The drug information and monitoring service (DIMS) in the Netherlands: A unique tool for monitoring party drugs
Raymond Niesink, Gerard Nikken, Frans Jansen, Inge Spruit
DIMS, Trimbos Instituut, Da Costakade 45, Utrecht 3500 AS, Netherlands
Phone no: +31 – 30 297 1100 Fax no: +31 – 30 297 1111 E-mail:
DIMS is the first drugs information and monitoring system and has been providing a service since 1992 for Europe and the rest of the world. It is a unique system for gaining insight into what kind of drugs are on the market and whether there are new drugs and new substances promoted as party-drugs.
In 1988, August de Loor started with the ‘Safe House Campaign’. This was a campaign to test ecstasy pills at rave parties. The idea behind the ‘Safe House Campaign’ was that by testing the pills, we could get information on what people are using and reduce the harm involved in using ecstasy pills. To gain insight into the type of drugs that are being used, it was decided not only to do the pill testing at rave parties but also in offices. In this way, people could come and get information about their pills and we would get information about those pills. This type of monitoring at the offices was started in 1992 and since then a lot of things have changed but the main objective of the DIMS project is to minimise the consequences of illicit drug use. The objective of the Dutch drug policy is to prevent and limit the associated risks of drug use, both to the user, to his or her immediate environment and to society. People are using anyway, even if it is forbidden. If they will keep using and if they do it in illegal circles you will never know what they use and how they use it. Only if you know what is being used, can you inform potential users about the harm that is connected with the use of these substances. We inform people about the wanted and negative effects of substances found in their pills. We give information about what will happen if you combine certain drugs.
How are we doing it? We are gathering information from people who are bringing the pills. We do sometimes encounter new substances on the market. For example, in previous years there were several new substances sold as MDMA: in 1993 there was DOB and in 1998 there was 4MTA. We are always the first to see these new substances and we try to make a very quick acute risk assessment. Later on, it is also done by a government department but if there is an acute risk with certain pills we perform interventions, for instance running a warning campaign in consultation with the Ministry of Health. The basis of the whole DIMS project is the exchange of information. We like to have information but if you want information and give nothing back, forget it. The idea behind DIMS is that if a consumer wants information about a pill we give them it, but we do also want information back.
DIMS is actually a network. It started it in 1992, but at the moment there are 25 offices for drug prevention taking part in this project and geographically it covers all The Netherlands. There are offices where you can take a substance to be tested, for example on a Thursday evening or on a Friday afternoon, and there they have a quick determination and testing system. They will also answer any questions about drugs. The consumer gives in the pills and the tester explains what has been determined and provides a report of what the pill is and what it probably contains. He will then explain about its risks. It may be a new pill that the tester does not know because it is not on the current determination list. In this case, when the consumer agrees, it is sent to the DIMS office at the Trimbos Instituut, and from here it is sent to the laboratory to be chemically analysed.
Who participates in this network? The main actors are the consumers - the users of recreational drugs; the DIMS participants - drugs prevention officers; the laboratory; the health inspectors; and of course, the Ministry of Health because they are the subsidiser of this programme.
So the system is actually based on the exchange of information. The consumer who walks into the office gets information on the content of his pills (the substances that are in the pill), the quality and the quantity, and information about the substances. For example, if a pill contains DOB instead of MDMA, the tester can tell him what DOB does: that it is a hallucinogenic substance and to take care because it lasts 10 -18 hours so if you were expecting to have ecstasy then you will have problems. In case there are a lot of pills on the market that contain other substances than MDMA, a warning campaign can be considered.
What does the consumer have to give? We want information from users on whether his or her friends have already used this pill, what the substance is, how it works and what feelings it causes. The next step is to ask in what type of setting it is used: in a disco, at rave parties or for example at home. So we get all this information about substances, where they are used and who is using them, all of which is very valuable information. It is very difficult to get this information in other ways. Of course, you can go to a disco and ask people under the age of 18 what they are using but they think you will tell his or her parents. Alternatively, if they go to an office, then you are somebody who gives objective information, and in turn they are taught the risks.
The next actor is the DIMS participant, the drugs prevention officer. What is his/her role? These people are responsible for all contacts with the consumers and for the exchange of information between users and the DIMS office at the Trimbos Instituut. It is not easy to do, and the people who do the drugs testing receive special training, in determining tablets as well as in the way to get on with consumers. The people who do this work have to be certificated and the agencies that they work for require an opium licence to do the work. For the DIMS participants, the drugs officers, taking part in the DIMS-network form a way to come in contact with users of recreational drugs. Users of party drugs would normally not go to agencies for drug control, because they do not think they have anything to do with drug problems
The second thing that DIMS participants receive is information about drugs used in their particular region. Every quarter of the year they receive information from us about what people in their region are using so that in terms of prevention activities, they can focus on what is actually being used. Of course, there is the weekly determination list which is updated every week. They also get toxicological and pharmacological information from us about new drugs, which we obtain from the network and from our own resources. They can attend training courses and information.
In case of emergencies we have a red alert system. Further, we provide newsletters and monitoring reports, etc. So the DIMS participants get a lot but they have to give us something for it in exchange. As a participant officer for drug prevention, you give all the pills or information about the pills that you have, including the effects of the pills if you have found that out from the customer; as well as information about the settings; and how they are used etc. These offices get information from us about risks for the consumers but the agencies are responsible for providing the information to consumers about the risks and also about what is in the drug. The DIMS participants also have to give us support in case of emergencies because we cannot do it from the office. We need the people in the regions to spread information very quickly about the network.
The next actor in the field is the DIMS office. What are we responsible for in the laboratory analysis? We are responsible for the tablets collected, and for disseminating the information around the network that we obtain about the drugs and, if necessary, we co-ordinate warning complaints. We co-ordinate an organised training certification programme and we report to the Ministry of Health, for example about what is on the market, new drugs and new sub-stances.
What are the results? About 20,000-25,000 tablets have been tested in the laboratory. That is a huge amount if you compare it to other monitoring systems in Europe or other parts of the world. There have been more than 25,000 tablets recognised on the list in offices and at the moment we get between 80 -100 samples per week tested for laboratory analyses, which is a really huge amount of tablets and a huge amount of information about synthetic drugs.
In 1991, when DIMS began (officially it started in 1992) there was already a warning system for LSD. Since 1992, there have been about ten major campaigns. In 1992 there were high levels of speed and MDMA and in 1993 it was the same, apart from it was spread over a lot of tablets with different logos. In 1993 there was LSD sold as ecstasy and in 1994 there was DOB. In 1995 we had 2CB and in 1995 there was also a tablet with an unknown substance with acute adverse effects. In 1995, we also campaigned because of wide variations in MDMA dosing. 1996 was a good year because we did not have to have a big campaign. In 1997, there was a general campaign because in that year the ecstasy market was leading a lot of other substances and the amount of tablets containing speed (amphetamine) instead of MDMA was much higher than normal. There were also many more speed tablets in the market than in previous years.
In 1997-1998, there was a big problem with pills and this was our last major campaign. There have also been some smaller campaigns about DOB pills etc. We are the ones who detect new drugs in the very early stages. Normally, all other countries or institutes do not see the pills until about six months later. We report first of all to the consumer because it is only fair if you have information to give information, and if you give someone information you get information back. We also report to the Ministry of Health who fund us, and then to a lot of others. We mainly report to them via the national drugs monitoring system.
Finally, we have the last actor in the field: the Ministry of Health. Why is this project important for the Ministry of Health? First of all, our Ministry of Health is not interested in information about individual drug users. It wants information on what drugs are on the market, which substances people are really using - and not from gossip but from which pills are actually seen. This provides the opportunity to base prevention campaigns or harm reduction campaigns on the real facts. That is only possible through a system like the DIMS. In this way, the Ministry of Health can also provide data for international organisations like the EMCDDA.
We are not monitoring in the sense that we know how many people are using. We are monitoring in the sense of what substances are on the market and what kinds of people use them. Of course, there are other surveys. Results from the different monitors and surveys are combined within the National Drugs Monitor. The DIMS has a good regional spread across the country and we think there are two types of youths: those who are involved with their own health and those who do not care. Those people who are really involved with their own health are the people who go to offices to let their pills be tested.
We always tell people that when they are using drugs, they are dealing with an illegal market, which means there are no quality guarantees. There are a lot of adulterated substances on the market and we always say that a person who takes these tablets does so at their own risk.
Often it is not the laboratory that gets information about a wrong pill. The first signs come most frequently from the field when somebody says I got this pill and my brother, sister or friend used it and got a headache or whatever. That is the first sign. The DIMS has an advisory board established by the Ministry of Health. Of course, a system like the DIMS costs a lot of money but we also get a lot of information back.