Drug Abuse in the Global Village



                        Extent of Drug Abuse

A national survey conducted in 1987 (NSS Market Research) on drug abuse in the population aged 15 and older found that lifetime prevalence was 6 per cent for cannabis abuse, 2 per cent for stimulants and 1 per cent for "hard drugs" (Ministry of Welfare et al. 1991).

Table 1. Prevalence of drug abuse by type in 1987 and 1990 in Amsterdam, 12 years and over

--------------------------------1987                1990---------------------------------------------
 Sample size                             4,376               4,444
 Ever used                                71.6                 67.4
 Used past year                        49.6                 46.2
 Used past month                      45.9                 42.4
 Sample size                             4,370               4,444
 Ever used                                87.6                 85.8
 Used past year                        78.8                 77.7
 Used past month                      71.1                 68.8
 Sample size                             4,372               4,442
 Ever used                                20.0                 18.7
 Used past year                        11.2                 9.4
 Used past month                      8.2                   6.4
 Sample size                             4,374               4,439
 Ever used                                22.2                 20.3
 Used past year                        10.7                 9.3
 Used past month                      7.3                   6.0
 Sample size                             4,370               4,442
 Ever used                                22.8                 24.1
 Used past year                        9.3                   9.8
 Used past month                      5.5                   6.0
 Sample size                             4,371               4,440
 Ever used                                5.6                   5.3
 Used past year                        1.6                   1.3
 Used past month                      0.6                   0.4
 Sample size                             4,366               4,440
 Ever used                                4.4                   4.0
 Used past year                        0.6                   0.5
 Used past month                      0.3                   0.2
 Sample size                             -                       4,442
 Ever used                                -                       1.0
 Used past year                        -                       0.7
 Used past month                      -                       0.1
 Sample size                             4,370               4,430
 Ever used                                3.8                   3.9
 Used past year                        0.4                   0.3
 Used past month                      0.1                   0.1
 Sample size                             4,366               4,430
 Ever used                                1.1                   0.9
 Used past year                        0.3                   0.1
 Used past month                      0.2                   0.0
 Sample size                             4,360               4,425
 Ever used                                9.2                   7.2
 Used past year                        2.4                   1.9
 Used past month                      1.1                   0.6
Pharm. opiates
 Sample size                             4,360               4,425
 Ever used                                -                       6.6
 Used past year                        2.0                   1.9
 Used past month                      0.9                   0.6
 Sample size                             4,360               4,425
 Ever used                                -                       1.1
 Used past year                        0.3                   0.1
 Used past month                      0.2                   0.0

            The estimated total number of drug addicts in the Netherlands is 21,000 (Bureau Driessen, 1991).
Amsterdam estimates between 5,000 and 7,000 addicts (Municipal Services 1990).

            A survey conducted in 1990 among a population aged 12 years old and over in Amsterdam indicates that even though Amsterdam is an urban area where drug abuse is expected to be high, cocaine abuse is very low and stable. Further, current use of hypnotics (11.2 per cent) and sedatives (10.7 per cent) surpass that of cannabis (9.3 per cent) (Ministry of Welfare et al. 1991).

            Another national survey conducted in 1988/1989, among students 10 to 18 years of age, found that lifetime prevalence of drug abuse is (9.6 per cent). Tranquilizers or sedatives lifetime prevalence is the highest (13 per cent), followed by cannabis (7.7 per cent), cocaine (0.7 per cent), heroin (0.5 per cent) and inhalants (3 per cent). Apart from tranquilizers and sedatives, survey findings indicate that abuse of illicit drugs such as cannabis and inhalants is generally irregular and experimental as is the case for cocaine, which is also abused for recreational purposes (Plomp, H.N. et al. 1991).

            Heroin abuse is common among drug addicts, who also tend to be multiple drug abusers. Crack and LSD abuse is negligible in the Netherlands (Ministry of Welfare et al. 1991).

                       Abuser Characteristics

Drug addicts tend to be 25 to 35 years of age (Ministry of Welfare et al. 1991). The average age of addicts appears to be on the rise. According to treatment data, most hard drug abusers are males (75 per cent) (WHO 1985-1990).

            Abuse of illicit drugs among students is highest in those 17 years of age and older, although this is subject to some variation according to the drug. Lifetime prevalence of cannabis abuse is highest among males 17 or older (21 per cent) and among 13 per cent of the females of the same age; heroin lifetime abuse is higher in the 15 to 16 age group and inhalants ever abuse is highest among children 10 years of age or younger. Cocaine abuse is negligible among students according to the same survey (Ministry of Welfare et al. 1991).

            Lifetime, annual and thirty days measures of drug abuse indicate that male students abuse drugs more often than female students. Male students tend to abuse medical preparations without prescription while female students abuse prescribed medicines more frequently (Ministry of Welfare et al. 1991).

            A study in Amsterdam revealed that the average age of cocaine abusers is 30 years and the age of first abuse is 22 (Ministry of Welfare et al. 1991).

            High socio-economic status of the breadwinner is reported to be positively associated to cannabis abuse among students. The association of education with drug abuse is reported to be weak (Ministry of Welfare et al. 1991).

                         Regional Variations

Drug abuse is generally more prevalent in urban areas (Ministry of Welfare et al. 1991).


According to survey data lifetime and current abuse of cannabis increased slightly between 1984 and 1988. The greatest increase in abuse among those 15 years of age or older. The age of first abuse of cannabis among students increased from the 13 through 14 years age group in 1984 to the 15 through 16 years age group in 1988/1989. Cocaine abuse appears low and stable in urban areas. Crack abuse is negligible (see table 1) (Plomp, H.N. et al. 1991).

            Drug abuse increased among those of relatively disadvantaged socio-economic background, particularly among ethnic minorities from Morocco and Turkey (Ministry of Welfare et al. 1991).

                             Mode of intake

Injection of drugs is prevalent among 40 per cent of drug addicts, especially opiate abusers. In some smaller cities, this percentage is lower since injecting is somewhat a taboo. The majority of drug abusers smoke drugs (60 per cent) or inhale the fumes (Chase the Dragon) (Ministry of Welfare et al. 1991).


Fifty two drug related deaths were reported in 1989. Drugs were either the primary or secondary cause of deaths. Amsterdam reported 13 drug related deaths in 1990 (Ministry of Welfare et al. 1991).

             Some 1,736 AIDS cases were reported in 1991, of which 8.8 per cent are intravenous drug abusers. The proportion of injecting drug abusers among AIDS patients increased slowly. AIDS transmission among those who inject drugs is higher than average. There is, however, no evidence of an explosive growth. In 1990, safer drug abuse practices is believed to have led to a slow down in new HIV infections among drug abusers who inject. However, HIV incidence rates in Amsterdam are believed to be high (5.6 per cent in 1988, 5.5 per cent in 1989) (Ministry of Welfare et al. 1991).


                           National Strategy

The Ministry for Welfare, Health and Cultural Affairs is responsible for coordinating the national drug policy. This includes the implementation of the Opium Act and other prevention and treatment policies. The Ministry of Justice is responsible for law enforcement policy (Netherlands 1991).

            The primary aim of Netherlands' drug policy is harm minimization through health promotion and reduction of drug abuse related risks and their consequences to society as a whole. The policy also aims to ascertain that prosecution and imprisonment do not cause more harm than drug abuse per se. Further, demand reduction programmes are make part of a social security system which guaranties a minimum income health care services. This policy aims to provide a safety net to ensure that the underlying reasons for drug abuse are dealt with and that their consequences are minimized (Netherlands 1991).



                           Treaty adherence

The Netherlands is Party to the 1961 Single Convention on Narcotic Drugs, as amended by the 1972 Protocol.


                          Primary Prevention

A comprehensive prevention programmes aims to reduce abuse of all licit and illicit drugs, including alcohol and tobacco consumption. The programme consists of communication and education campaigns. School health education programmes address all drug abuse. Prevention activities target especially high risk groups through street workers programmes. The whole programme consist of a wide range of prevention activities which make part of a comprehensive social welfare system. Many projects target young people for purpose of prevention and risk reduction (Netherlands 1991).

            Needle exchange programmes are widespread, 130 in 1990 in 58 municipalities. Needle exchange is often part of methadone maintenance programmes. Street prostitutes in larger cities are also provided with syringes. In a few municipalities, pharmacists exchange needles and syringes. Mobiles and automat machines are used to facilitate needle exchange (Netherlands 1991).

            About 30 per cent of the prisoners are drug abusers. Nurses, working in prisons, and probation personnel are trained to provide AIDS education (Netherlands 1991).

            In some cities, drug addicts forming "Junky unions", play an active role in AIDS prevention and peer counselling. These mutual help groups are funded by the Ministry of Welfare, Health and Cultural Affairs as part of its harm reduction policy (Ministry of Welfare et al. 1991).

                 Treatment and Rehabilitation

Primary care facilities are increasingly utilized in lieu of specialized treatment in order to increase accessibility and reduce stigmatisation of drug abusers. Treatment start with outreach harm reduction programmes, intake in primary care facilities, drug maintenance (mainly methadone) when deemed necessary and then socio-economic support and social reintegration if needed (Ministry of Welfare et al. 1991). It is estimated that about 70 to 80 per cent of drug addicts are in contact with treatment agencies (Ministry of Welfare et al. 1991).

            The Consultation Bureaus for Alcohol and Drug Problems (CADs) form a nationwide network of non governmental organizations, consisting of 17 main branches, 44 subsidiaries and 45 consulting rooms. CADs provide non-residential mental health care and social work services including psychotherapy, counselling, material assistance, family therapy, prevention and AIDS prevention (Ministry of Welfare et al. 1991).

            Residential drug free treatment facilities provide services to alcohol and other drugs addicts throughout the country. There are 1,000 beds in independent clinics, therapeutic communities or specialized units in psychiatric hospitals (Ministry of Welfare et al. 1991).

            Methadone substitution programmes. Methadone is supplied to approximately 75 per cent of all addicts in approximately 60 municipalities, or 37 per cent (16,000) of CAD's 1989 case load (Ministry of Welfare et al. 1991).


      Arrests, Convictions and types of Offences

No information reported in Annual Reports Questionnaire by 31st December 1993.


Cocaine seizures increased significantly between 1988 (517 kg) and 1991 (2,492 kg), in spite of some fluctuation. Heroin seizures remained stable for the same period. Cannabis seizures increased from 60 tonnes in 1988 to 96 tonnes in 1991. Amphetamine seizures have almost tripled since 1990 (about 500 kg per year) (see table 2). Police efforts led to the detection of clandestine amphetamine laboratories in 1990 and to the dismantling of manufacturing and exportation organizations (Ministry of Welfare et al. 1991).

Table 2. Type and amounts of seized drugs in the Netherlands from 1988 to 1991.

---------------1988                1989                1990                1991
Heroin (kg)       510                  492                  532                  406
Cocaine (kg)    517                  1,425               4,288               2,492
 (kg)                 53                    65                    47                    128
LSD (dosages) 468                  8,075               5,146               1,630
MDMA (kg)    -                       0.750               0.322               0.700
                                                and                   and
                                                930,000           48 tablets
Cannabis (kg)   68,238             42,315             109,762           96,292
Source: National Criminal Intelligence Service for 1988 to 1990; for 1991, Country report of the Netherlands to the Meeting of Heads of National Narcotics Bureaus, Lyon, May 1992.

                      Supply Source of Drugs

Most heroin seized originates from South West Asia and Turkey (67 per cent in 1991), followed by South East Asia (12 per cent). Chinese crime syndicates are reported to be reestablishing themselves in the illicit traffic of heroin originating from South East Asia. Nigerian couriers are increasingly involved in the illicit traffic of heroin coming from Asia . Seized cocaine originates from Colombia. There is evidence that Surinam and other countries in the Caribbean are used as transit countries. Most cocaine is trafficked by air and sea. Most seized cannabis was shipped or transported by lorries from North Africa (Ministry of Welfare et al. 1991).

                       References and Notes

** The Legal, Administrative and Other Action Taken to Implement the International Drug Control Treaties section was prepared by the Secretariat of the Commission on Narcotic Drugs based on Annual Reports Questionnaires for the years .... (not available by January 15th 1994).

Bureau Driessen 1991. Assessment of municipalities and recent research on all methadone programmes in the Netherlands.

Municipal Services 1990. Capture/recapture data based on data systems of Municipal Health Service, Municipal Police, local studies.

Ministry of Welfare et al. 1991. The drug abuse situation in the Netherlands. Ministry of Welfare, Health and Cultural Affairs and Ministry of Justice. September 1991 version.

Plomp, H.N. et al. 1991. Smoking, Alcohol consumption and the use of drugs by school children from age 10. Fourth National youth health survey on smoking alcohol consumption and use of drugs in the Netherlands. H. N. Plomp, H. Kuipers, M.L. van Oers 1991.

National Criminal Intelligence Service for 1988 to 1990; for 1991, Country report of the Netherlands to the Meeting of Heads of National Narcotics Bureaus, Lyon, May 1992.

WHO 1985-1990. First European Summary of Drug Abuse (ESDA) 1986-1989/90, WHO.