Europe: Drugs -- Dutch Practice Liberal Policies (Part 2)

The Netherlands has been known for centuries as a land of tolerance, and in modern times its reputation has been reinforced by what outsiders perceive as the country's liberal drug laws. Officials defend their regulations and policies as part of a comprehensive program to protect public health. In the second of a five-part series on drugs in Europe, RFE/RL correspondent Jeremy Bransten reports from Amsterdam on Dutch drug practices.

Amsterdam, 28 November 2000 (RFE/RL) -- A common misconception about drugs in the Netherlands is that they are legal. In fact, cannabis and its by-products, marijuana and hashish, have been decriminalized. This means that their sale and use in moderate amounts is not prosecuted.

When the Dutch parliament revised the country's drug laws in 1976, it did not legalize any narcotic substances. Instead, it divided illegal drugs into two classes: those with unacceptable health risk -- such as heroin and cocaine -- classified as "hard drugs," and cannabis-based "soft drugs," which present a lesser medical risk.

The reality was that increasing numbers of people were using marijuana recreationally. Rather than clog the criminal justice system with legions of pot smokers, Dutch politicians decided to bring marijuana into the open and refocus police resources on other issues. As a result, what were called "coffee shops" were allowed to open. In these cafes, which sell no alcohol, people can purchase limited amounts of cannabis and smoke a marijuana joint without fear of prosecution.

The other benefit of the policy, as the Dutch see it, is that it isolates the hard drug market from the recreational user. That's because cannabis consumers no longer regularly come into contact with street dealers and more harmful drugs. Roel Kerssemakers is deputy manager of prevention at the Jellinek Clinic in Amsterdam, which counsels drug addicts and alcoholics. He explains:

"It is possible in the Netherlands to buy cannabis in coffee shops. It's not legal but it's tolerated and of course, no other drugs are allowed to be sold in those coffee shops. Young people who want to try cannabis go to a coffee shop and only come into contact with cannabis and not with other drugs. And in many other places or cities you see that those drug markets are much more mixed."

Since the policy was implemented, the authorities have concentrated on pursuing drug traffickers and dismantling domestic drug laboratories, when they find them. As for users of hard drugs, they are monitored and encouraged to turn to the public health system for treatment. But unless they commit other crimes, they are not prosecuted.

Dutch drug policy is guided by the principle of what is described as "harm reduction." This means that drugs are seen as a public health issue. The authorities recognize that some people will want to use drugs -- the overwhelming majority of them occasionally and experimentally. The goal is to minimize the harm those drugs do to individuals and to society. A good deal of money is spent on prevention and education in the Netherlands, but when that fails, the authorities take a pragmatic approach, providing users safe conditions to feed their habit.

The Dutch say their coffee-shop policy has worked. After nearly a quarter-century of cannabis decriminalization, statistics indicate that marijuana and hashish use among Dutch teenagers and young adults has not grown and is in fact lower than in many other Western countries. Tim Boekhout van Solinge, a criminologist and drug-policy expert at the University of Amsterdam, notes:

"Eighty-five percent of the Dutch population have never, in their life, tried cannabis. So it's 15 percent (of people) who have what you call lifetime experience prevalence. It's lower than in the UK, or the U.S., lower than Ireland, about the same level as Germany, Belgium, France. France is a bit higher, Spain is a bit higher -- it's kind of in the average, you could say."

A peek inside the coffee shops that cluster in downtown Amsterdam usually reveals more foreigner than locals. Especially on weekends, hordes of young people from Britain, Ireland, and France descend on Amsterdam in search of a trouble-free high. At the Magic Mushroom coffee shop, waiter Scott -- himself an American -- says local people who come into the shop have long since learned to handle cannabis. It's mostly the foreigners who can be a nuisance.

"A lot of people who live in Holland, or in Amsterdam specifically, really don't party that much. They don't smoke every day, they're not -- I mean, I would say the people who party and really give it a bad name here are the tourists because I always see people wandering around, screaming and breaking bottles. Most of the time, they're not people who live here. Everybody who lives here knows how to just be chilled back, respect everything and be responsible for it."

Kathy and Jennie, both university students from Ireland, agree. They themselves admit to smoking a lot of marijuana in Amsterdam, but classify it as vacation-time. If there were coffee shops back home, they say, few people would binge.

Kathy: "If we were living here, we wouldn't be like this. Obviously, for the first while, do you know what I mean? We wouldn't be doing this every day, know what I mean? You have to run your normal life.

Jenny: "It's only [be]cause you're on your holidays. It's just like going anywhere on your holidays."

In response to pressure from its European Union neighbors, the Netherlands amended its coffee-shop policy in 1995, lowering the amount of cannabis sold to a customer at one time from 30 to 5 grams. This has had little practical effect on local users, as the amount is enough to keep any moderate smoker satisfied, but the authorities wanted to lower the number of binge smokers from abroad.

What about hard drugs? The emergence of AIDS and hepatitis C in recent years put new urgency into harm reduction program for intravenous drug users, such as heroin addicts. Because the HIV and hepatitis C virus can be transmitted through shared needles, rates of infection among drug users in many countries have risen sharply.

The Netherlands, along with many other European countries, has instituted needle exchange programs, where addicts can receive clean needles for used ones, thus eliminating the risk of infection. But here again, the Dutch have gone one step further, encouraging heroin addicts on a wide scale to switch to methadone as a substitute drug. Methadone, which is taken orally and eliminates heroin addicts' cravings for 24 to 70 hours, allows many former heroin users to lead a relatively normal life.

As a result of the methadone program, Amsterdam's heroin addict population has shrunk from 10,000 in the early 1980s to 5,500 today. What's more, the average age of heroin addicts in the city has risen from 25 to more than 40 years old. Simply put, heroin is no longer seen as "cool" by young people, who now seldom try it.

Roel Kerssemakers of Amsterdam's Jellinek Clinic says the fact that heroin addicts are often visible on city streets, and not hidden from public view, acts as a further deterrent effect on teenagers.

"We keep our drug users alive (chuckle). Because we have such a good helping system. We help them. We have a lot of facilities for them and that's why they stay alive and, well, get old. And so a lot of young people who see those drug users in the city, they consider those heroin users as old people." John-Peter Kools works for the Mainline organization, an outreach non-governmental organization that deals directly with addicts on Amsterdam's streets. Mainline acts as a conduit between addicts and the authorities, relaying information about treatment programs, providing counseling and also giving a voice to the down-and-out who want to be heard by officialdom. Kools sees the benefits of the methadone policy in human terms for the addicts themselves.

"This is in fact a major success of the Dutch drug policy. On the other hand, people are still using drugs, but they are alive and they've got reasonable good health, so overall, I think, it's a big success. Although, on a personal level, for those people, when you ask them: Are you satisfied with your life? They say: 'No I'm not.' But they [also] say: 'I'm healthy, I'm alive. I can visit my parents, I can see my children, I can function.' That's something."

Drug use patterns, like fashion, can change quickly. The frequency of drug use and how much is being used depends on a range of factors, from immutable givens such as geography to economic variables such as the level of youth unemployment. One key, Dutch and international experts agree, is education. From the age of 12, Dutch students take a special subject in school called "Health Education," which takes a holistic approach. In the class, students are taught about drugs -- legal and illegal -- in a broader context. They are involved in problem-solving exercises that encourage them to participate and exercise judgment. The Jellinek Clinic's Kerssemakers explains:

"We pay attention in health education to nutrition, to all kinds of physical aspects of growing up, but also to all kinds of social things, like how to resolve a problem or deal with conflicts or expressing your emotions and all these kinds of things, making your own choice and not allowing yourself to be influenced by peer pressure, by advertisements etc., etc."

When drugs are discussed in school, concrete information is given about the effects of different narcotics and their relative dangers. Then, it is hoped -- and statistics demonstrate -- most teenagers make reasonable choices.

Education and drug-use prevention also have to evolve, to keep up with new trends. Synthetic drugs such as "Ecstasy" have become a new concern in the Netherlands as elsewhere in Europe and in the United States. The stimulants are popular with teenagers at dance clubs on the weekends. Research continues into their potential long-term effects, but the main concern is that many pills sold as Ecstasy in dance clubs are often something entirely different and potentially more dangerous. Here, too, the Dutch are ahead, with a program that allows people to bring in their pills to their local health authority, including the Jellinek Clinic, for testing. The test is free of charge and without any stigma. Kerssemakers says:

"People can just deliver their pills and then we try to find out what's in it. Sometimes, we can recognize the pill immediately and sometimes we cannot and then we have to send it to the laboratory and the person will get, a week later, they will get the results and then he knows what's in it."

Approaching drug issues as public health problem seems to be working in the Netherlands, ensuring that the public is informed, teenagers are kept from damaging their health, and the small population of addicts gets the help it needs. Holland is coping, and it has held out long enough to have the satisfaction of seeing many of its European neighbors come around to its way of thinking.