past four years have been characterised by virtually no criticism of the Netherlands’ policy. Methadone dispensation has been widespread in Germany, Germany has been setting up experiments with heroin dispensation, and the cannabis policies of the federal states are now comparable with the Dutch policy (although Germany has no coffeeshops).

We have gone through a similar process with France. Large numbers of people used to come from Lille to buy drugs in Rotterdam. This not only caused a good deal of nuisance in both cities, but also attracted criticism at a high political level. At one point, when President Chirac came under attack because of the French atomic tests in the Pacific, he remarked that the damage caused by the nuclear tests was negligible in comparison with the disastrous effects of the Netherlands’ drug policy. We went to Lille, where we discussed these issues in depth with the local administrators. From these discussions we learned that, as in Germany, the differences between our views were much smaller than the national politicians wanted us to believe. Various collaborative projects were then started, including an annual Dutch-French study week in which researchers, social workers and local politicians compare notes about their experiences and problems. Many improvements were also achieved in the area of co-operation between the Dutch, Belgian and French police forces. All in all, it is true to say that Franco-Dutch relations are now excellent again. 

Sweden was the next country to suddenly begin expressing fierce criticism of the Netherlands’ drug policy. In this case, the criticism was mainly of a moral nature. Sweden has a long tradition of a strongly prohibitionist alcohol policy, and this attitude also extends to its drug policy. Swedish drug policy has become exceptionally restrictive since the ‘eighties. We also attempted to develop a dialogue with the Swedes, but it must be admitted that this was frequently very difficult to achieve, if only because it was difficult for the Swedes themselves to conduct a rational debate on drug policy in their own country. I will confine myself here to the statement that Sweden has moderated its position, partly because a European comparison of the results (e.g., the number of hard drug addicts and drug-related deaths) revealed that the Swedish policy was not more effective, and partly because it became evident that the Netherlands was not isolated in its policy.

After Sweden, the US went on the offensive. Soon after the appointment of General McCaffrey as the US’s drugs tsar, a journalist travelled to Amsterdam where he spoke to a number of people under the pretext that he was writing a novel on drug-related crime. The journalist then incorporated the information he gathered into an article that was published in the influential journal “Foreign Affairs”, under the headline: “The half-baked Dutch drug experiment”. The article was literally crammed with errors, false quotations and malicious suggestions. For example, it stated that drug use in the Netherlands had exploded by 250% in a very short period, that the number of murders and other types of crime had “skyrocketed”, that the cannabis grown in the Netherlands had a THC content of 35%, that the Netherlands was a paradise for criminals, that the number of heroin addicts was double that in the UK, etc.

Requests for rectification by the Dutch ambassador to the US had no effect whatsoever. Instead, General McCaffrey kept on quoting the article in Foreign Affairs in his speeches and documents to demonstrate that the Netherlands’ policy was – in his words – ‘a complete disaster’, and that the Netherlands occupied a completely isolated position in the world.

The aforementioned statistics from Foreign Affairs or McCaffrey are now turning up again in Canada. The Canadian Police Association has consulted this same source to prove the point it wants to make, apparently without these police detectives having made the slightest effort to check whether any of it was actually true.  

The Netherlands was far from happy with these attacks on our drug policy. We did whatever we could to respond to the criticisms. But the effect of this foreign criticism was not to persuade us to abandon the fundamental principles of our drug policy. Why not?

It was not because we had a sacred belief in our own policy, at any rate. We are well aware of our drug policy’s shortcomings and failures. But the main reason why we have not changed tack is our view that, in many respects, the results of our policy are no worse – and in some respects they are better – than the results achieved in comparable countries. Based on the facts and figures, we feel that a policy such as the one championed by the US is not a desirable alternative. What is more, in recent years a large number of countries have begun pursuing policies that are more or less comparable with the Dutch approach. If you separate the international debate from the political rhetoric, it is clear that the Netherlands does not have a particularly eccentric policy at all. For example, the system currently in discussion in Switzerland is comparable to a large extent with the coffee shops, and it is also more progressive than the Dutch system in many other respects. I have already mentioned the German federal states, and the marked change in the French position. Countries like Portugal, Belgium and Luxembourg are also steadily moderating their positions. Luxembourg already has and Belgium is preparing a distinction in their law between cannabis and hard drugs.

Also in the UK, that has the highest prevalence figures on cannabis in the EU, a debate about cannabis decriminalization has been going on in the recent years, with proponents even from the police and the Conservative party.


6. Conclusions 

- Our cannabis policy has not led to a significant increase in cannabis use, in comparison with other countries. The fact that the rate of cannabis use is comparable with that in other countries shows that the effect of policy on the number of users is probably slighter than we think. Presumably other factors, such as trends in youth culture, social inequality and other social influences, play a much more important role than policy-makers think.

- In our view, however, this does not mean that it makes no difference whether a country pursues a liberal or a restrictive drug policy. Investing in a policy that aims to protect health pays for itself in terms of mortality, morbidity and the existence of marginalisation. A situation like that in a number of other countries, where the mostly youthful users run the risk of coming into contact with the judicial system, is seen as highly undesirable in the Netherlands. The harm done by a criminal record is greater than the harm caused by (generally) a few years of experimental drug use.

- There are no indications that our policy on cannabis has led to an increase in the number of hard-drug users. The wide range of care and prevention facilities has ensured that hard drug use has remained limited, and that the users' state of health can be described as reasonable.

- No causal link can be established between a policy that focuses on harm limitation and the fact that a proportion of the international drug dealing and production takes place from or through the Netherlands.

- A good drug policy must consist of an interplay between practice, science and politics. These three are inextricably interconnected, but each also has its own role to play. Monitoring is therefore an absolutely essential element of the policy. Without monitoring, the effects of a policy cannot be measured, the quality of the work cannot be improved, and a meaningful debate can never be conducted.

- The political debate on drugs – both at the national and, more often, at the international level – is often conducted on the basis of incorrect or faulty arguments. Facts and moral opinions are jumbled up together. However, international opinions at the scientific and practical levels actually differ far less widely than some politicians want people to think. In practice, a rapid process of bottom-up drug policy harmonisation is currently taking place in a number of European countries.

- Finally, at the practical and policy levels there is a growing awareness that the existing collection of tools, which is dominated to a large extent by the international drug treaties, is inadequate for the purpose of making the drug problem truly manageable. This fact is extremely difficult to acknowledge at the political level, not only for political reasons but also because there are no usable alternatives. The conclusion, therefore, is that at the practical and scientific levels we need to invest more effort in devising suitable alternatives, preferably through cross-border links with colleagues from other countries.  

BK 9/9/01

[1] Parnassusplein 5, P.O.Box 20350, 2500 EJ The Hague, tel +31 70 340 6937, +31 23 5341691, E-mail: ad.keizer@minvws.nl
[2] E.g: last month prevalence pupils 15-16 yrs (1999): Netherlands 14%, Ireland 15%, UK 16%, France 22%, USA 19% ; General population, last year prevalence (1994-1998): Netherlands 5%, UK 9%, France 5%, USA 9%. 
[3] Netherlands 2.5,  Sweden 3, UK 5.6,  France 3.9,  Italy 7.2 (per 1000 inhabitants).
[4] Drug related deaths per 1000 inhabitants: Netherlands 0.5,  Germany 1.3,  UK 2.7,  Sweden 1.9
[5] Percentage injecting drug users of all AIDS cases (1998): Netherlands 11, UK 6, Ireland 26, Germany 12, France 18, Portugal 61.

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