 The Netherlands has a special way of dealing with drug problems, which has proved to be more successful than the approach followed in most other countries. The Dutch level of HIV among drug users is low, heroin use is decreasing, cannabis use among young people is on a par with the European average, and drug users are not criminalized. The Open Society Foundation has published a report on Dutch drug policy. We interviewed the authors about their findings. When you look back in history, you see that already long before, you know, there was cannabis in the 17th century, we had, you know, sort of the opium regi, it was called, in which we had a system for legal distribution of opium already. In 1914 in Amsterdam, we had the Dutch, or the Royal Dutch Cocaine Factory. So we produced these, you know, all kinds of drugs before prohibition came into place. In the 1960s, you know, that's when we really saw that not only in the Netherlands, but in other countries as well, all kinds of drug use come up as part of the counterculture that was growing at the time. Of course, it was cannabis, there was also a lot of acid going around, LSD, amphetamines. In the Netherlands, we very quickly understood that if criminalization is your main instrument, you know, it will push people to the margins of society, and that's what we always wanted to prevent. In 1969 already, the Public Prosecutor's Office gave out guidelines that emphasized that drug users and especially cannabis users would not be prosecuted to the full extent of the law. Until the early 70s, we had house dealers at pub venues which were tolerated by police. They had a specialized table in the corner of the venue where a dealer sat which sold many cannabis and they trusted these dealers so they would permit them to stay there. And this would eventually be turned into a policy and this policy would give way to the coffee shops. Following the recommendations of the Hulsmann and Barn commissions, in 1976 the Opium Act was revised and their possession was decriminalized. In order to prevent cannabis users from coming into contact with heroin dealers, toleration of the separate sale of small amounts of cannabis products became the official policy. Decriminalization, that was the first step in an approach from a law enforcement approach to more to the public health approach. Because we think that public health is more effective in reducing the damage and all these things from their taking. The success of the Dutch drug policy is that they let it happen to have wheat shops that you can buy there as a consumer small amount for your daily needs. The coffee shops have a function as a kind of a shop but also a social function like in a café or a restaurant and simply the function that you can buy good quality marijuana there or hashis. We're a coffee shop slash bar. There are actually five main rules that you have to oblige by. The first one is that you cannot have anybody in your coffee shop that is under the legal age of 18. You cannot sell more than five grams per person per day. You cannot be a nuisance to your local environment. You can't do advertising for your cannabis products. You cannot have more than 500 grams of the product that you sell in-house. The big increase you saw in the early 80s happening and I think halfway the 90s there were more than 2000 coffee shops in the Netherlands. The motive behind the cannabis policy was to keep people away from heroin because in 1972 banks suddenly there was heroin and I think in that sense we've been very successful. We can see that in Holland this approach has a result of less consuming wheat than in other countries where the repression is much more higher. The Dutch youth isn't really that interested in using cannabis. It's not so much a big of a deal. For us it's kind of normal because it's something that's just there. It's the same with drinking alcohol in a bar. Critics have said cannabis use and other drug use will skyrocket. That's clearly disproven. It's simply not true. I always refer here then to EMCDA data and they have this very lovely graph which is on trends in cannabis use. If you see the graph it's just a big mess. That's the point. There's no connection between policy and prevalence in Europe because we see both countries with very strict policies and we see countries with more relaxed policies and they might have the same prevalence or not. And if you look at the Netherlands we're somewhere in the middle. This is data from a few years ago. So before the decriminalization in certain states in the US but if you looked at prevalence, both lifetime prevalence and recent use in the US which has a restrictive policy for the most part it was twice as high as in the Netherlands. The Netherlands is on a par with the European average. If you look at other drugs, and we already mentioned heroin we're in the lower regions compared to other European countries. The first time that we noticed that was in 1984 that the prevalence or the incidence of heroin use was leveling off. That's a very important consequence of leaving other options. There's better drugs folks, there's drugs that will not harm you as this drug. The cultivation of cannabis is still illegal. Coffee shops work in a very schizophrenic situation because they have a legal front door where they can sell small quantities and on the back door they cannot buy. They are obliged to work together with criminals. There is no reason to say we allow people to sell it but we do not allow people to grow it. You need to establish grow facilities in order to provide the coffee shop. We talked a lot about coffee shops, can you also talk about other drugs? Already in, I think in 1968, methadone was introduced in the Netherlands and especially in the early 1980s after there were like junkie unions and they were focusing on, you know, we need harm reduction. This is the red light district and this is where usually the action would go on. I used a long-time heroin cocaine. I started to use heroin with my girlfriend when I was 18 and I started as a volunteer by the drugs union at MD&G. I like to help people and last six years I've paid job there. If you look at the introduction of needle exchange in the Netherlands it's never been really a big, you know, moral issue. Already in Amsterdam in the early 70s you had some organizations that run now we call them consumption rules but there were shooting rooms at that time. The Rainbow Foundation is aiming to help out the drug addicts and the homeless in Amsterdam. We do that by having shelters, drop-in houses, user rooms, needle exchange and also day activity projects. We try to provide anyone who wants to inject with everything that they need to do so hygienically and clean. People sharing needles basically spread the disease rather rapidly. In Amsterdam in the 80s people were dying from it. As soon as people realized needle exchanges popped up so the basic idea was you give us the used needles, we burn them, we incinerate them you get the clean ones back. In that way you don't have to be affected through the needle. The back is a user room and the glass wall is basically because we're trying to get people out of the user room as soon as they're done using. The policy is more aimed towards re-socializing, getting people back into their life except responsibilities and in the end, if possible, get them back into society. In just about all the larger cities, Amsterdam, Rotterdam, The Hague, Utrecht, Groningen and some more, there's the option for people to get hair room prescription. It's only a very small and specific well circumscribed group of people that are receiving heroin. These people that are in these programs, they have never done very well in the standard methadone programs. I'm the team leader of this heroin project. We are treating now 47 patients with heroin so they don't have to steal from other people or to barge in or begging or something. The nurses, they observe the patients while they're smoking the heroin. And then we have a social worker here for eight hours a week. He will help the people with other kinds of problems they have. You can see the patients, they come at ease. No hunting for drugs. Then in their mind they will be an opener. They are becoming such a better life that they said, I want to go to get a job. I want to learn something. I want to have another life. I want to go to detox, etc. What you can clearly see a positive effect of Dutch drug policy is the fact that people stopped injecting heroin and started smoking heroin on Mars. It meant that we averted an HIV epidemic. The prevalence of overdose is very low in the Netherlands. We have a stable population of heroin users. There are almost no new people added to that group and that people were old, they continue to live. I mean they don't die of overdose, they don't die of infectious diseases. We are dealing at this point with an aging population. The average age of people is 50 years. So we are going now towards developing like geriatric services, geriatric drug services. We do see that our policy has resulted in much less drug related harm than in countries around us.