Losing the Drug War

Amsterdam
If the reigning symbol of U.S. drug policy in 2005 is a combat plane diving over Latin American cocaine fields, for more than a generation Holland’s has been its smoke-filled coffee shops, bathed in the fumes of government-approved marijuana.
In almost every respect, the approach to drugs – hard and soft – by these two NATO allies represents polar opposites on the scale between de facto total war and de facto legalization. Since 1975, marijuana and other cannabis derivatives have been openly sold and consumed in hundreds of cafes and other outlets licensed by the Dutch authorities.
More recently, cities here have begun providing free doses of heroin to addicts, in a test program watched closely by governments across Europe.
The reasoning behind these measures could hardly be more distant from the “zero-tolerance” logic that prevails in the United States. “The principal objective of our policy is to prevent or limit the harm to users from drug consumption,” explained an official at the Netherlands Ministry of Health, Welfare and sport, which oversees matters relating to drugs.
A Barganews survey found overwhelming support for the Dutch approach in Europe – and overwhelming doubt about the wisdom of America’s militarized $18 billion “war on drugs,” even among conservatives.
Overall, “the U.S. has been slowly losing the international debate over drug policy to the Dutch,” according to Craig Reinarman, Professor of Sociology and Legal Studies at the University of California, an expert on international drug laws.
While Washington intensifies the war, its own military partners in Portugal, Britain, Australia, New Zealand, Spain, Germany and Italy have led a worldwide trend toward the Netherlands’ harm reduction philosophy. Many, like the Dutch, have extended it to the decriminalization of use (but not trafficking) in heroin, cocaine and other narcotics.
“The weakness in U.S. policy is that it is based purely on a moral condemnation of drugs,” says Peter Cohen,” director of the Center for Drug Research at the University of Amsterdam.

Moral outrage is not the issue, the pragmatic Dutch contend. What matters in policy-making is the bottom line – the effects of drugs and drug laws alike on social stability and public health – and they muster a blizzard of statistics to bolster their case for tolerance.
More than a quarter century after access to marijuana was legalized in Holland, 15.6 percent of Dutch over the age of 12 have tried it at least once in their lives; in America, where access is a crime and 700,0000 arrests on marijuana charges are made each year, the official figure is 32.9 percent.
The Dutch Ministry of Health, Welfare and Sport reports that 2.1 percent of the nation’s adults have experimented with cocaine, as compared with 10.5 percent of Americans.
The rate of heroin use in the United State is three times that in the Netherlands.
In Italy and Spain, before the adoption of the Dutch approach, more than 60 percent of those who took drugs intravenously contracted AIDS from contaminated needles. In the Netherlands, which has supported clean needle distribution for two decades, less than 11 percent of drug-injectors have AIDS.
According to the Lisbon-based European Monitoring Center for Drugs and Drug Addiction, the rate of drug-related deaths in Sweden – which has Europe’s harshest narcotics laws – is seven times higher than Holland’s. In England and Wales, it is eleven times higher.
In the United States, more than 185 of every 100,000 residents are now imprisoned on drug charges – well over twice the total imprisonment rate for all crimes in the Netherlands – and despite the widespread belief, even among drug experts and law enforcement authorities in the United States, that prisons are training grounds in the use and distribution of narcotics.
American critics, led by former drug czar Barry McCaffrey, bitterly challenge the Dutch policy of tolerance, contending that it will inevitably fail. Some European officials, notably in Britain and France, complain that tons of potent Dutch-grown “nederweit” marijuana and Dutch-manufactured ecstasy, a synthetic drug favored by the young, are smuggled across the borderless European Union.
Nonetheless, even the French and British have adopted central features of the Netherland’s harm-reduction approach. Indeed, the most sustained challenge to “the Dutch Way” on this side of the Atlantic doesn’t come from outside the Netherlands. It comes from the Dutch themselves.

The keystones of drug policy here are the treatment of addiction as a “health problem,” rather than a criminal offense, and a formal separation of the market for “soft drugs” like marijuana, from the traffic in such “hard drugs” as heroin, cocaine, amphetamines and ecstasy.
Both have their roots in the revolution that swept moral questions off of the Dutch drug policy agenda in the 1960s.
The health focus has given birth to one of the world’s most extensive infrastructures of free medical clinics, psychiatric facilities and needle exchange centers for intravenous users.
The formal distinction between soft and hard drugs has produced 861 licensed coffee shops for the sale and use of cannabis – and a body of criminal penalties for trafficking in more dangerous substances that often go beyond those of most other countries. A repeat offender can be sentenced to 16 years in prison for narcotics-related offences.
The catch-phrases for these two policy keystones are “medicalization” and “market separation.” Increasingly, they are the subject of intense criticism, from Holland’s left and right alike.
“Terms like ‘hard drugs’ and ‘soft drugs’ are quite misleading,” argues Jop Arnold, coordinator of the Amsterdam Drug Users Advocacy Group. “If one person smokes grass morning to night in large quantities, and another takes a small amount of cocaine one a month, who is the hard drug user? It’s a very personal thing, very individual. Market separation says nothing about that, and even less about the way market forces function.”
In an institution that traces its roots to the leftist student revolt of the late 1960s and early 1970s, when allusions to market forces were heresy, Arnold’s words mark the distance that has opened between Amsterdam’s once-radical drug policies and the drug scene today.
Among other changes, drug choice itself has evolved away from marijuana and heroin and toward the use of ecstasy and cocaine, which is currently the fastest-growing form of substance abuse in Europe.
The Advocacy Group is located in a ramshackle townhouse in the city’s red light district, the setting for a milestone in liberalized drug programs. It was here, in 1977, that the world’s first free needle exchange was established for narcotics users.
What makes the group revolutionary still, 25 years after it was founded, is that it aims to gives drug users themselves a decisive voice in drug policy. “We sit down at a table together with relatives, active members of the local community, shopkeepers, doctors and police, to look for policy solutions that are in everyone’s interest,” says Arnold.
The group is funded by Amsterdam’s municipal authorities, which treats its recommendations as expert advisories on the drug environment. They played a crucial role in persuading the city to begin its controversial experiment in treating heroin addicts with free, controlled doses of actual heroin, rather than blocking their access to it.
“Problem users are caught in a cycle of distress, craving and a hustle for money that allows them to buy what they need to cope,” says Arnold. “When the cops hit hard at supply, the distress level soars and so does the craving, and the user often has no alternative but crime to satisfy it – which in the end, only makes the level of distress go through the roof and puts people in jail.”
Controlled narcotics doses, he argues, break the cycle. “That addresses the real purpose of a drug policy – bringing the least harm to citizens, users and non-users alike. We should have done this with heroin twenty years ago, and we should be doing it with cocaine right away,” says Arnold.
But he emphasizes that the users’ direct involvement in hammering out new policies is vital. “Asking people with drug problems to swallow what someone else tells will accomplish very little. Recovering the will to make decisions about their own lives is the only thing that will help them.”

You can’t get any further from Jop Arnold’s world of whorehouses, free heroin doses and needle exchanges than De Hoop (“The Hope”) a complex of neatly maintained buildings in provincial Dordrecht, a city of 120,000 about 70 miles south of Amsterdam. The stern Dutch Reformed Church is deeply rooted in the surrounding countryside, and evangelical Protestantism is the unambiguous credo of De Hoop, which was founded in 1975.
“Every worker in our organization is required to have a Christian commitment,” says chief spokesman Frans Koopmans.
The troubled people who come to De Hoop from all over the Netherlands run the religious and racial gamut, reflecting the country’s complex multicultural tapestry. But there isn’t even a Roman Catholic on the staff, much less a Muslim or Buddhist.
Although Koopmans is quick to point out that “our clients are not obliged to become Christian, only to accept our approach to the treatment of addiction,” the stern ethic of Calvinism is evident at every turn in De Hoop’s program. Drug users undergo immediate detoxification upon admission – cold turkey, with nothing more than mild tranquilizers to ease the ordeal – under medical supervision in the facility’s 70-bed psychiatric hospital.
De Hoop’s hospital is reluctantly subsidized by the Dutch government, says Koopmans. “They give us money because we have a reputation for producing results, but they’d be much happier if we downplayed our Christian identity, which is intrinsic to what we do.”
No methadone or other narcotic substitute is employed at De Hoop. Everyone rises at 7am, performs chores, attends individual therapy sessions and goes to bed by 10:30 pm. The hospital’s doors are locked from the outside. Until clients have completed two months of clinical treatment, they are only allowed to leave the complex if they decide to quit the program.
About 60 percent do quit, and an estimated 20 percent of those who finish the program eventually wind up back drugs. But the overall 32 percent success rate is considered well over average in the drug treatment universe.
When in-patient clinical treatment ends, job training begins in one of several businesses owned by De Hoop: a childcare center, a music and book mail order operation, a construction material factory and a printing plant. The skills learned are real skills, meant to send clients on to real jobs; in the Calvinist world view, the ultimate therapy is work.
Koopmans regards Amsterdam’s nederweit coffee shops and heroin-maintenance clinics as anathema. “The trouble with the Netherlands nowadays is that anything goes. There is contempt for the rules that every civil society needs to function. Addicts, especially, need to learn where limits lie, because they are people who have seen everything and it has brought them nothing.”
Yet the striking thing is that he and Jop Arnold are in remarkable agreement on basic principles, starting with the emphasis on harm reduction. “Thanks to the wide range of public drug programs, it’s quite hard to die from addiction in the Netherlands, and that’s a very good thing,” says Koopmans.
And like Arnold, “we don’t believe that every client is the same. There is little group counseling here. The response to drugs depends on the individual. The separation of ‘hard’ drugs’ from ‘soft drugs’ makes no real sense.”
Both Arnold and Koopmans note that fewer than 50 people die annually in the Netherlands from overdoses of drugs classified as “hard” – while legal tobacco products kill roughly 30,000 and alcoholic beverages more than 2,000.
The two men also agree that the American approach is likely to solve no problem and create many new ones. “You can never halt drug problems by putting people in jail or trying to destroy supply. Bombing cocaine fields won’t eliminate the market for drugs,” says Koopmans.
“Declaring war on drugs raises the cycle of distress, craving and violence to a global level,” says Arnold.

“The purpose of the drug war, and of current U.S. policy, is not really to make a difference in drug consumption,” believes the University of Amsterdam’s Peter Cohen. “It is to allow politicians to make lifestyle statements in their re-election campaigns.”
Long known as a contentious advocate of the Netherlands approach in international forums, Cohen now says that “the very pre-occupation with national policy” may miss the point.
Surfing through a maze of websites and files in his book-strewn central Amsterdam office, overlooking the city’s picturesque network of 17th century canals, Cohen soon buries a reporter in data that calls into question virtually every existing national policy – including the Dutch version that has become the leading model for Europe.
The most compelling statistics in the data bank, in his view, concern a comparative study of marijuana use in Holland, San Francisco and the north German port city of Bremen, carried out in partnership with the University of California’s Craig Reinarman.
In Amsterdam, where access to marijuana has effectively been decriminalized for three decades, the latest survey found that 37 percent of all inhabitants had sampled the drug. In San Francisco, where use of marijuana is tacitly ignored but dealers are actively prosecuted, the figure was 68 percent.
Hard drug statistics for the two cities showed a similar pattern, with just 8 percent of Amsterdamers admitting to cocaine use at least once in their lives, as against 38 percent of San Franciscans.
The surprise came when the researchers looked at Bremen, a provincial capital where police are required by law to arrest anyone in visible possession of marijuana. The figure for lifetime marijuana use in this far more repressive context proved to be just 17 percent – almost exactly the same as the proportion in the Dutch city of Rotterdam, where municipal drug enforcement practices are even more liberal than those of Amsterdam.
The pattern, says Cohen, “was no pattern,” except that use was considerably higher in affluent cities with what he referred to as “Amsterdam or San Francisco’s self-propelling population, the buzz of creativity and intellectual ferment that make it easier to reject traditional behavioral values.”
By contrast, it was lower in working-class cities like Rotterdam or Bremen, regardless of policy.
“This doesn’t mean that policy is totally irrelevant, only that it is a small aspect of many determinants – ethnicity, culture, lifestyle, economic status – which play a role in drug use,” says Cohen.
“But that’s hard to tell politicians, who build their electoral campaigns on promises to solve the ‘drug problem’ with “policy reform.’”