"High Risk" Substance Use In The Netherlands

"Studies reporting estimates of high-risk drug use can help to identify the extent of the more entrenched drug use problems, while data on first-time entrants to specialised drug treatment centres, when considered alongside other indicators, can inform an understanding of the nature of and trends in high-risk drug use.

"In the Netherlands, high-risk drug use is mainly linked to use of heroin or crack cocaine. There are also reports of dependent gamma-hydroxybutyrate (GHB) users, but their total number is unknown. The most recent estimate suggested that there were 14,000 high-risk opioid users in the country in 2012 (1.3 per 1 000 inhabitants aged 15-64 years). Available data indicate a decline in the estimated number of opioid users in the last decade. Based on a study in the three largest cities, the prevalence of crack cocaine use ranged between 1.6 and 2.2 per 1,000 inhabitants aged 15-64 years in 2013. Many high-risk drug users, including opioid users, also use crack cocaine and a range of other licit and illicit substances. In 2016, a general population survey estimated that 1.4 % of people older than 18 years in the Netherlands were high-risk cannabis users.

"Data from specialised treatment centres indicate that the number of new treatment entrants has remained stable in recent years, following an increase during the period 2006-11. In 2015, the largest group of first-time drug-treatment entrants comprised those who required treatment for cannabis use. Cocaine (crack) is the second most commonly reported primary substance among first-time clients, although the trend indicates a decline from 2008.

"The number of primary heroin users requiring treatment for the first time has declined since 2007 and has remained relatively stable since 2012. Overall, heroin users entering treatment are older than other treatment clients. Injecting drug use is rare among those entering treatment."