The nature of the drugs problem is constantly changing. This has consequences for the care provided and for prevention work. New drugs, changing patterns of use and new risk groups impose considerable demands on prevention workers and require a dynamic approach. For example, the emergence of ecstasy and other similar drugs demands a different attitude and approach from the traditional activities engaged in in the past. Prevention can no longer be limited to traditional target groups, such as schoolchildren and, in respect of secondary prevention, the users of heroin. As regards its ability to respond appropriately to new developments, prevention work needs to be improved. The activities concerned still do not reach new risk groups and hidden users enough, as illustrated by the fact that it is frequently organisations other than the traditional institutions which are most active in visiting young people who go to discos, coffee shops and raves and use drugs there. The traditional institutions too will be expected to adopt an active approach to new user groups and to the visiting of places where drugs are used.
As regards prevention, it is difficult to say what specific results the various activities of recent years have had because insufficient evaluation has been carried out. Precisely because the field to be covered by both primary and secondary prevention activities is becoming broader, it must be clear what is effective and what is not. Research into the effectiveness and efficiency of prevention work will therefore be promoted, as will the monitoring of developments in the nature and extent of drug use. An understanding of the latter is absolutely essential if we are to respond properly to new trends. Market surveys through a monitoring system are extremely important for prevention work and for those providing care. They enable prevention workers to understand sooner and better social trends which may affect the drugs problem. Monitoring is also important for those providing, allowing them, for example, to develop at an early stage new strategies to limit damage. The government has reserved funds for proper monitoring.
The conclusion was drawn above that problematic drug use is closely linked to social deprivation. In order to be able to reach new risk groups at an early stage, prevention work will have to focus its attention on a broader front and bear such social deprivation in mind more. In order to reach groups such as young people with no fixed address, truants and marginalised groups of both Dutch and foreign origin, there will also have to be cooperation with other institutions, such as the youth services. Policy on the big cities provides for an integrated approach to the dangers of large numbers of young people in the cities becoming marginalised. This year the authorities in the big cities are to draw up concrete plans of action to tackle this problem, working in conjunction with the Public Prosecutions Department and the police.
Policy should be based on the "facet approach", which involves taking the various angles of the problem into account as much as possible. We would refer in this connection to the policy document on health from 1995 to 1998 ("Gezond en Wel, kader van het volksgezondheidsbeleid 1995-1998") (Lower House 1994-95, no. 24126) and to the policy document entitled "Regie in de Jeugdzorg" (Management in youth services)*.
In the case of drug addiction the old adage that prevention is better than cure is particularly true. Research has shown that the decisive preventive factor for young people is a sufficient awareness of the risks. For some years now the NIAD has been carrying out a considerable number of information activities aimed at young people, in collaboration with municipal health service departments and schools. It is expected that a freephone information number will be started up in autumn 1995, dealing with questions on alcohol, drugs, tobacco and gambling. As part of the integrated approach to youth problems in the big cities, which forms an important part of the policy on the big cities, and in other contexts too, we will encourage a new drive to provide good quality, realistic information in schools on the use and misuse of alcohol, nicotine and drugs, geared specifically to problem groups as well as to pupils in general. At the suggestion of the Public Prosecutions Department, for example, the Alcohol and Drug Clinic (CAD) in Drenthe has followed the example of a successful German initiative and produced video clips on the risks of drug use which can be used to provide information in discos etc. The opportunities for carrying out public information activities in coffee shops will also be better exploited. To complete the picture as regards prevention, drug dealers who operate in or near schools or who use pupils to deal for them must be punished severely. The Minister of Justice will request the Public Prosecutions Department to bear this in mind in its investigation and prosecution policy. The sale of hard drugs to young people will meet with particularly severe penalties.
The increase in the use of designer drugs such as ecstasy requires a new approach. The problem from the point of view of prevention is that in general these drugs do not result in physical dependency, though they can cause serious damage to health. The fact that pills of inferior quality are put on the market is an additional problem. The above-mentioned monitoring system will cover the quality of these drugs too. Policy is also geared to developing new methods of communication and a national working party is currently preparing activities in this area. Greater attention can also be devoted to prevention through administration. As stated above, the Minister of Health, Welfare and Sport has recently sent a memorandum to the municipalities containing guidelines for the development of a policy on large- scale events (Stadhuis en House, 1995).
Executive agencies in particular have noted a lack of national support for prevention work in the form of information, the promotion of expertise and innovation. This is not a desirable situation, since there is insufficient opportunity for spotting both duplication and gaps in the prevention work being carried out. Nor is there sufficient information on how the care of addicts ties in with the activities of the police and judicial authorities.
In the near future we will enable a national support body for standards in prevention work to be established to meet these needs.