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The Dutch and their drugs: The end of an era? Reflections on Dutch policies towards tobacco, alcohol and illegal drugs
Abstract
Dutch drug policy has received a great deal of attention all over the world and many have judged this policy to be (too) liberal and (too) tolerant. This article describes the highlights in The Netherlands with regard to the use of illegal drugs and the use of tobacco and alcohol, the policies towards these substances, recent discussions and expected changes in the near future. A tendency towards a more repressive policy can be detected. Rational arguments do not seem to play the dominant role in the public acceptance of a substance, nor in regard to the public acceptance of possible policy options.
... From a Dutch policy oriented point of view, illicit drug use is seen as a behaviour that cannot be totally banned (Garretsen, 2010). The use of illicit drugs is seen as an unavoidable reality in society, and one which cannot be eliminated with strict and stringent policy measures (Ministry of Health Welfare and Sports, 2003). ...
... This segregation of the markets for soft and hard drugs was introduced in the 1970s. The underlying argument was that by separating the markets, cannabis users are no longer dependent on the illegal market, and switching to other more harmful drugs may reduce as these are not sold in coffee shops (Garretsen, 2010). This was operationalized by licensed coffee shops that must comply with strict rules for selling cannabis. ...
... An explanation for this finding may be the indirect effect of drug use in society and the way Dutch drug policy is operated, as described in the 'Introduction' section. This might interact with how Dutch citizens perceive illicit drug use in the Dutch society (Garretsen, 2010); even among non-users, the difference in acceptance between the two countries indicates that drug use and national drug policy in society might indirectly affect the level of acceptance. In contrast to the non-users, Dutch and Norwegian current users generally showed no significant differences from each other, implying that own use plays a role in the level of acceptance of illicit drug use, which was confirmed in the regression analysis. ...
This study investigated whether Dutch and Norwegian parents differ in their perceptions on parental measures and how parents view governmental responsibility to prevent adolescents from substance use. Data were derived from a cross-sectional internet survey conducted in the Netherlands and Norway. A subsample of Dutch (n = 2017) and Norwegian parents (n = 844) was selected. Parents were asked about their perceptions on different parental measures in relation to substance use, e.g. setting the right example, setting rules, parental behavior in the presence of adolescents, and how they view governmental responsibility compared with parental responsibility in relation to substance use among adolescents. The parental responsibility for taking parental measures against adolescents’ substance use was emphasized by both the Dutch and Norwegian parents. Compared to Dutch parents, Norwegian parents were slightly more positive about taking parental measures. Dutch frequent and heavy drinkers and Norwegian men were the most negative about parental perceptions on alcohol measures. Regarding perceptions on parental measures on drug use, Dutch and Norwegian lifetime cannabis users and current cannabis users supported parental measures to a lesser extent. Overall, the results suggest that both Dutch and Norwegian parents feel the responsibility to provide measures to prevent children from alcohol and drug use, irrespective of the alcohol and drug policy in their own country. Both the Dutch and Norwegian supported parental measures to prevent adolescents from substance use.
... From a Dutch policy oriented point of view, illicit drug use is seen as a behaviour that cannot be totally banned (Garretsen, 2010). The use of illicit drugs is seen as an unavoidable reality in society, and one which cannot be eliminated with strict and stringent policy measures (Ministry of Health Welfare and Sports, 2003). ...
... This segregation of the markets for soft and hard drugs was introduced in the 1970s. The underlying argument was that by separating the markets, cannabis users are no longer dependent on the illegal market, and switching to other more harmful drugs may reduce as these are not sold in coffee shops (Garretsen, 2010). This was operationalized by licensed coffee shops that must comply with strict rules for selling cannabis. ...
... An explanation for this finding may be the indirect effect of drug use in society and the way Dutch drug policy is operated, as described in the 'Introduction' section. This might interact with how Dutch citizens perceive illicit drug use in the Dutch society (Garretsen, 2010); even among non-users, the difference in acceptance between the two countries indicates that drug use and national drug policy in society might indirectly affect the level of acceptance. In contrast to the non-users, Dutch and Norwegian current users generally showed no significant differences from each other, implying that own use plays a role in the level of acceptance of illicit drug use, which was confirmed in the regression analysis. ...
Aim: This study aims to explore differences between Dutch and Norwegian adults in the acceptance of illicit drug use in relation to the normalization thesis. Methods: Data were collected in November 2008. In total, 2150 Norwegian and 5616 Dutch respondents were included and the samples were weighted. The level of acceptance was assessed by measuring beliefs and opinions among Dutch and Norwegian people of 16 years and older and among different user groups in the Netherlands and Norway. t-Tests, χ 2-tests and multiple regression analyses were conducted to examine the differences between both countries. Findings: Norwegian and Dutch respondents were somewhat reserved concerning the acceptance of illicit drug use. However, the acceptance of illicit drugs among Dutch respondents was significantly higher compared to Norwegian respondents. Regarding different user groups, even non-users in both countries showed a significant difference, with Dutch non-users accepting illicit drug use to a larger extent than Norwegians. Conclusions: According to the findings of this study, the acceptance of illicit drug use seems to be larger in the Dutch society than in the Norwegian one.
... The importance of individual freedom in Dutch society has been reported to have been changing on a number of fronts, with tolerance shown to minority groups, including drug users, apparently diminishing (Garretsen 2010). Meanwhile, the plummeting public opinion of tobacco (Garretsen 2010) may contribute to negative attitudes toward around cannabis due to the tendency of users to smoke the two simultaneously as a joint. ...
... The importance of individual freedom in Dutch society has been reported to have been changing on a number of fronts, with tolerance shown to minority groups, including drug users, apparently diminishing (Garretsen 2010). Meanwhile, the plummeting public opinion of tobacco (Garretsen 2010) may contribute to negative attitudes toward around cannabis due to the tendency of users to smoke the two simultaneously as a joint. ...
This research was conducted as part of a master's level course on qualitative fieldwork methods. We studied a community of individuals who spend time in a single Dutch coffeeshop, i.e. a cannabis dispensary. We’ve sought to characterize and contextualize this group of people that society marginalizes due to their cannabis use. We’ve gathered users’ perceptions of social acceptability of cannabis use and have considered the nature of the community existing within the coffeeshop. We’ve found that it does offer a sort of ‘safe space’ where one can escape stigma and form community bonds if one wishes. This has implications for individuals’ sense of well-being. This work seeks to contribute to informed debates about cannabis in society from a standpoint of tolerance.
... Other additional elements are controlling measures, such as controlled access for the sale of cannabis, harm reduction, wellorganized addictive care and educational measures. This drug policy has been part of Dutch culture for years and a majority of the population seemed to agree with the existence of coffee shops as a place for selling cannabis, as long as no nuisance is caused by the coffee shops or their customers (Garretsen, 2010). However, problems related to drugs use occur. ...
... However, problems related to drugs use occur. These problems are caused by the organized crime behind the cannabis production (Garretsen, Blanken, van Mastrigt, & van Oers, 1996), foreign trading, especially in cities at the country border (Garretsen, 2010), criminal offences committed by customers of coffee shops (Garretsen, et al., 1996) and the physical and psychological damage by using cannabis regularly, especially among youngsters (Arseneault et al., 2002; Boys et al., 2003; Fergusson, Horwood, & SwainCampbell, 2002; Rey, Sawyer, Raphael, Patton, & Lynskey, 2002). These negative effects were reasons for the Dutch government to evaluate the national drug policy recently. ...
Aim: The aim of this study was to examine the opinion on Dutch cannabis policy measures and to explore whether the popularity of these policy measures depends on the extent to which lay people are affected by these measures. The extent to which people are affected has been made operational by: (1) own cannabis use and (2) cannabis use in social network. Methods: A panel survey was carried out among a representative probability of households with 8280 members of above 16 years. People's opinions were examined on four restrictive availability measures and two educational measures. Descriptives, one-way ANOVA and regression analysis were used to obtain the opinion on cannabis policy measures. Findings: The educational measures were popular among more than 90% of all respondents. The measures that restrict the availability of can-nabis were more popular among non-users than among users. Having cannabis users within a social network made a significant difference to the opinion on cannabis policy measures. Own cannabis use seems to be the strongest predictor for the opinion of restrictive availability measures. Conclusions: The opinion of a cannabis policy measure depends on whether one is affected by that policy measure.
The college years represent a vulnerable period for developing health-risk behaviours (e.g., physical inactivity/unhealthy eating habits/substance use/problematic internet use/insufficient sleep). This study examined current health behaviour levels (RQ1), health behaviour classes (RQ2) and between-class differences in socio-demographics (RQ3) and mental well-being (RQ4) among Dutch university students (n = 3771). Participants (Mage = 22.7 (SD = 4.3); 71.2% female/27.3% male/1.5% other) completed an online survey (Oct-Nov 2021). Descriptive statistics (RQ1), Latent Class Analysis (RQ2), and Kruskal-Wallis/Chi-square tests (RQ3-4) were used. RQ1: Prevalence rates suggest that a subsequent proportion of the student sample engages in health-risk behaviours. RQ2: Four classes were identified: class 1 (n = 862) "Licit substance use health-risk group", class 2 (n = 435) "Illicit and licit substance use health-risk group", class 3 (n = 1876) "Health-protective group" and class 4 (n = 598) "Non-substance use health-risk group". RQ3: Class 1 represents relatively more international students and students in a steady relationship. Class 2 represents relatively more older/male/(pre-)master students and students living with roommates/in a steady relationship/with more financial difficulty. Class 3 represents relatively more younger/female students and students living with family/with lower Body Mass Index (BMI)/less financial difficulty. Class 4 represents relatively more younger/non-Western/international/bachelor students and students living with children/single/part of LGBTIQ+ community/with higher BMI. RQ4: Class 3 has significantly higher mental well-being while class 4 has significantly lower mental well-being, relative to the other classes. Above findings provide new insights which can help educational institutes and governments better understand the clustering of students' health behaviours and between-class differences in socio-demographics and mental well-being.
The aim of the paper is to give insight in the effects of the Rotterdam drug policy: are there, at first sight, improvements in liveability within the city and in the quality of life of marginalised people? This is an explorative study based on policy documents, literature and qualitative interviews. The Rotterdam street image is described and an overview of measures taken by the municipality to combat and control drug-related and other problems are presented. In general, the street image in Rotterdam became less strongly characterised by the presence of homeless and addicts than in the 1990s and early 2000. In the well-known nuisance-related locations associated with those years the visible presence of the addicts, the drug dealers and the homeless was greatly reduced. In recent years the control of the municipality over the (social) addiction care has increased. Compared with a decade ago, the Rotterdam drug policy has become more pro-active. Although the elements of compulsion and pressure have been increased in the Rotterdam drug policy, it is also coupled with care for the client. Care, treatment and social recovery are the necessary components to prevent recidivism and to decrease nuisance.
The aim of this study was to examine the development of alcohol consumption and 'binge drinking' in The Netherlands over the period 1997-2005.
Data from three national population surveys commissioned by the Dutch Ministry of Health were compared.
Decreases in binge drinking have appeared, especially for youngsters, which are not explained by changes in the composition of the population according to religious orientation, and for which no other explanation can be given at present.
Trends in binge drinking in The Netherlands can vary over relatively short spaces of time.
Alcohol consumption causes an estimated 4% of the global disease burden, prompting governments to impose regulations to mitigate the adverse effects of alcohol. To assist public health leaders and policymakers, the authors developed a composite indicator-the Alcohol Policy Index-to gauge the strength of a country's alcohol control policies.
The Index generates a score based on policies from five regulatory domains-physical availability of alcohol, drinking context, alcohol prices, alcohol advertising, and operation of motor vehicles. The Index was applied to the 30 countries that compose the Organization for Economic Cooperation and Development and regression analysis was used to examine the relationship between policy score and per capita alcohol consumption. Countries attained a median score of 42.4 of a possible 100 points, ranging from 14.5 (Luxembourg) to 67.3 (Norway). The analysis revealed a strong negative correlation between score and consumption (r = -0.57; p = 0.001): a 10-point increase in the score was associated with a one-liter decrease in absolute alcohol consumption per person per year (95% confidence interval, 0.4-1.5 l). A sensitivity analysis demonstrated the robustness of the Index by showing that countries' scores and ranks remained relatively stable in response to variations in methodological assumptions.
The strength of alcohol control policies, as estimated by the Alcohol Policy Index, varied widely among 30 countries located in Europe, Asia, North America, and Australia. The study revealed a clear inverse relationship between policy strength and alcohol consumption. The Index provides a straightforward tool for facilitating international comparisons. In addition, it can help policymakers review and strengthen existing regulations aimed at minimizing alcohol-related harm and estimate the likely impact of policy changes.
Alcohol has been central to social, religious and personal use throughout the history. Alcohol drinking goes back almost as far as the human race does. A hundred years, therefore, may be seen as only a flash. The past century, however, has witnessed a fundamental change in dealing with alcohol problems. Hence, to give an overview of a hundred years of alcohol polices is a rather ambitious task and the contributions to this book shed only some light on the way in which alcohol policy issues have changed in this period.
This authoritative volume is relevant to both scientists and policy makers providing a state of the art in alcohol policy from different perspectives, covering both science/research/treatment and prevention practice and linking these areas.
Sweden and The Netherlands are often referred to as the archetypes of prohibition and harm reduction, respectively. Both nations have, however, recently adopted political measures that fit well in the other country's model. But they have also taken steps that reflect traditional thinking. Are we witnessing the initial stages of convergence or are recent developments better interpreted as adjustments? This article addresses these questions by comparing Swedish and Dutch theoretical understandings of ‘the drug problem’. Goals and practices are illuminated in the context of underlying theory, raising the question: Can substantial convergence be achieved without significant prior changes in theoretical perceptions? It is found that the theoretical understandings of the two paradigms do not mix easily, complicating attempts at convergence. Moreover, both countries have invested a great deal of political prestige in their respective models, further exacerbating the problem. A conceivable way to circumvent these difficulties is suggested.
For years, many saw Dutch Drug Policy as a liberal, and successful, policy and policy makers from many other countries wanted to 'go Dutch'. Harm-reduction measures and the tolerant Dutch attitude towards cannabis products have drawn international attention, positive and negative. However, things are changing rapidly. Dutch citizens no longer accept the present policy. Many harm-reduction measures are under pressure. It is argued that a new drug policy should pay more attention to the position of the so-called third party, those who suffer most from issues like drug-related nuisance. It is possible that within a few years those who are in favour of a liberal drug policy will not go Dutch, but will perhaps have to turn to other countries, for instance, the UK. However, those responsible for drug policies should learn from the latest developments in the Netherlands too.
For years, many saw Dutch Drug Policy as a liberal, and successful, policy and policy makers from many other countries wanted to ‘go Dutch’. Harm‐reduction measures and the tolerant Dutch attitude towards cannabis products have drawn international attention, positive and negative. However, things are changing rapidly. Dutch citizens no longer accept the present policy. Many harm‐reduction measures are under pressure. It is argued that a new drug policy should pay more attention to the position of the so‐called third party, those who suffer most from issues like drug‐related nuisance. It is possible that within a few years those who are in favour of a liberal drug policy will not go Dutch, but will perhaps have to turn to other countries, for instance, the UK. However, those responsible for drug policies should learn from the latest developments in the Netherlands too.
Sweden and The Netherlands are often referred to as the archetypes of prohibition and harm reduction, respectively. Both nations have, however, recently adopted political measures that fit well in the other country's model. But they have also taken steps that reflect traditional thinking. Are we witnessing the initial stages of convergence or are recent developments better interpreted as adjustments? This article addresses these questions by comparing Swedish and Dutch theoretical understandings of 'the drug problem'. Goals and practices are illuminated in the context of underlying theory, raising the question: Can substantial convergence be achieved without significant prior changes in theoretical perceptions? It is found that the theoretical understandings of the two paradigms do not mix easily, complicating attempts at convergence. Moreover, both countries have invested a great deal of political prestige in their respective models, further exacerbating the problem. A conceivable way to circumvent these difficulties is suggested. Prohibition has long been the dominant paradigm upon which international treaties and the drug policies of many countries have been based. Due to various forms of secondary harm originating in prohibitionary measures, there has been increasing opposition and an alternative paradigm – harm reduction – has been evolving since the 1960s. Sweden and The Netherlands are the European countries most often referred to as the archetypes for these two paradigms, but changes in drug policies seem to be taking place in both countries. There are several reasons for this, of which pressures from the international community and domestic tensions between various lobby groups are of primary importance. Perhaps a certain amount of change is inherent in the very nature of drug policy as it is difficult to find a balance between different interests. For instance, if policy emphasises public health at the expense of public order, a backlash may occur, moving policy towards the latter, which in turn might activate lobbyists who are not satisfied with the direction developments are taking. As there is no drug policy that does not have significant costs for at least a part of the population, there will always be interest groups demanding different priorities.
To what extent are addiction care, prevention and policy evidence-based? Are activities and programs based on research results?
Are the activities undertaken effective? Are new activities evaluated and if so, in such a way that their effectiveness can
be solidly assessed? This chapter addresses these questions. Among other it is stated that the clinical sector, the cure,
is more evidence-based than the not-clinical sector, the care and the prevention sectors. In these sectors activities are
insufficiently evidence-based. Possible explanations for this are discussed. A closer co-operation between researchers and
addiction care and prevention organisations is recommended as is the establishment of academic workplaces (like academic hospitals)
in this sector.
Despite a diversity of cultural, social and economic experiences with alcohol at national level, a broad unity of purpose is emerging within the alcohol problems perspective. The scientific basis for that perspective finds its support in a sustained international research effort. With the publication in 1994 of the WHO report "Alcohol Policy and the Public Good", that perspective has been given persuasive empirical underpinning and a sharp focus. Essentially the problems perspective suggests that the target for public policy is the prevention or alleviation of population-wide alcohol-related problems, with problems broadly defined. The test for any policy within this arena is then whether it contributes to the achievement of that target. The perspective is thus rational, empirical, rooted in the traditions of public health, and readily intelligible to the ordinary citizen. Key conclusions emanating from "Alcohol Policy and the Public Good" are summarized. That text is rounded off by the challenging assertion that "Drinking problems are not carried by an uncontrollable tide. With public will, and on the evidence, they are capable of amelioration." A positive response to that challenge by the nations of Europe is both necessary and feasible.
The article addresses the Dutch alcohol policy over the last decades and the present state of the art. In Dutch society an ambivalent attitude towards alcohol consumption prevails. Developments in legislation and regulations, in prevention and care are described. Several key problems are identified. Among others it is concluded that too little attention is paid to alcohol compared to other drugs. Both in prevention and care evidence-based work has to be stimulated. Legislation and regulations are insufficiently used and evaluated. The government needs to constantly evaluate its policy and develop its options within the area of legislation and regulations, which should also include a critical comparison with the situation in other countries.
Alcoholic beverages, and the problems they engender, have been familiar fixtures in human societies since the beginning of recorded history. We review advances in alcohol science in terms of three topics: the epidemiology of alcohol's role in health and illness; the treatment of alcohol use disorders in a public health perspective; and policy research and options. Research has contributed substantially to our understanding of the relation of drinking to specific disorders, and has shown that the relation between alcohol consumption and health outcomes is complex and multidimensional. Alcohol is causally related to more than 60 different medical conditions. Overall, 4% of the global burden of disease is attributable to alcohol, which accounts for about as much death and disability globally as tobacco and hypertension. Treatment research shows that early intervention in primary care is feasible and effective, and a variety of behavioural and pharmacological interventions are available to treat alcohol dependence. This evidence suggests that treatment of alcohol-related problems should be incorporated into a public health response to alcohol problems. Additionally, evidence-based preventive measures are available at both the individual and population levels, with alcohol taxes, restrictions on alcohol availability, and drinking-driving countermeasures among the most effective policy options. Despite the scientific advances, alcohol problems continue to present a major challenge to medicine and public health, in part because population-based public health approaches have been neglected in favour of approaches oriented to the individual that tend to be more palliative than preventative.
To quantify the implementation of tobacco control policies at country level using a new Tobacco Control Scale and to report initial results using the scale.
A questionnaire sent to correspondents in 30 European countries, using a scoring system designed with the help of a panel of international tobacco control experts.
The 30 countries are ranked by their total score on the scale out of a maximum possible score of 100. Only four countries (Ireland, United Kingdom, Norway, Iceland) scored 70 or more, with an eight point gap (most differences in scores are small) to the fifth country, Malta, on 62. Only 13 countries scored above 50, 11 of them from the European Union (EU), and the second largest points gap occurs between Denmark on 45 and Portugal on 39, splitting the table into three groups: 70 and above, 45 to 62, 39 and below. Ireland had the highest overall score, 74 out of 100, and Luxembourg was bottom with 26 points. However even Ireland, much praised for their ban on smoking in public places, did not increase tobacco taxes in 2005, for the first time since 1995.
Although the Tobacco Control Scale has limitations, this is the first time such a scale has been developed and applied to so many countries. We hope it will be useful in encouraging countries to strengthen currently weak areas of their tobacco control policy.
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