Abuse as a Disease, Not a Crime
Thirty years ago, there were an estimated 25,000 to 30,000 heroin addicts in the Netherlands. Since then, the country's total population has grown by 6 percent. But the number of junkies has remained the same. Few new users have joined their ranks, and theirs is an aging cohort.
There's a popular misconception in the United States that Holland has a permissive attitude toward drugs. It doesn't. Instead, the country has adopted a more pragmatic approach to drug abuse. It still vigorously prosecutes large-scale drug trafficking. But it considers drug users a public-health problem, not a criminal one. Addicts caught stealing or breaking other laws are prosecuted, but they aren't arrested for possession.
"The view is that addiction is a brain disease, and it requires treatment, not incarceration," says Wim van den Brink, a psychiatrist at the Academic Medical Center of the University of Amsterdam. That policy makes for a remarkable statistic: About 70 percent of Holland's drug addicts are in treatment programs; only 10 to 15 percent of America's are.
Savings. Does Holland's pragmatism explain why the country's heroin problem has stabilized? Van den Brink admits there's no empirical evidence to back up that conclusion. Yet numerous studies show it's much less expensive to treat abusers than to toss them into prison. A 1994 Rand analysis concluded that for every extra dollar spent on addiction treatment, taxpayers save $7.46 in societal expenses, including the cost of incarceration.
Holland's decriminalization policy also extends to marijuana; Amsterdam's pot-selling coffee shops are infamous. But the logic behind allowing the sale of small amounts of cannabis is to separate the markets for soft and hard drugs, making it less likely that pot smokers will try something worse. Among teens ages 12 through 18, the number of cannabis users in Holland dropped from 11 to 9 percent between 1996 and 2003.
The Netherlands has also tried treating junkies with prescription heroin. A 2005 study found this too saved money because participants stopped committing crimes to support their habits.
The United Kingdom routinely prescribed heroin to addicts from the 1920s to the '60s, and its addict population remained stable at fewer than 2,000. When laws changed in 1971, the legal market gave way to an illegal one, and the addict population has grown to 300,000.
There are also antidrug campaigns in Holland's schools. Harald Wychgel, spokesman for a drug research center, says the messages encourage people to "make fact-based decisions ... though some facts are scary."
Instead of "Just say no," the Dutch message is "Just say 'know.'"
This story appears in the March 26, 2007 print edition of U.S. News & World Report.