Background:Ecstasy (3,4-methylenedioxymethamphetamine (MDMA)) has a relatively low harm and low dependence liability but is scheduled on List I of the Dutch Opium Act (‘hard drugs’). Concerns surrounding increasing MDMA-related criminality coupled with the possibly inappropriate scheduling of MDMA initiated a debate to revise the current Dutch ecstasy policy.Methods:An interdisciplinary group of 18 experts on health, social harms and drug criminality and law enforcement reformulated the science-based Dutch MDMA policy using multi-decision multi-criterion decision analysis (MD-MCDA). The experts collectively formulated policy instruments and rated their effects on 25 outcome criteria, including health, criminality, law enforcement and financial issues, thematically grouped in six clusters.Results:The experts scored the effect of 22 policy instruments, each with between two and seven different mutually exclusive options, on 25 outcome criteria. The optimal policy model was defined by the set of 22 policy instrument options which gave the highest overall score on the 25 outcome criteria. Implementation of the optimal policy model, including regulated MDMA sales, decreases health harms, MDMA-related organised crime and environmental damage, as well as increases state revenues and quality of MDMA products and user information. This model was slightly modified to increase its political feasibility. Sensitivity analyses showed that the outcomes of the current MD-MCDA are robust and independent of variability in weight values.Conclusion:The present results provide a feasible and realistic set of policy instrument options to revise the legislation towards a rational MDMA policy that is likely to reduce both adverse (public) health risks and MDMA-related criminal burden.
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In Antenne Amsterdam wordt sinds 1993 jaarlijks het middelengebruik bij jongeren en jongvolwassenen in de hoofdstad in kaart gebracht. Dit gebeurt op basis van een combinatie van kwalitatieve en kwantitatieve methoden. In 2023 verzamelden we informatie via (1) interviews met een 26-koppig uitgaanspanel die vanuit insidersperspectief of vanuit hun werk als beveiliger, manager of organisator vertellen over het trendsettende uitgaansleven; (2) interviews met een panel kwetsbare jeugd waarin zeven professionals zijn vertegenwoordigd die met buurtjongeren werken; (3) een anonieme survey (vragenlijsten) over middelengebruik onder voetballers en publiek bij twaalf amateurclubs; en (4) analyse van testuitslagen van meer dan vijfduizend vrijwillig aangeleverde drugsmonsters bij testservices. De Amsterdamse drugs- en gebruikersmarkt wordt gekenmerkt door golfbewegingen. Twintig jaar geleden werd in Antenne 2003 een 'nieuwe nuchterheid’ aangekondigd; tien jaar later zagen we in Antenne 2013 meer middelengebruik over de hele linie; en weer tien jaar verder lijken zich onder trendsettende uitgaanders in 2023 de contouren van een hernieuwde nuchterheid af te tekenen. De voetbalsurvey laat zien dat vrijetijdsdomeinen van sport en uitgaansleven overlappen. Sporten en middelengebruik zijn niet noodzakelijk tegenpolen, maar vaak twee kanten van dezelfde medaille. De meeste sporters en uitgaanders zijn mensen die gezonde en ongezonde gewoontes balanceren.
Cannabis is commonly characterized as the most normalized illicit drug. However, it remains a prohibited substance in most parts of the world, including Europe, and users can still be subject to stigmatization. The objective of this study is to assess to what extent and how cannabis users in different countries with different cannabis policies perceive, experience and respond to stigmatization. We conducted a survey in the Dutch coffeeshops among 1225 last year cannabis users from seven European countries, with national cannabis policies ranging from relatively liberal to punitive. Three dimensions of cannabis-related stigma were investigated (discrimination, perceived devaluation and alienation) and a sum score was used to reflect the general level of stigmatization. Perceived devaluation was the highest-scoring dimension of stigma and discrimination the lowest-scoring. The general level of stigmatization was lowest in the Netherlands and highest in Greece. This indicates that punitive cannabis policy is associated with stigma and liberal cannabis policy is associated with de-stigmatization. Besides country, daily cannabis use was also found to be a significant predictor of stigma, but gender, age, household type and employment status were not.
