Paper to be
presented at the hearing of the Special Committee on illegal Drugs,Ottawa, November 19, 2001-09-28
Bob Keizer Drug policy advisor,
Ministry of Health, Welfare and Sports of The Netherlands
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)
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.
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.
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. 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).
- 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
and addicts infected with HIV is low.
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:
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.
(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
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.
- 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
- 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.
Parnassusplein 5, P.O.Box 20350, 2500 EJ The Hague, tel +31 70 340 6937, +31
23 5341691, E-mail: email@example.com
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%.
Netherlands 2.5, Sweden 3, UK
5.6, France 3.9,
Italy 7.2 (per 1000 inhabitants).
Drug related deaths per 1000 inhabitants: Netherlands 0.5,
Germany 1.3, UK 2.7, Sweden
Percentage injecting drug users of all AIDS cases (1998): Netherlands 11, UK
6, Ireland 26, Germany 12, France 18, Portugal 61.