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Addiction, drugs and the Dutch


Amsterdam, Netherlands -- HEROIN IS illegal here, but even pushers may not get "busted" if they are 1) quiet and/or 2) do not offend sensibilities by getting too rich from drugs. Marijuana is also illegal, but virtually nobody ever gets in trouble for smoking it in public.

As a matter of fact, prostitution is also illegal in Holland, but along the canals in the "red light" area, nearly naked women sit in the windows.

"You see we manage all of this," said Ernst Bruning, director of the international affairs bureau of the Municipal Health Service, as he related to me the different morality here. "We try in Holland to manage social problems. It's a different paradigm."

Indeed, to understand the Netherlands' managed social morality and in particular, their unique drug program -- I have come back here on a regular basis (and beautiful Amsterdam makes it easy). The last time I visited -- almost exactly five years ago -- I made a list of the words and phrases they use: "harm reduction . . . non-moralistic judgments . . . a Junkie Union . . . no shame . . . no crack . . . not a therapeutic community . . . case management . . . a businesslike climate."

Above all, the Dutch have constructed their drug policy upon the principle of "social peace." The Dutch actually hate drugs, but they also treat addiction as a reality of modern life, one that can be somewhat contained if treated primarily as a health matter.

After severe outbreaks of heroin and cocaine addiction started here with the "flower children" of the early '70s, the Dutch came upon the idea of "harm reduction." That meant not only stressing a health response to addiction as opposed to a police response, but also giving an unusual discretion to the police. Even a heroin pusher's treatment would depend upon his behavior. In short, rewards work toward the goal of "social peace."

When I was here in 1989, trying to see if there was anything applicable in the Dutch policy to the enormous American problem, there were about 6,500 hard-drug users in Amsterdam. Today there are about the same number. But there is a consequent reality of incalculable importance.

"In the past 15 years, for the generation under 22 years of age, the percentage using hard drugs dropped from 15 percent to 2.5 percent," said Dirk H. van der Woude, of the Municipal Health Service. "And the average age of hard-drug users has gone up from 26.8 years in 1981 to 34.2 years in 1993."

These figures are important because they are a reflection of the Dutch wisdom in recognizing the reality of a "time of epidemics." During such periods, the powers-that-be must try to "maintain" those already addicted, while at the same time helping the next generation to avoid addiction at all costs. It now appears that that distinction has worked.

How did this happen? Mr. Bruning credits anti-drug education in the schools, but he readily acknowledges other factors. "Something just happens after a while," he said, noting that throughout history epidemics at some point have begun to wane. "Then there was the fact that we separated soft and hard drugs, until we got to the point today where hard drugs are not pushed so much." (Soft drugs, like marijuana, can be bought and consumed openly, as in the coffeehouses, while hard drugs, like heroin, are not generally tolerated.)

Then he cited the country's methadone program, which is used to wean drug users off hard drugs such as heroin. It is even given out in police stations and on some buses.

And, finally, he says, the very open presence of junkies on the streets of Amsterdam -- a public presence that many Dutch thoroughly despise -- has convinced the majority of the new generation that this is not fashionable and is not what they want to be.

There are still plenty of problems: Hard drugs are now pouring into Europe from the former Soviet Union; junkies traverse formerly closed borders, open because of the European Union; respectable Dutch people are increasingly angry about the crime spawned by the drug users with their expensive habits.

Still, what Holland could teach a more moralistic America is: Figure out what you can reasonably expect to do with the problem and the tools you have at hand, devise a program to maximize your strengths, and above all, plan so that you diminish the problem, thus sparing the next generation.

Georgie Anne Geyer is a syndicated columnist.

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