CHAPTER 11 EPILOGUE

The thesis closes with an epilogue in which developments in some
fields of formal social control after the second problem definition are
briefly depicted. The purpose of the epilogue is to show that the basic
features of the first problem definitions and action programmes not only
were preserved after the period studied, but even strengthened.
Furthermore, it will become clear that the historical lines concerning
strategies of formal social control as outlined in chapter 10 still stand
today.


The Netherlands

In summer 1985, the Amsterdam GGD detected the AIDS virus in old
blood samples of drug users and the emergence of HIV among drug
users was confirmed.
The appearance of AIDS did not influence Dutch drug policy at
large. The harm reduction approach was already adopted and
methadone programmes had already been established throughout the
country. A needle exchange programme had been started by the
"junkiebond" in Amsterdam to reduce the spread of Hepatitis B and
was adopted by professional institutions such as the CADs and GGD. A
number of innovations were introduced, however. Condoms and leaflets
with information to avoid HIV by practising safe sex and safe use were
distributed to drug users. Typical for the Dutch policy is that drug users
became active in prevention activities, the "peers to peers" approach. It
is striking that all these activities were executed side by side by both
`junkiebonds' and professionals.105 Another example is that the
`junkiebonds' were invited to participate in the Dutch AIDS Co-
ordination Team (DACT). 106 The reaction in the Netherlands to HIV
among drug users was perfectly in line with the overall drug policy to
reduce the risks of drug use to the drug user and society was the main
goal.

Nuisance

The issue of drug-related nuisance continued to occupy the agenda of
politicians during the 1980s on the national as well as the local level. In
1988 the governmental memorandum "Coercion and dissuasion in
assistance to addicts" appeared. The background to this memorandum
was increase of drug-related nuisance. The memorandum was an
inventory of the possibilities to apply coercion and dissuasion in the
fields of psychiatry, youth welfare, and penal law. The conclusion was
that at that moment no possibility existed for compulsory admission to
treatment under current laws. A starting point for the policy would be
that the addict, in spite of his addiction, remained responsible for his
actions, according to the same juridical principles as for all other
citizens. To the government, there was no reason to initiate a change of
legislation. Instead, creative use had to be made of the possibilities to
exert pressure on addicts to enter treatment when they encountered
justice. The Rotterdam "drug-related crime" project, was mentioned as
an example. While conditional dismissal of prosecution, detention, or
sentence had been applied in individual cases since the 1960s, the
Rotterdam project (which would soon be followed in other cities as
well) meant a closer institutionalised co-operation between justice and
treatment agencies. As soon as the addict who had chosen of treatment
dropped out, a cell in prison was waiting. The memorandum repeats a
theme that has become prominent in the thesis; namely, local
developments and practices largely steer the national drug policy.


Coffee shops

However, heroin addicts were not the only ones to cause nuisance.
Developments in the field of coffee shops also urged the government to
adjust its policy. In 1987, the City of Amsterdam tightened control of
coffee shops by implementing the so-called AHOJ-G criteria, i.e. A-no
advertising, H-no hard drugs, O-no nuisance, J-no to minors (18 years),
G-no quantities larger than 30 grams. In 1991, the Prosecutor-General
proclaimed the AHOJ-G criteria to come into force nationally.
The policy of tolerating the purchase of cannabis up to 30 grams in
coffee shops created a tricky situation for Dutch authorities. Since trade
in and production of cannabis products were still criminal acts, coffee
shops could, in principle, be prosecuted for violating the Opium Act
when keeping a stash larger than 30 grams. To circumvent this
difficulty, the maximum stash of cannabis in coffee shops was set in the
guideline to half a kilo. However, an additional problem remained; the
proprietors of coffee shops had to buy their products on the illegal
market. In the Netherlands, this is called the "back door problem".
While the "front door" problem could be solved by guidelines that set
priorities for prosecution, the back door problem constitutes an
insurmountable difficulty for the Dutch government as long as trade in
cannabis is prohibited by the UN conventions.
Eventually, the cannabis trade came out of the shadow of the heroin
problem in which it had stayed during the 1980s. It had become a
tremendously profitable industry with an estimated total annual
turnover of 6.5 billion guilders in 1995. Especially its link to organised
crime, which was depicted as a threat to Dutch society during the 1980s
and 1990s, provoked governmental interventions. Nevertheless, the
government stated in its 1995 memorandum: "Continuity and Change",
that coffee shops in the Netherlands had proved their raison d'être
during the past twenty years by separating the markets of soft and hard
drugs, but now they needed more stringent regulations.107 The AHOJ-G
criteria had to be enforced more forcefully. Furthermore, the
establishment of coffee shops in the vicinity of schools, youth centres
and psychiatric clinics was to be obstructed. In order to enable a
tightened control of coffee shops and other premises for cannabis retail
trade, the government announced that substantial discretionary powers
were to be delegated to the local authorities.108
Apart from internal problems, international pressure, especially from
France and Belgium, was a reason to increase control of the cannabis
branch too. The decision to lower the maximum quantity of cannabis to
be purchased in coffee shops to 5 grams was due to international
pressure.
Another problem was constituted by the fast-growing cultivation of
Dutch marijuana of superior quality. In 1995, the market share of home-
grown marijuana was estimated at 50% of the Dutch soft-drug market.
Today, the Netherlands is largely self-supporting regarding marijuana.
Actions against home grown cannabis products, however, show the
basic feature of Dutch drug policy. Large-scale commercial cultivation
was to be the main target for prosecution; cultivation of up to five
marihuana plants for personal use would have low priority for
prosecution. In 1999, the back door problem caused sixty lord mayors
to propose regulating the supply of Dutch marijuana to coffee shops
under the supervision of the municipalities and justice. Through this the
quality of cannabis could be controlled and some wind taken out of the
sails of organised crime. The proposal was adopted by the Lower House
in 2000, but rejected by the Minister of Justice because it would be in
conflict with international treaties. This means that Dutch governments
still have to navigate between local demands and the international
context.


Heroin prescription and compulsory care

The governmental memorandum in 1995 contained some other
novelties as well. Plans to start experiments with the prescription of
heroin and compulsory care were announced, which meant that some
old issues finally could be settled. After fourteen years, the government
had adopted the municipal proposals on heroin prescription and
compulsory care. The prescription of heroin to a limited and narrowly
defined category of heroin addicts started as an experiment in 1998.
The question is why. According to the government, the efficiency of
abstinence-oriented methods had proven to be limited in a longer
perspective. Harm reduction oriented assistance on the other hand was
quite effective, and a substantial number of Dutch addicts were
relatively socially integrated. However, a category of extremely
problematic addicts remained for whom low-threshold methadone
programmes and social support did not seemed to have achieved any
positive effects. For this category, without serious criminality or
psychiatric disturbances, heroin experiments were to be set up
throughout the country and evaluated during a three-year period.
The same year as the heroin experimented started, a bill was
launched to enable an experiment with compulsory admission of drug
addicts to special units located at prisons. According to the bill the court
could sentence drug addicts, who have been sentenced for three (petty)
crimes within a period of five years, to compulsory care for a maximum
period of two years. The bill on Judicial Compulsory Care of Addicts
(SOV) was adopted by the parliament in 2001. The law recalls the penal
approach during the first decades of the twentieth century towards
alcoholics that repeatedly violated the prohibition of public
drunkenness (three strikes and you're out). However, this time
recidivists are not send to a working camp but placed in a setting
aiming for their rehabilitation. While the heroin project can be regarded
as a supplement to the harm reduction programme, compulsory care is
aimed at reducing nuisance. Socially unadjusted behaviour had to be
counteracted, and adjusted behaviour, where possible, be rewarded.
This means that the main feature of the Dutch action programme,
namely, local experimentalism, still prevails.


Sweden

The demands for a criminalisation of use, rejected by the government in
1984, stayed on top of the drug policy agenda. Pressure from public
opinion, led by popular movements and motions from MPs, kept the
pressure on the government and in spring 1986, the Department of
Justice invited representatives of all parties in the Riksdag to discuss the
issue. These discussions resulted in a memorandum from the
Department of Justice and a bill to criminalise use of drugs was
presented in 1987. The main reason was, according to the Minister of
Justice, to get the matter out of the world and to clean the path for more
important issues.
In 1988, use became criminalised and penalised by a fine. The
proposal was heavily criticised because of the omission of
imprisonment as a sentence, which would enable the police to sample
urine or blood tests as evidence. Another disadvantage was that the
court could not sentence offenders to probation and treatment.
After the elections in 1991, a non-socialist government had come
into office that in December 1992 announced a change to the Drug Act.
Minor drug offences, including drug use, would be punishable by a
maximum of six months' imprisonment or a fine. In 1993, a revised
Drug Act authorised the police to call upon a suspect to undergo a urine
or blood test. Between 1993 and 1999, over 63,000 urine and blood
tests were sampled to detect drug use.
The prevalence rates of drug abuse, which was of such importance
for the evaluation of the outcome of the drug policy, were perceived as
positive for the Swedish policymakers. During the 1980s, annual
surveys among youth aged 15/16, showed that drug use continued to
decline and in 1989, the rate of lifetime prevalence among students
reached its lowest point of 3%. However, the mechanism of
constructing an image of crisis was maintained. When, the alleged new
cannabis wave obviously had been efficiently halted by an anti-drug
culture, the next threat came naturally. When HIV/AIDS was known to
be spreading among intravenous drug abusers, these were depicted as
the biggest threat to the normal population. Unlike homosexual males,
drug abusers had sexual contacts with ordinary people, for example by
prostitution. More than ever, drug abusers were a threat to Swedish
society. Strategies to confine the dissemination of HIV as applied in
other countries, i.e. needle exchange programmes and substitute drugs
like methadone, were flatly rejected because they would be inconsistent
with the goal for the drug policy and would give the wrong signal to the
people. Needle exchange activities were forced to close down and only
three programme were permitted as experiments. An expansion of the
methadone programme was rejected as well. Instead, the government
launched an offensive against HIV/AIDS among drug abusers in 1985.
All abusers would be reached for testing and treatment because curing
addicts was by far the most efficient way to halt HIV/AIDS among
them. At the end of the 1980s, when it became obvious that HIV was
not spreading at the speed that was feared, interest declined.


Devil's advocates

In 1989, the Government's Action Group against Narcotics was
installed. Members were Directors-General, MPs, and departmental
officials. The Action Group's final report, in 1991, with the title: "We
Will Never surrender", stressed that the struggle against drugs was to
continue. While the situation in Sweden was depicted as quite
satisfactory, the international situation was threatening. The emerging
international legalisation movement was part of that threat. Debates on
the legalisation of drugs in other Western countries were depicted as a
threat to Sweden, and if one listens carefully, the first voices that
advocated a relaxation of the Swedish policy could be heard. Again, the
threat came from outside the country. The struggle against such
pernicious thoughts took different shapes.
In January 1990, for example, a conference on cocaine was to be held
in Gothenburg. One of the key speakers was the US scholar Lester
Grinspoon. When it came to the knowledge of the conference arrangers
that Grinspoon had advocated the legalisation of marijuana, they
cancelled the invitation. After protests from other invited speakers, who
threatened to cancel their participation, the arrangers sent a new
invitation and Grinspoon was allowed to speak. In her closing speech,
the chairman of the Social Democratic youth league, Lindh (minister
for foreign affairs 1998­) warned against debaters that were open to
"the new" and discussed legalisation of drugs. They acted as devil's
advocates (Göteborgsposten 27 January 1990).
In 1991, a leaflet from the National Police Board, called: "Drugs:
Laws, Facts, Arguments", was distributed to policemen policing the
streets. The leaflet reviewed the most common arguments advocating
legalisation and contained counter-arguments that could be used by the
officers in case they encountered advocates of the legalisation of drugs.
In the middle of the 1990s, the media and the police observed a new
drug, Ecstasy, at rave parties. A youth culture had emerged again, but
this time an initiative to establish an anti-drug culture, as in 1981, failed
to appear. Instead, a special commando was established within the
Stockholm police in 1996 to crack down on drug-using youth at rave
parties, thereof its nickname: "Rave Commission". The practice of
tracing (and deterring) drug use at dance parties by means of urine tests
would eventually become common practice in other parts of Sweden
and on other premises such as discotheques and at pop festivals.
From the onset of the 1990s the situation regarding the prevalence of
drug abuse changed. Annual surveys showed a slow but steady increase
of lifetime prevalence and in 1999 the rates were at the same level as at
the start of 1980s. Furthermore, a case-finding survey in 1992, showed
that the number of severe drug abusers had increased considerably
during the 1980s and 1990s: from 10,000­14,000 in 1979 to 14,000­
20,000 in 1992. Especially worrying was the fact that heroin abuse had
increased during the 1990s. Against the background of these
developments a new Narcotics Commission was installed 1998. In its
final report in 2001, the Commission concluded that a gap had occurred
between the goal for the drug policy "a drug-free society", and reality.
Nevertheless, the goal was to be maintained. This means that the
Swedish stand, which can be described as fundamentalist, still prevails
and sets the course for the action programme.


The context

From the perspective that the process of problem definition and the
shape of the action programme are confined by contextual
circumstances, some important changes in the contexts need to be
addressed.
At the international level, a profound change is the development of
the European Union. The issue of the Dutch policy on cannabis in
European discussions, for example, has changed from a symbolic level
to a practical problem, especially when the Schengen treaty came into
force, and border control of EU citizens was in principle abolished. The
free movement of goods and persons had several repercussions. For the
Dutch it meant increased demands from neighbouring countries on the
Dutch government to act against drug tourism. Furthermore,
discussions started to harmonise the national drug policies of EU
countries for combating the supply and availability of drugs.
However, pressure on the government also came from populations in
border cities that were sick and tired of drug tourists invading their
neighbourhoods. This pressure was reason for the government in 1995
to announce that nuisance caused by foreign addicts and drug tourists
would be forcefully counteracted. Under no circumstance could it be
accepted that the Netherlands would become the central refuge for
European heroin addicts. An end was to be made to the export of
foreign drug problems to the Netherlands.
On the other hand, European countries had not succeeded in solving
their drug problems either, and in particular the use of cannabis had
continued to increase. In contrast to the situation in the early 1970s, this
time there seems to be support from neighbouring countries, such as
some federal states in Germany and Belgium, that in principle have
adopted the Dutch approach to cannabis, not only as a local practice but
also as a governmental policy. This development has eased
international pressure on the Dutch government. However, a domestic
strong opinion exists, accusing the government of being cowardly in
giving in to international pressure.
Another contextual national factor is the increase of organised crime
and criminality in general in the Netherlands. Demands on the central
and local governments to maintain public order have given law-and-
orders issues an advanced position on the political agenda. During the
period 1985­1995, the capacity of cells in prisons was increased from
5000 to 12,000, not least due to increased prosecution of drug offences.
The Netherlands was not a paradise of permissiveness any longer, at
least for those that do not follow the Dutch rules.
In the Swedish context, several changes occurred as well. The
emergence of satellite and cable television has reduced possibilities to
ban false prophets from public discussions on drugs. The basic facts
provided through state channels now face competing views that are just
a few clicks away on the Internet. The potential of the central state to
counteract drug-glorifying messages mediated by music and other
media, by orchestrating a healthy youth culture has diminished.
Swedish youth has become international too and the traditional youth
organisations have become marginal compared to two decades ago.
Furthermore, a strong decline in the interest in drug issues has been
noticed recently. This is credited to an unanticipated effect of the
struggle against liberal ideas. The anxiety about being denominated as a
drug liberal has hampered discussion and criticism, and fewer young
debaters of society are engaged in the public debate on drug issues.

Furthermore, several state operatives have been delegated to
municipalities. Earmarked subsidies, previously an important
instrument to steer local practices, have merged into a general state
subsidy. In addition, primary education has become a responsibility for
the municipalities and it is up to the local headmaster to implement
information on alcohol, tobacco, and drugs. When Sweden was hit by
an economic recession at the beginning of the 1990s, municipalities had
to prioritise their spending and assistance to drug abusers was not
among the top priorities. The emphasis on expensive intramural care
was replaced by (cheaper) ambulatory care by social services.
Furthermore, municipalities drastically reduced their (expensive)
referrals to compulsory care. However, while prevention and assistance
suffered from budget cuts, the control system remained intact and was
even reinforced. Especially after the revision of the Drug Act in 1993,
actions against street-level dealing and drug abusers became the main
target for police activities.


Discussion

The developments that have been described in the epilogue show that
the institutional factors, despite contextual changes, continue to
dominate the basic features of the practices of formal social control in
both countries. However, due to the process of nation states becoming
subordinated to the international community and in particular the
European Union, this international context will influence national
strategies to larger degree than before. It may be expected that both the
Swedish and Dutch drug policy will be pushed to a European
mainstream problem definition, at least at the rhetorical level.
Concerning national and local control practices, changes will be closely
related to the question how historically grown institutional factors and
local circumstances are changing.
As for the Netherlands, the conclusion can be drawn that the
intention to play down the role of justice in approaching drug users, as
stated in the first problem definition in 1970s, was not realised. On the
contrary, the role of justice became more profound in relation to
extreme problematic addicts. However, the basic principles as
formulated by the Baan Committee still prevail: "a drug policy can
contribute to reduce the risks related to drug use, for the user and
society. The drug policy should be based on an analysis of these risks."
In Sweden, the diminishing role of the central state can be expected
to have serious consequences for the struggle against drugs that it has
been leading for several decades. At least one instrument to steer
opinion moulding and sending correct and consistent messages to the
people has disappeared, the monopoly on providing the basic facts on
drugs. This opinion moulding has been an important part of the action
programme. With its reduction, it remains to be seen whether the goal
of a "drug-free society" can be upheld.



105 Today a national point of support to drug users (LSD) assists drug users in
deliberations with local assistance organisations and authorities.
106 The DACT was established by gay organisations together with clinics for sexual
transmitted diseases and invited the national blood bank, the FZA, and clinics for
treatment of drug users to participate.
107 At the end of the 1990s, the situation concerning heroin use was described as
stabilising with an estimated number of 28,000 heroin addicts. Furthermore, the
number of young heroin addicts seemed to bedeclining.
108 Today a majority of municipalities pursue a zero-toleance policy on coffee
shops.

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